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Research ArticleOriginal Research

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

Barcey T. Levy, Arthur Hartz, George Woodworth, Yinghui Xu and Suzanne Sinift
The Journal of the American Board of Family Medicine July 2009, 22 (4) 360-367; DOI: https://doi.org/10.3122/jabfm.2009.04.080071
Barcey T. Levy
PhD, MD
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Arthur Hartz
MD, PhD
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George Woodworth
PhD
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Yinghui Xu
MS
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Suzanne Sinift
MA
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    Figure 1.

    Osteoporosis screening chart reminder.

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    Table 1.

    Patient Characteristics in the Three Osteoporosis Screening Study Groups

    Patient CharacteristicsChart Reminder (n = 102)Patient Education + Chart Reminder (n = 62)Usual Care (n = 31)P
    Age (years)73.673.674.1.964
    Educational level college or higher (%)33.348.424.2.038
    Sum of medical conditions (mean)4.04.34.4.422
    BMD during past 14 months (%)22.622.69.7.265
    Annual exams within 26 months (mean)2.22.01.7.004
    • BMD, bone mineral density.

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    Table 2.

    Osteoporosis Screening Intervention Effectiveness According to Four Types of Analyses

    EffectsConventional AnalysesHierarchical Bayesian Analyses
    LogisticHierarchicalWithout Collateral DataWith Collateral Data
    ORP*ORP*ORP†ORP†
    Regular menstruation0.44.0270.44.0280.42.0260.43.030
    Total medications0.78.0040.78.0040.76.0020.77.002
    Osteoporosis history2.56.0072.56.0082.69.0052.68.006
    Had BMD during past 14 months0.19.0010.19.0010.17<.0010.17<.001
    Average BMD rate within each clinic1.06.0591.06NA1.07.1011.07.052
    Chart reminder2.27.1632.27NA2.58.1722.37.156
    Chart reminder + patient education4.99.0324.99NA5.94.0605.47.029
    • * Nominal one-sided P based on the t-distribution.

    • † Bayesian analog of one-sided P: the probability that the intervention did not increase BMD testing.

    • BMD, bone mineral density; OR, odds ratio.

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    Table 3.

    Sensitivity Analyses to Between-Clinic Standard Deviation, σe

    σeEffectMedian Odds RatioP*
    0.1Chart reminder2.71.131
    Chart reminder + Education6.17.033
    0.3Chart reminder2.58.169
    Chart reminder + Education5.89.038
    0.5Chart reminder2.45.229
    Chart reminder + Education5.59.076
    • * Bayesian analog of one-sided P: the probability that the intervention did not increase rates of bone mineral density testing.

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The Journal of the American Board of Family Medicine: 22 (4)
The Journal of the American Board of Family Medicine
Vol. 22, Issue 4
July-August 2009
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Interventions to Improving Osteoporosis Screening: An Iowa Research Network (IRENE) Study
Barcey T. Levy, Arthur Hartz, George Woodworth, Yinghui Xu, Suzanne Sinift
The Journal of the American Board of Family Medicine Jul 2009, 22 (4) 360-367; DOI: 10.3122/jabfm.2009.04.080071

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Interventions to Improving Osteoporosis Screening: An Iowa Research Network (IRENE) Study
Barcey T. Levy, Arthur Hartz, George Woodworth, Yinghui Xu, Suzanne Sinift
The Journal of the American Board of Family Medicine Jul 2009, 22 (4) 360-367; DOI: 10.3122/jabfm.2009.04.080071
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  • Response: Re: Interventions to Improving Osteoporosis Screening: an Iowa Research Network (IRENE) Study
  • Response: Re: Interventions to Improving Osteoporosis Screening: an Iowa Research Network (IRENE) Study
  • Re: Interventions to Improving Osteoporosis Screening: An Iowa Research Network (IRENE) Study
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