Virginia A. Moyer, MD, MPH; Michael L. LeFevre, MD, MSPH; Albert L. Siu, MD, MSPH
Potential Conflicts of Interest: Disclosure forms from USPSTF members can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-0215.
Moyer VA, LeFevre ML, Siu AL. Vitamin D and Calcium Supplementation to Prevent Fractures in Adults. Ann Intern Med. 2013;159:856-857. doi: 10.7326/0003-4819-159-12-201312170-00016
Download citation file:
Published: Ann Intern Med. 2013;159(12):856-857.
The USPSTF anticipated the challenges and honest scientific disagreements on the use of vitamin D and calcium supplementation to prevent fractures.
Dr. Sugiyama's suggestion that mechanical effects play a substantial role in bone strength and quality—and therefore in risk for fractures, regardless of or despite supplement use—is an important observation. The Task Force agrees that more research is needed.
Dr. Reidenberg highlights the challenges of drawing conclusions from the WHI study and other randomized, controlled trials of vitamin D and calcium. As he mentions, the standard technique for studying the effectiveness of an intervention is intention-to-treat analysis to avoid bias due to asymmetrical withdrawal from the trial. The Task Force concurs that statistical significance differs from clinical significance, and it is important to understand the meaning of the results. The challenges of determining the effectiveness of nutritional supplements is a broader issue that the field will need to address.
Learn more about subscription options.
Register Now for a free account.
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only