Screening to prevent fragility fractures among adults 40 years and older in primary care: protocol for a systematic review

Simple item page
dc.contributor.authorGates, Michelle
dc.contributor.authorPillay, Jennifer
dc.contributor.authorThériault, Guylène
dc.contributor.authorLimburg, Heather
dc.contributor.authorGrad, Roland
dc.contributor.authorKlarenbach, Scott
dc.contributor.authorKorownyk, Christina
dc.contributor.authorReynolds, Donna
dc.contributor.authorRiva, John J
dc.contributor.authorThombs, Brett D
dc.contributor.authorKline, Gregory A
dc.contributor.authorLeslie, William D
dc.contributor.authorCourage, Susan
dc.contributor.authorVandermeer, Ben
dc.contributor.authorFeatherstone, Robin
dc.contributor.authorHartling, Lisa
dc.date.accessioned2019-08-25T00:02:28Z
dc.date.available2019-08-25T00:02:28Z
dc.date.issued2019-08-23
dc.date.updated2019-08-25T00:02:28Z
dc.description.abstractAbstract Purpose To inform recommendations by the Canadian Task Force on Preventive Health Care by systematically reviewing direct evidence on the effectiveness and acceptability of screening adults 40 years and older in primary care to reduce fragility fractures and related mortality and morbidity, and indirect evidence on the accuracy of fracture risk prediction tools. Evidence on the benefits and harms of pharmacological treatment will be reviewed, if needed to meaningfully influence the Task Force’s decision-making. Methods A modified update of an existing systematic review will evaluate screening effectiveness, the accuracy of screening tools, and treatment benefits. For treatment harms, we will integrate studies from existing systematic reviews. A de novo review on acceptability will be conducted. Peer-reviewed searches (Medline, Embase, Cochrane Library, PsycINFO [acceptability only]), grey literature, and hand searches of reviews and included studies will update the literature. Based on pre-specified criteria, we will screen studies for inclusion following a liberal-accelerated approach. Final inclusion will be based on consensus. Data extraction for study results will be performed independently by two reviewers while other data will be verified by a second reviewer; there may be some reliance on extracted data from the existing reviews. The risk of bias assessments reported in the existing reviews will be verified and for new studies will be performed independently. When appropriate, results will be pooled using either pairwise random effects meta-analysis (screening and treatment) or restricted maximum likelihood estimation with Hartun-Knapp-Sidnick-Jonkman correction (risk prediction model calibration). Subgroups of interest to explain heterogeneity are age, sex, and menopausal status. Two independent reviewers will rate the certainty of evidence using the GRADE approach, with consensus reached for each outcome rated as critical or important by the Task Force. Discussion Since the publication of other guidance in Canada, new trials have been published that are likely to improve understanding of screening in primary care settings to prevent fragility fractures. A systematic review is required to inform updated recommendations that align with the current evidence base.
dc.identifier.citationSystematic Reviews. 2019 Aug 23;8(1):216
dc.identifier.doihttps://doi.org/10.1186/s13643-019-1094-5
dc.identifier.urihttp://hdl.handle.net/1880/110783
dc.identifier.urihttps://doi.org/10.11575/PRISM/44928
dc.language.rfc3066en
dc.rights.holderCrown.
dc.titleScreening to prevent fragility fractures among adults 40 years and older in primary care: protocol for a systematic review
dc.typeJournal Article
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
13643_2019_Article_1094.pdf
Size:
1.13 MB
Format:
Adobe Portable Document Format
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
0 B
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Open Access Publications