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Guidelines for the management of osteoporosis: the present and the future

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Abstract

Evidence-based guidelines are increasingly used in the management of osteoporosis and have the potential to produce uniformly high standards of clinical care across different sectors of the health service. National guidelines for the prevention and treatment of osteoporosis are now available in a number of countries and, although sharing similarities, also differ in some respects. This review considers the challenges involved in the development and implementation of guidelines and proposes a paradigm for the unification of guidelines in the future.

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References

  1. Sackett DL, Rosenberg WMC, Gary JAM, Haynes RB, Richardson WS (1996) Evidence based medicine: what it is and what it isn’t. Brit Med J 312:71–72

    CAS  PubMed  Google Scholar 

  2. Grol R, Dalhuijzen J, Mokkink H, Thomas S, Veld C, Rutten G (1998) Attributes of clinical guidelines that influence use of guidelines in general practice. Brit Med J 317:858–861

    CAS  PubMed  Google Scholar 

  3. The AGREE collaboration (2001) Appraisal of guidelines for research and evaluation. www.agreecollaboration.org

  4. Gunawardena H, Speden D, Saharia AR, Wickramasuriya R, Javaid MK, Potter J, Compston J (2004) A multi-centre secondary care based national audit of bone prophylaxis in glucocorticoid induced osteoporosis. Osteoporos Int 15 [Suppl 1]:S11

  5. Bone and Tooth Society of Great Britain, National Osteoporosis Society and Royal College of Physicians (1999) Glucocorticoid-induced osteoporosis. Guidelines on prevention and treatment. Royal College of Physicians, London. www.rcplondon.ac.uk

  6. Kanis JA, Johansson H, Oden A et al (2004) A family history of fracture and fracture risk: a meta-analysis. Bone 35:1029–1037

    Article  CAS  PubMed  Google Scholar 

  7. Kanis JA, Johnell O, De Laet et al (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35:375–382

    Article  CAS  PubMed  Google Scholar 

  8. Concato J, Shah N, Horwitz RI (2000) Randomised, controlled trials, observational studies and the hierarchy of research designs. New Engl J Med 342:1887–1892

    Article  CAS  PubMed  Google Scholar 

  9. Benson K, Hartz AJ (2000) A comparison of observational studies and randomized controlled trials. New Engl J Med 342:1878–1886

    Article  CAS  PubMed  Google Scholar 

  10. Vandenbroucke JP (2004) When are observational studies as credible as randomised trials? Lancet 363:1728–1731

    Article  PubMed  Google Scholar 

  11. Concato J, Horwitz RI (2004) Beyond randomised versus observational studies. Lancet 363:1660–1661

    Article  PubMed  Google Scholar 

  12. Greenhalgh T (1997) Assessing the methodological quality of published papers. Brit Med J 315:305–308

    CAS  PubMed  Google Scholar 

  13. Cranney A, Tugwell P, Wells G, Guyatt G (2002) Systematic reviews of randomised trials in osteoporosis: Introduction and methodology. Endocr Rev 4:497–507

    Google Scholar 

  14. Dimai HP, Pietschmann P, Resch H, Leb G, Klaushofer K (2002) Leitfaden zur medikamentösen Therapie der postmenopausalen Osteoporose. Wien Med Wschr 152:596–612

    CAS  PubMed  Google Scholar 

  15. Brixen K et al (2002) Consensus report on osteoporosis. Ugeskr Laeger [Suppl] 10

  16. National Agency for Accreditation and Evaluation in Health Care (ANAES) (2000) Les indications des measures quantitatives du tissu osseux: actualization. www.anaes.fr

    Google Scholar 

  17. Dachverbandes der deutschsprachigen osteologischen Fachgesellschaften (DVO) (2003) Osteoporose bei Frauen nach der Menopause und im hoheren Lagensalter, Prophylaxe, Diagnose, Therapie—Emfehlungen des Dachverbandes der deutschsprachigen osteologischen Fachgesellschaften (DVO). www.bergmannsheil.de/leitlinien-dvo (for the English version: www.lutherhaus.de/osteo/leitlinien-dvo/pages/english.php)

  18. Longoni P, Pappalepore V, Bianchi ML, Ortolani S, Sacchi G, Tempesta F (2001) Percorsi diagnostici e terapeutici condivisi sull’osteoporosis. Editech Pharma Srl, Milan

  19. El-Hajj Fuleihan G, Baddoura R, Awada H, Okais J, Risk P, McClung M (2002) Lebanese guidelines on osteoporosis assessment and treatment. Lebanese Med J 50:75–125

