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

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 (<10%), moderate (10%–20%) or high (>20%). It is unknown whether one reporting system is more effective...

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Autores principales: Beattie, Karen A., Ioannidis, George, MacDermid, Joy C., Grewal, Ruby, Papaioannou, Alexandra, Adachi, Jonathan D., Hodsman, Anthony B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5094883/
https://www.ncbi.nlm.nih.gov/pubmed/24206869
http://dx.doi.org/10.1016/j.jocd.2013.09.007
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author Beattie, Karen A.
Ioannidis, George
MacDermid, Joy C.
Grewal, Ruby
Papaioannou, Alexandra
Adachi, Jonathan D.
Hodsman, Anthony B.
author_facet Beattie, Karen A.
Ioannidis, George
MacDermid, Joy C.
Grewal, Ruby
Papaioannou, Alexandra
Adachi, Jonathan D.
Hodsman, Anthony B.
author_sort Beattie, Karen A.
collection PubMed
description 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 (<10%), moderate (10%–20%) or high (>20%). It is unknown whether one reporting system is more effective in helping family physicians (FPs) identify individuals who require treatment. Individuals ≥50 yr 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 an osteoporosis 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.
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spelling pubmed-50948832016-11-03 Appropriate Osteoporosis Treatment by Family Physicians in Response to FRAX vs CAROC Reporting: Results From a Randomized Controlled Trial Beattie, Karen A. Ioannidis, George MacDermid, Joy C. Grewal, Ruby Papaioannou, Alexandra Adachi, Jonathan D. Hodsman, Anthony B. J Clin Densitom Article 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 (<10%), moderate (10%–20%) or high (>20%). It is unknown whether one reporting system is more effective in helping family physicians (FPs) identify individuals who require treatment. Individuals ≥50 yr 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 an osteoporosis 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. 2013-10-25 2014 /pmc/articles/PMC5094883/ /pubmed/24206869 http://dx.doi.org/10.1016/j.jocd.2013.09.007 Text en http://creativecommons.org/licenses/by/4.0/ Open access under CC BY-NC-ND license
spellingShingle Article
Beattie, Karen A.
Ioannidis, George
MacDermid, Joy C.
Grewal, Ruby
Papaioannou, Alexandra
Adachi, Jonathan D.
Hodsman, Anthony B.
Appropriate Osteoporosis Treatment by Family Physicians in Response to FRAX vs CAROC Reporting: Results From a Randomized Controlled Trial
title Appropriate Osteoporosis Treatment by Family Physicians in Response to FRAX vs CAROC Reporting: Results From a Randomized Controlled Trial
title_full Appropriate Osteoporosis Treatment by Family Physicians in Response to FRAX vs CAROC Reporting: Results From a Randomized Controlled Trial
title_fullStr Appropriate Osteoporosis Treatment by Family Physicians in Response to FRAX vs CAROC Reporting: Results From a Randomized Controlled Trial
title_full_unstemmed Appropriate Osteoporosis Treatment by Family Physicians in Response to FRAX vs CAROC Reporting: Results From a Randomized Controlled Trial
title_short Appropriate Osteoporosis Treatment by Family Physicians in Response to FRAX vs CAROC Reporting: Results From a Randomized Controlled Trial
title_sort appropriate osteoporosis treatment by family physicians in response to frax vs caroc reporting: results from a randomized controlled trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5094883/
https://www.ncbi.nlm.nih.gov/pubmed/24206869
http://dx.doi.org/10.1016/j.jocd.2013.09.007
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