Is Too Much Intervention Recommended in the ACP Osteoporosis Treatment Guidelines?
Authors: Pablo Alonso-Coello, Alberto López, Laurie J. Pencille, Victor M. Montori
Journal: Annals of Internal Medicine (2009)

Letters17 February 2009Is Too Much Intervention Recommended in the ACP Osteoporosis Treatment Guidelines?Pablo Alonso-Coello, MD, Alberto López, MD, Laurie J. Pencille, BA, and Victor M. Montori, MD, MScPablo Alonso-Coello, MDFrom Iberoamerican Cochrane Center, Hospital de la Santa Creu i Sant Pau and CIBER de Epidemiología y Salud Pública (CIBERESP), 08025 Barcelona, Spain; Área IX de Atención Primaria, 28914 Leganés, Spain; and Mayo Clinic, Rochester, MN 55905.Search for more papers by this author, Alberto López, MDFrom Iberoamerican Cochrane Center, Hospital de la Santa Creu i Sant Pau and CIBER de Epidemiología y Salud Pública (CIBERESP), 08025 Barcelona, Spain; Área IX de Atención Primaria, 28914 Leganés, Spain; and Mayo Clinic, Rochester, MN 55905.Search for more papers by this author, Laurie J. Pencille, BAFrom Iberoamerican Cochrane Center, Hospital de la Santa Creu i Sant Pau and CIBER de Epidemiología y Salud Pública (CIBERESP), 08025 Barcelona, Spain; Área IX de Atención Primaria, 28914 Leganés, Spain; and Mayo Clinic, Rochester, MN 55905.Search for more papers by this author, and Victor M. Montori, MD, MScFrom Iberoamerican Cochrane Center, Hospital de la Santa Creu i Sant Pau and CIBER de Epidemiología y Salud Pública (CIBERESP), 08025 Barcelona, Spain; Área IX de Atención Primaria, 28914 Leganés, Spain; and Mayo Clinic, Rochester, MN 55905.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-4-200902170-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We reviewed the American College of Physicians (ACP) guidelines on the treatment of low bone density or osteoporosis to prevent fractures (1). Strengths of these guidelines include their rigorous methods; their use of the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach (2); and that they are based on an extensive systematic review. However, we are worried that adherence to these guidelines may not yield the balance of benefits and costs that the authors judged as favorable when they made strong treatment recommendations, and we have a few questions to clarify this issue.The panel strongly ...References1. Qaseem A, Snow V, Shekelle P, Hopkins R, Forciea MA, Owens DK; Clinical Efficacy Assessment Subcommittee of the American College of Physicians. Pharmacologic treatment of low bone density or osteoporosis to prevent fractures: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2008;149:404-15. [PMID: 18794560] LinkGoogle Scholar2. Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al; GRADE Working Group. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336:924-6. [PMID: 18436948] CrossrefMedlineGoogle Scholar3. World Health Organization Collaborating Centre for Metabolic Bone Diseases. FRAX: WHO Fracture Risk Assessment Tool. Accessed at www.shef.ac.uk/FRAX/ on 5 January 2009. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Iberoamerican Cochrane Center, Hospital de la Santa Creu i Sant Pau and CIBER de Epidemiología y Salud Pública (CIBERESP), 08025 Barcelona, Spain; Área IX de Atención Primaria, 28914 Leganés, Spain; and Mayo Clinic, Rochester, MN 55905.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPharmacologic Treatment of Low Bone Density or Osteoporosis to Prevent Fractures: A Clinical Practice Guideline from the American College of Physicians Amir Qaseem , Vincenza Snow , Paul Shekelle , Robert Hopkins Jr. , Mary Ann Forciea , Douglas K. Owens , and Is Too Much Intervention Recommended in the ACP Osteoporosis Treatment Guidelines? Amir Qaseem , Paul Shekelle , and Douglas K. Owens Metrics Cited ByGeneral medical practitioners' knowledge and beliefs about osteoporosis and its investigation and managementAdherence to Bisphosphonate Therapy in Postmenopausal Osteoporotic Women 17 February 2009Volume 150, Issue 4Page: 285-286KeywordsBone densityHip fracturesMedical risk factorsMotivationOsteopeniaOsteoporosisSystematic reviewsTreatment guidelines ePublished: 17 February 2009 Issue Published: 17 February 2009 CopyrightCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...