Fracture Risk Screening Studies in Older Women
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Questions and Answers

What was the primary outcome of the meta-analysis described in the text?

  • All fractures, (major) osteoporotic fractures, and hip fractures (correct)
  • Hip fractures only
  • Skull and foot fractures
  • Osteoporotic fractures and all-cause mortality

    • What criteria were used to define major osteoporotic fractures?

  • All upper and lower extremity fractures
  • Fractures of the spine and hips
  • All fractures except skull, finger, hand, toe, and foot fractures
  • All hip, vertebral, wrist, and humerus fractures (correct)

    • How was between-study heterogeneity estimated?

  • Using I2-statistics (correct)
  • Using chi-square statistics
  • Using t-tests
  • Using p-values

    • What was the principal summary measure used in the meta-analysis?

    <p>Hazard ratio (HR) (A)</p> Signup and view all the answers

    What was excluded in the post-hoc sensitivity analysis?

    <p>The hip fracture data of one study (B)</p> Signup and view all the answers

    How many articles reported trials on screening for fracture prevention?

    <p>9 (B)</p> Signup and view all the answers

    Which studies were included in the meta-analysis?

    <p>ROSE study, SCOOP study, and SOS (A)</p> Signup and view all the answers

    What is the ultimate goal of osteoporosis care?

    <p>To reduce fractures and their consequences (B)</p> Signup and view all the answers

    What is the treatment gap referred to in the text?

    <p>The gap between high-risk individuals and those receiving anti-osteoporosis medication (B)</p> Signup and view all the answers

    Why has screening for high fracture risk not been implemented in the UK and the Netherlands?

    <p>Because of the absence of evidence of its effectiveness (C)</p> Signup and view all the answers

    Which country recommends bone mineral density measurements for all men and women aged 65 and older?

    <p>Canada (A)</p> Signup and view all the answers

    What was observed in one study regarding hip fractures and the screening group compared with usual care?

    <p>A statistically significant reduction in hip fractures (D)</p> Signup and view all the answers

    What is the current challenge in osteoporosis care according to the text?

    <p>Large and increasing proportion of high-risk individuals not receiving medication (B)</p> Signup and view all the answers

    What has been observed in several large randomized screening studies for fracture prevention?

    <p>No reduction in any type of fractures (C)</p> Signup and view all the answers

    What did different countries have varied policies on with respect to population screening for high fracture risk?

    <p>Age at which screening should begin (A)</p> Signup and view all the answers

    What was the reason for performing a sensitivity analysis on hip fractures without the findings from the SCOOP study?

    <p>To determine the effect of medication alone on reducing hip fractures (B)</p> Signup and view all the answers

    Why did the participation rate vary in the screening programs of the three studies?

    <p>As a reflection of different levels of interest and willingness to participate (A)</p> Signup and view all the answers

    What was a limitation of the study according to the text?

    <p>Incomplete blinding due to the nature of the intervention (B)</p> Signup and view all the answers

    Why did the authors pool results from participants with baseline FRAX data in one of the studies?

    <p>To reach a population comparable to other intention-to-treat populations (B)</p> Signup and view all the answers

    What was observed in a recent trial examining the effect of 5-mg zoledronate infusions at 18-month intervals?

    <p>Consistent reduction in hip fractures in osteopenic women receiving infusions (C)</p> Signup and view all the answers

    Why is it stated that a fracture-reducing intervention is unlikely to be cost-effective if it does not lead to a reduction of hip fractures?

    <p>To emphasize the importance of reducing hip fractures for cost-effectiveness (D)</p> Signup and view all the answers

    What does the text suggest about the need for BMD and fracture risk assessment before initiating anti-osteoporosis medication?

    <p>Its implications for osteoporosis management strategies are unclear (C)</p> Signup and view all the answers

    What does the text recommend policymakers and guideline committees consider based on the current findings?

    <p>Implementation of population screening for osteoporosis in primary care (D)</p> Signup and view all the answers

    What was the number needed to treat for an osteoporotic fracture among the women in the group with an increased fracture risk who started anti-osteoporosis medication?

    <p>25 (C)</p> Signup and view all the answers

    What was the number needed to treat for a hip fracture among the women in the group with an increased fracture risk who started anti-osteoporosis medication?

    <p>28 (D)</p> Signup and view all the answers

    What was the pooled hazard ratio (HR) for the secondary outcome of all-cause mortality?

    <p>1.04 (95% CI = 0.95–1.14) (C)</p> Signup and view all the answers

    What was the relative risk reduction for major osteoporotic fractures according to the text?

    <p>9% (C)</p> Signup and view all the answers

    What percentage of participants in the intervention groups were advised to use anti-osteoporosis medication, according to the text?

    <p>11–18% (C)</p> Signup and view all the answers

    How many patients would need to be treated with alendronate for 5 years to prevent one fracture, as per the text?

    <p>$20-200$ (A)</p> Signup and view all the answers

    What is the number needed to screen by breast cancer screening, according to the text?

    <p>$800$ (B)</p> Signup and view all the answers

    What was the distinct significant relative risk reduction of hip fractures observed in the SCOOP study?

    <p>$28$% (B)</p> Signup and view all the answers

    What was the percentage of participants in the intervention group that started medication after screening in the SCOOP study?

    <p>18% (A)</p> Signup and view all the answers

    What was the mean 10-year hip fracture probability in the screened, high-risk group in the SOS study?

    <p>15.7% (A)</p> Signup and view all the answers

    What was the main indication for DXA in the ROSE study?

    <p>Major osteoporotic fracture probability ≥ 15% (A)</p> Signup and view all the answers

    What did the pooled hazard ratio (HR) indicate for hip fractures?

    <p>Reduced risk (A)</p> Signup and view all the answers

    In which study was there no blinding of outcome data?

    <p>SCOOP study (A)</p> Signup and view all the answers

    What was the number needed to screen, starting with the completion of a complete questionnaire, to prevent one hip fracture?

    <p>272 (B)</p> Signup and view all the answers

    What was the percentage of women who underwent bone densitometry examinations to prevent one osteoporotic fracture?

    <p>46% (B)</p> Signup and view all the answers

    What was the population age range in the SCOOP study?

    <p>70–85 years (A)</p> Signup and view all the answers

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