0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Comment & Response |

Treatment of Osteoporotic Vertebral Fractures—Reply

Brendan J. McCullough, MD, PhD1; Richard A. Deyo, MD, MPH5,6,7,8,9; Jeffrey G. Jarvik, MD, MPH1,2,3,4
[+] Author Affiliations
1Department of Health Services, University of Washington, Seattle
2Department of Radiology, University of Washington, Seattle
3Department of Neurological Surgery, University of Washington, Seattle
4Department of Pharmacy, University of Washington, Seattle
5Department of Family Medicine, Oregon Health and Science University, Portland
6Department of Medicine, Oregon Health and Science University, Portland
7Department of Public Health and Preventive Medicine, Oregon Health and Science University, Portland
8Center for Research in Occupational and Environmental Toxicology, Oregon Health and Science University, Portland
9Kaiser Permanente Center for Health Research, Portland, Oregon
JAMA Intern Med. 2014;174(4):642-643. doi:10.1001/jamainternmed.2013.13481.
Text Size: A A A
Published online

Extract

In Reply We appreciate the comments of Edidin and colleagues as they touch on key elements of our study,1 and their previous article2 provides insightful contrast to our own.

We included the “preprocedure subgroup” analysis to illustrate that a substantial proportion of the augmented group (29%) had a markedly lower risk of complications compared with controls despite being “theoretically” equivalent—both groups had the same treatment during this time (no augmentation), and we controlled for baseline characteristics, including Quan comorbidity scores, prior inpatient admissions, and chronic pulmonary disease, among others, using traditional multivariate models. Edidin et al are right to be concerned that these traditional multivariate models might not adequately account for acute differences in health at the time, such as patients needing emergent care. We agree. There are many other clinical details available in real-time that are not evident in billing claims data. The entire clinical picture at presentation, past and present, will influence therapeutic decisions as well as eventual patient outcomes. We suggest selection bias is the unmeasured factor allowing 2 “theoretically” equivalent groups to have such different outcomes.

Topics

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

April 1, 2014
Michaël Laurent, MD
1Division of Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium
JAMA Intern Med. 2014;174(4):641-642. doi:10.1001/jamainternmed.2013.13482.
April 1, 2014
Avram Allan Edidin, PhD; Steven M. Kurtz, PhD; Kevin L. Ong, PhD
1School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, Pennsylvania
2Exponent Inc, Philadelphia, Pennsylvania
JAMA Intern Med. 2014;174(4):642. doi:10.1001/jamainternmed.2013.13490.
CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

134 Views
0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Jobs
×
brightcove.createExperiences();