Appropriate Osteoporosis Treatment by Family Physicians in Response to FRAX vs CAROC Reporting: Results From a Randomized Controlled Trial

Autor: Anthony B. Hodsman, Jonathan D. Adachi, Joy C. MacDermid, Alexandra Papaioannou, Ruby Grewal, Karen A. Beattie, George Ioannidis
Rok vydání: 2014
Předmět:
Male
Fracture risk
FRAX
treatment recommendation
fracture risk
Endocrinology
Diabetes and Metabolism
Osteoporosis
Alternative medicine
Comorbidity
law.invention
Absorptiometry
Photon
Cohen's kappa
Randomized controlled trial
Risk Factors
law
Surveys and Questionnaires
Medicine and Health Sciences
Orthopedics and Sports Medicine
Aged
80 and over
Physicians
Family
Middle Aged
3. Good health
Radiology Nuclear Medicine and imaging
Female
Canada
medicine.medical_specialty
Risk Assessment
Sensitivity and Specificity
Article
decision making
Predictive Value of Tests
Osteoporosis treatment
Bone mineral density
medicine
Humans
Radiology
Nuclear Medicine and imaging
Aged
business.industry
medicine.disease
osteoporosis
Physical therapy
Radius Fractures
business
Decision making
Treatment recommendation
Reporting system
Osteoporotic Fractures
Zdroj: Bone and Joint Institute
Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry
ISSN: 1094-6950
DOI: 10.1016/j.jocd.2013.09.007
Popis: © 2014 The International Society for Clinical Densitometry. Canadian guidelines recommend either the FRAX or the Canadian Association of Radiologists and Osteoporosis Canada (CAROC) fracture risk assessment tools to report 10-yr fracture risk as low (20%). It is unknown whether one reporting system is more effective in helping family physicians (FPs) identify individuals who require treatment. Individuals ≥50yr old with a distal radius fracture and no previous osteoporosis diagnosis or treatment were recruited. Participants underwent a dual-energy x-ray absorptiometry scan and answered questions about fracture risk factors. Participants' FPs were randomized to receive either a FRAX report or the standard CAROC-derived bone mineral density report currently used by the institution. Only the FRAX report included statements regarding treatment recommendations. Within 3 mo, all participants were asked about follow-up care by their FP, and treatment recommendations were compared with anosteoporosis specialist. Sixty participants were enrolled (31 to FRAX and 29 to CAROC). Kappa statistics of agreement in treatment recommendation were 0.64 for FRAX and 0.32 for bone mineral density. The FRAX report was preferred by FPs and resulted in better postfracture follow-up and treatment that agreed more closely with a specialist. Either the clear statement of fracture risk or the specific statement of treatment recommendations on the FRAX report may have supported FPs to make better treatment decisions.
Databáze: OpenAIRE
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