    Google Scholar 

  20. Osteoporose Tweede herziene richtlijn (2002). www.cbo.nl/product/richtlijnen/folder20021023121843/article20021118165847/pdf/osteoporose [English summary: Pols HA, Wittenberg J (2002) CBO guideline “Osteoporosis” (2nd version). NTVG Ned Tijdschr Geneeskd 146:1359–1363]

    Google Scholar 

  21. Guía de Práctica Clínica de la Sociedad Espanola de Investigaciones Óseas Y Metabolismo Mineral (SEIOMM) (2001) Osteoporosis postmenopáusica. www.seiomm.org

  22. SBU (The Swedish Council onTechnology Assessment in Health Care). No 165: Osteoporos-prevention, diagnostic och behandling

  23. Medical Products Agency. www.mpa.se

  24. Royal College of Physicians. (1999) Osteoporosis. Clinical guidelines on prevention and treatment and Royal College of Physicians and Bone and Tooth Society of Great Britain: Update on pharmacological interventions and an algorithm for management 2000. Royal College of Physicians, London, www.rcplondon.ac.uk

    Google Scholar 

  25. Scottish Intercollegiate Guidelines Network (SIGN) (2002) Guidelines 56. Prevention and management of hip fracture in older people. SIGN, Edinburgh, www.sign.ac.uk

  26. Scottish Intercollegiate Guidelines Network (2003) Management of osteoporosis. www.sign.ac.uk

  27. Brown JP, Josse RJ, the Scientific Advisory Council of the Osteoporosis Society of Canada (2002) Clinical practice guidelines for the diagnosis and management of osteoporosis in Canada. Can Med Assoc J [Suppl] 167:1–22; www.osteoporosis.ca

    Google Scholar 

  28. The National Osteoporosis Foundation (NOF) (2003) Physician’s guide to prevention and treatment of osteoporosis. National Osteoporosis Foundation, Washington, DC

  29. American Association of Clinical Endocrinologists (2003) Medical guidelines for clinical practice for the prevention and treatment of postmenopausal osteoporosis. Endo Pract 9:545–564

    Google Scholar 

  30. Nelson HD, Helfand M, Woolf SH, Allen JD (2002) Screening for postmenopausal osteoporosis: a review of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 137:529–541, 526–528; http://www.ahrq.gov/clinic/3rduspstf/osteoporosis/osteorr.htm

    Google Scholar 

  31. International Society for Clinical Densitometry (ISCD) (2004) J Clin Densitometry 7:7–12; http://www.iscd.org/Visitors/official.cfm

    Google Scholar 

  32. North American Menopause Society (NAMS) http://www.menopause.org/aboutmeno/consensus.htm

  33. American College of Rheumatology ad hoc Committee on Glucocorticoid-induced Osteoporosis (2001) Recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis. 2001 update. Arthritis Rheum 44:1496–1503

    PubMed  Google Scholar 

  34. International Osteoporosis Foundation (2001) Osteoporosis in the European Community: A call to action. An audit of policy developments since 1998. www.osteofound.org/advocacy_policy/eu_calltoaction_report.html

    Google Scholar 

  35. European Union Osteoporosis Consultation Panel (2003) Osteoporosis in the European Community: Action plan. A report of the European Union Osteoporosis Consultation Panel. www.osteofound.org/advocacy_policy/eu_policy_project.html

    Google Scholar 

  36. Kanis JA, Borgstrom B, De Laet C, Johansson H, Johnell O, Jonsson B et al (2005) Assessment of fracture risk. Osteoporos Int 16:581–589

    Article  PubMed  Google Scholar 

  37. Compston JE (2004) UK and US guidelines on glucocorticoid-induced osteoporosis: similarities and differences. Curr Rev Rheumatol 6:66–69

    Google Scholar 

  38. Kanis JA, Johnell O, Oden A, De Laet C, Oglesby A, Jönsson (2002) Intervention thresholds for osteoporosis. Bone 31:26–31

    Article  CAS  PubMed  Google Scholar 

  39. Kanis JA, Johnell O, Oden A, De Laet C, Jönsson B, Dawson A (2002) Ten-year risk of osteoporotic fracture and the effect of risk factors on screening strategies. Bone 30:251–258

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Medicine, University of Cambridge School of Medicine, Cambridge, UK

    Juliet Compston

  2. Department of Medicine, Addenbrooke’s Hospital, P.O. Box 157, Cambridge, CB2 2QQ, UK

    Juliet Compston

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  1. Juliet Compston
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Correspondence to Juliet Compston.

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Compston, J. Guidelines for the management of osteoporosis: the present and the future. Osteoporos Int 16, 1173–1176 (2005). https://doi.org/10.1007/s00198-005-1894-4

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  • DOI: https://doi.org/10.1007/s00198-005-1894-4

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