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Treatment recommendations based on fracture risk status are not consistently provided in osteoporosis guidelines
- Source :
- Rheumatology international. 38(12)
- Publication Year :
- 2018
-
Abstract
- We examined international osteoporosis guidelines to determine the tools used to assess fracture risk, the classification of fracture risk presented, and the recommendations based on fracture risk status. We conducted a document analysis of guidelines from the International Osteoporosis Foundation (IOF) website retrieved as of May 10, 2018, focusing on guidelines written in English only. Two reviewers independently reviewed each document and the following data were extracted: (1) fracture risk tool(s) endorsed; (2) classification system used to describe fracture risk status (e.g., low, moderate, high); and (3) recommendations based on risk status (e.g., pharmacological treatment). Two additional reviewers verified all data extraction. A total of 112 guidelines were listed on the IOF website, of which 94 were located either through the provided link or through a PubMed search. Of 70 guidelines written in English, 63 guidelines discussed the concept of fracture risk of which, 39 endorsed FRAX. Twenty-eight guidelines defined fracture risk categories or thresholds which determined recommendations. In total, 26 provided a risk category or threshold which constituted an indication for pharmacotherapy. Twelve guidelines reported a moderate, medium, or intermediate risk category which was associated with variable recommendations for testing and treatment. Despite the generally accepted international shift to fracture risk as a basis for treatment decisions, the majority of guidelines in English did not provide treatment recommendations based on fracture risk status. In guidelines with recommendations based on fracture risk status, thresholds and recommendations varied making international comparisons of treatment difficult.
- Subjects :
- Fracture risk
medicine.medical_specialty
FRAX
Immunology
Osteoporosis
Clinical Decision-Making
030209 endocrinology & metabolism
Risk Assessment
Pharmacological treatment
Decision Support Techniques
03 medical and health sciences
0302 clinical medicine
Rheumatology
Risk Factors
medicine
Immunology and Allergy
Humans
030203 arthritis & rheumatology
Risk status
Bone Density Conservation Agents
business.industry
medicine.disease
3. Good health
Treatment Outcome
Data extraction
Family medicine
Practice Guidelines as Topic
Risk assessment
business
Intermediate risk
Osteoporotic Fractures
Subjects
Details
- ISSN :
- 1437160X
- Volume :
- 38
- Issue :
- 12
- Database :
- OpenAIRE
- Journal :
- Rheumatology international
- Accession number :
- edsair.doi.dedup.....57d1addb7a81b0fc94af715a303ad882