ReviewGeriatric orthopaedic surgery & rehabilitation2021
The Clinical Impact of Fracture Liaison Services: A Systematic Review.
Review in Geriatric orthopaedic surgery & rehabilitation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Examining treatment targets and equity in bone-active medication use within secondary fracture prevention: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024Pooled it
- Healthcare professionals' perspectives and experiences of osteoporosis medication treatment: a qualitative systematic review.Archives of osteoporosis · 2024Pooled it
- Remote Bone Health Service for Osteoporosis Screening in High-Risk Men: A Cluster Randomized Clinical Trial.JAMA internal medicine · 2025Trial
- A territorially coordinated, eHealth-supported fracture liaison service following femur fragility fracture: a pilot randomised controlled trial.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- An audit of the fracture liaison service at Helen Joseph Tertiary Hospital, Johannesburg, South Africa.Archives of osteoporosis · 2026Article
- Estimating the Extent of Missed Opportunities for Osteoporosis Treatment Before Hip Fracture Occurrence.Calcified tissue international · 2026Article
- Association between post-discharge destination and osteoporosis medication use after acute-care hospital discharge for hip fracture: a population-based cohort study.Archives of osteoporosis · 2026Article
- Development of a gender score and its association with treatment outcomes in fragility fracture patients screened through Ontario's Fracture Screening and Prevention Program.Archives of osteoporosis · 2026Article
- Towards an Integrated Person-Centred Care Pathway to Support the Recovery Journey Post Hip Fracture: A Qualitative Study.Journal of advanced nursing · 2026Article
- Review
- Bone Optimization for Perioperative Spine Patients: A Multidisciplinary Approach at a Single Academic Center.Journal of clinical medicine · 2025Article
- Efficacy of a Computerized Therapeutic Decision-Making Algorithm in a Fracture Liaison Service Targeting Hip Fracture Patients.Journal of clinical medicine · 2025Article
- Patient education following vertebral fragility fracture: a scoping review.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Article
- Enrollment in a fracture liaison service does not guarantee post fracture follow-up.Journal of clinical & translational endocrinology · 2025Article
- Fracture liaison service evaluation during admission for fragility femur fracture increases rates of bone health intervention and outpatient follow-up.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Article
- Rate of Osteoporosis Evaluation and Treatment Following Kyphoplasty in Patients With Vertebral Compression Fractures: A Retrospective Study and Review of the Literature.Geriatric orthopaedic surgery & rehabilitation · 2025Article
- Developing fracture liaison service framework based on comparative analysis and scoping review.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2024Article
- Lessons Learned: Evaluation of Fracture Liaison Service Quality Improvement Efforts in a Large Academic Healthcare System.Journal of general internal medicine · 2024Article
- Secondary osteoporosis prevention: three-year outcomes from a Fracture Liaison Service in elderly hip fracture patients.Aging clinical and experimental research · 2024Article
- Secondary fracture and mortality risk with very high fracture risk osteoporosis and proximal femoral fracture.Journal of bone and mineral metabolism · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionA fracture liaison service (FLS) is a coordinated system of care that streamlines osteoporosis management in the orthopaedic setting and can serve as an effective form of secondary preventative care in these patients. The present work reviews the available evidence regarding the impact of fracture liaison services on clinical outcomes.
methodsThe literature was reviewed for studies reporting changes in the rates of bone mineral density scanning (DXA), antiresorptive therapy, new minimum trauma fractures, and mortality between cohorts with access to an FLS or not. Studies including intention to treat level data were retained. A Medline search for "fracture liaison" OR "secondary fracture prevention" produced 146 results, 98 were excluded based on the abstract, 38 were excluded based on full-text review. Ten level III studies encompassing 48,045 patients were included, of which 5 studies encompassing 7,086 were analyzed. Odds-ratios for DXA and anti-osteoporosis pharmacotherapy rates were calculated from data. Fixed and random effects analyses were performed using the Mantel-Haenszel method.
resultsFour studies reported, on average, a 6-fold improvement in DXA scanning rates (Figure 1). Six studies reported, on average, a 3-fold improvement in antiresorptive therapy rates (Figure 2). Four large studies reported significant reductions in the rate of new fractures using time-dependent Cox proportional hazards models at 12 months (HR = 0.84, 0.95), 24 months (HR = 0.44, 0.65), and 36 months (HR = 0.67). Five large studies reported mortality improvements using time-dependent Cox proportional hazards models at 12 months (HR = 0.88, 0.84, 0.81) and 24 months (HR = 0.65, 0.67).
conclusionsThe findings suggest that fracture liaison services improve rates of DXA scanning and antiresorptive therapy as well as reductions in the rates of new fractures and mortality among patients seen following minimum trauma fractures across many time points.
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