Silverman S L, Kupperman E S, Bukata S V
Cedars-Sinai Medical Center, Los Angeles, CA, USA.
David Geffen School of Medicine, UCLA, Los Angeles, CA, USA.
Osteoporos Int. 2016 Jul;27(7):2197-2206. doi: 10.1007/s00198-016-3513-y. Epub 2016 Apr 25.
We used the RAND UCLA appropriateness method to decide appropriateness of use of osteoporosis medication after incident fracture and potential for fracture healing and make suggestions for trial design for clinical and preclinical research.
To develop appropriateness criteria to assist in the use and study of osteoporosis medications in patients with recent fracture and in the potential use of osteoporosis medications to enhance delayed fracture healing. To promote further research by suggesting preclinical and clinical trial design for studies where fracture healing is the endpoint.
RAND/UCLA appropriateness method (RUAM).
A panel of experts, both members and non-members of the International Osteoporosis Foundation Fracture Working Group, were identified consisting of geriatricians, rheumatologists, orthopedists, endocrinologists, and internists. This resulted in a round 1 panel of 15 panelists, round 2 panel of 15 members, and a round 3 panel of 14 members.
Agreement on statements and scenarios using RUAM. Three rounds of voting by panelists took place. Agreement in a third round was reached for 111 statements and scenarios, measured by median panel ratings and the amount of dispersion of panel ratings, based on the interpercentile range.
An expert panel validated a set of statements and scenarios about the use of osteoporosis medications after incident fracture and use of these medications to enhance delayed fracture healing and made recommendations for study designs to investigate the effect of osteoporosis medications on fracture healing.
The result of this exercise is intended to assist in improving patient care by identifying the appropriateness of use of osteoporosis medications after fracture and in fracture healing and to make suggestions for further preclinical and clinical research.
我们采用兰德加州大学适宜性方法来确定骨质疏松症药物在发生骨折后使用的适宜性以及骨折愈合的可能性，并为临床和临床前研究的试验设计提出建议。
制定适宜性标准，以协助在近期骨折患者中使用和研究骨质疏松症药物，以及在潜在使用骨质疏松症药物促进延迟骨折愈合方面提供帮助。通过为以骨折愈合为终点的研究提出临床前和临床试验设计建议，推动进一步研究。
兰德/加州大学适宜性方法（RUAM）。
确定了一个专家小组，成员包括国际骨质疏松基金会骨折工作组的成员和非成员，由老年病学家、风湿病学家、骨科医生、内分泌学家和内科医生组成。这产生了第一轮由15名小组成员组成的小组、第二轮由15名成员组成的小组和第三轮由14名成员组成的小组。
使用RUAM对陈述和情景达成的共识。小组成员进行了三轮投票。根据百分位数范围，通过中位数小组评分和小组评分的离散程度衡量，在第三轮中对111条陈述和情景达成了共识。
一个专家小组验证了一组关于骨质疏松症药物在发生骨折后使用以及使用这些药物促进延迟骨折愈合的陈述和情景，并为研究骨质疏松症药物对骨折愈合影响的研究设计提出了建议。
本研究结果旨在通过确定骨折后和骨折愈合过程中骨质疏松症药物使用的适宜性来协助改善患者护理，并为进一步的临床前和临床研究提出建议。
