JABFM
HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

The Journal of the American Board of Family Medicine 23 (1): 131- (2010)
DOI: 10.3122/jabfm.2010.01.090200
© 2010 American Board of Family Medicine
This Article
Right arrow Full Text (PDF) Freely available
Right arrow Rapid Responses: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Rapid Responses are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Google Scholar
Right arrow Articles by Cox, L. A.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Cox, L. A.
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

Correspondence

Re: Interventions to Improving Osteoporosis Screening: An Iowa Research Network (IRENE) Study

Lora A. Cox, MD

Department of Family Medicine
UPMC St. Margaret
Pittsburgh, PA
coxla{at}upmc.edu

To the Editor: In a busy clinical practice with complicated patients, it can be difficult remembering to perform all the recommended preventative care interventions.1 Previous studies have demonstrated how the use of prompts improves physician performance of preventative care measures.2 The IRENE study uses a simple "sticky note" on patients’ charts, with or without patient education, in an effort to improve rates of bone mineral density (BMD) testing for osteoporosis screening.3 The study concludes that the addition of their intervention improved osteoporosis screening within family medicine practices as compared with no intervention in the usual care physician practices. This conclusion may be overestimated given that the baseline characteristics of the intervention and usual care practices were so different.

The usual care physician practice had (1) lower rates of previous BMD screening, (2) fewer numbers of previous annual visits for patient participants, and (3) lower patient educational levels. It would be interesting to investigate other demographic and socioeconomic characteristics of the usual care practice and how those characteristics may have impacted rates of osteoporosis screening in that population. Previous studies of screening for other disease entities, namely cervical cancer4 and colon cancer,5 have suggested an association between lower socioeconomic indicators (income, education level) and lower screening rates. It may follow that the socioeconomic characteristics of the usual care practice served as significant confounding variables in this study.

In randomized controlled trials, it is important that the intervention and control groups are as similar as possible. In this study, the dissimilarities between the baseline characteristics of the physician practices were significant enough that the validity of the results must be called into question.

Notes

The above letter was referred to the authors of the article in question, who offer the following reply.

References

  1. Yarnall KSH, Pollak KI, Ostbye T, Krause KM, Michener JL. Primary care: Is there enough time for prevention? Am J Public Health 2003; 93: 635–41.[Abstract/Free Full Text]

  2. Wallis DH, Chin JL, Sur DK, Lee MY. Increasing rates of influenza vaccination during pregnancy: A multisite interventional study. J Am Board Fam Med 2006; 19: 345–9.[Abstract/Free Full Text]

  3. Levy BT, Hartz A, Woodworth G, Xu Y, Sinift S. Interventions to improving osteoporosis screening: An Iowa Research Network (IRENE) study. J Am Board Fam Med 2009; 22: 360–7.[Abstract/Free Full Text]

  4. Carlos RC, Fendrick AM, Patterson SK, Bernstein SJ. Associations in breast and colon cancer screening behavior in women. Acad Radiol 2005; 12(4): 451–8.[CrossRef][Medline]

  5. Zimmerman RK, Nowalk MP, Tabbarah M, Grufferman S. Predictors of colorectal cancer screening in diverse primary care practices. BMC Health Serv Res 2006; 6: 116.[Medline]


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 J Am Board Fam MedHome page
B. T. Levy, A. Hartz, and Y. Xu
Response: Re: Interventions to Improving Osteoporosis Screening: an Iowa Research Network (IRENE) Study
J Am Board Fam Med, January 1, 2010; 23(1): 131 - 132.
[Full Text] [PDF]

This Article
Right arrow Full Text (PDF) Freely available
Right arrow Rapid Responses: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Rapid Responses are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Google Scholar
Right arrow Articles by Cox, L. A.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Cox, L. A.
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS