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

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Figure 1.
Osteoporosis screening chart reminder.

Table 1.

Patient Characteristics in the Three Osteoporosis Screening Study Groups

Patient Characteristics	Chart Reminder (n = 102)	Patient Education + Chart Reminder (n = 62)	Usual Care (n = 31)	P
Age (years)	73.6	73.6	74.1	.964
Educational level college or higher (%)	33.3	48.4	24.2	.038
Sum of medical conditions (mean)	4.0	4.3	4.4	.422
BMD during past 14 months (%)	22.6	22.6	9.7	.265
Annual exams within 26 months (mean)	2.2	2.0	1.7	.004

Table 2.

Osteoporosis Screening Intervention Effectiveness According to Four Types of Analyses

Effects	Conventional Analyses				Hierarchical Bayesian Analyses
Effects	Logistic		Hierarchical		Without Collateral Data		With Collateral Data
	OR	P^*	OR	P^*	OR	P^†	OR	P^†
Regular menstruation	0.44	.027	0.44	.028	0.42	.026	0.43	.030
Total medications	0.78	.004	0.78	.004	0.76	.002	0.77	.002
Osteoporosis history	2.56	.007	2.56	.008	2.69	.005	2.68	.006
Had BMD during past 14 months	0.19	.001	0.19	.001	0.17	<.001	0.17	<.001
Average BMD rate within each clinic	1.06	.059	1.06	NA	1.07	.101	1.07	.052
Chart reminder	2.27	.163	2.27	NA	2.58	.172	2.37	.156
Chart reminder + patient education	4.99	.032	4.99	NA	5.94	.060	5.47	.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.

Table 3.

Sensitivity Analyses to Between-Clinic Standard Deviation, σ_e

σ_e	Effect	Median Odds Ratio	P^*
0.1	Chart reminder	2.71	.131
0.1	Chart reminder + Education	6.17	.033
0.3	Chart reminder	2.58	.169
0.3	Chart reminder + Education	5.89	.038
0.5	Chart reminder	2.45	.229
0.5	Chart reminder + Education	5.59	.076