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Bone Densitometry and Treatment for Osteoporosis in Older Men—Reply
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In Reply: We agree with Dr Ito that substantial heterogeneity exists in the older male population with respect to not only functional status but also to the presence or absence of additional factors that confer fracture risk independent of age, prior fracture status, and bone mineral density. As stated in our article, the results of our modeling study are applicable to men with average risks within the subsets defined by age and prior clinical fracture status.
However, the relevant quality of life statistic for cost-effectiveness modeling studies of fracture prevention therapies is the absolute decrease in quality of life following fracture, not the pre-fracture quality of life. While one study has suggested that the acute loss in quality of life following fractures is greater among persons with higher pre-fracture quality of life,1 other studies suggest that the proportion of persons who subsequently regain their pre-fracture ability to walk may be . . . [Full Text of this Article]
John T. Schousboe, MD, MS
john.schousboe@parknicollet.com
Park Nicollet Health Services
Minneapolis, Minnesota
Brent C. Taylor, PhD, MPH;
Howard A. Fink, MD, MPH
Center for Chronic Disease Outcomes Research
Minneapolis Veterans Administration Medical Center
Minneapolis
Douglas C. Bauer, MD
Department of Medicine and Epidemiology
University of California
San Francisco
Robert L. Kane, MD
Division of Health Policy and Management
School of Public Health
University of Minnesota
Minneapolis
Kristine E. Ensrud, MD, MPH
Center for Chronic Disease Outcomes Research
Minneapolis Veterans Administration Medical Center
Minneapolis
RELATED LETTER
Bone Densitometry and Treatment for Osteoporosis in Older Men
Kouta Ito
JAMA. 2007;298(18):2136-2137.
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