Mark J. Bolland, MBChB, PhD; Andrew Grey, MD; Ian R. Reid, MD
Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L15-0123.
Bolland MJ, Grey A, Reid IR. Screening for Vitamin D Deficiency. Ann Intern Med. 2015;162:736-737. doi: 10.7326/L15-5094
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Published: Ann Intern Med. 2015;162(10):736-737.
TO THE EDITOR:
We read LeBlanc and colleagues' review (1) with great interest. Approximately twice as many meta-analyses have been done on vitamin D supplements for falls and fractures as randomized trials. Conclusions of these meta-analyses differ largely because of the methods adopted, such as the choice of studies included (2, 3). LeBlanc and colleagues assessed the effectiveness of vitamin D supplementation on mortality, falls, and fractures in vitamin D deficiency, including 11, 5, and 5 trials, respectively, for each outcome. In contrast, we included 38, 20, and 23 trials, respectively, in meta-analyses of vitamin D supplementation for these conditions (4, 5). The differences in study inclusion are largely due to LeBlanc and colleagues' requirement that baseline 25-hydroxyvitamin D [25-(OH)D] levels be measured in all participants. They aimed to include only studies in which 90% of participants had 25-(OH)D levels less than 75 nmol/L, but random sampling of baseline levels is sufficient to assess this criterion. Baseline 25-(OH)D levels were reported in a sample or in all participants in most (34 of 42) trials in our meta-analyses, with 25 of 32 (78%) reporting mean baseline 25-(OH)D levels less than 50 nmol/L; thus, 90% of participants most likely had 25-(OH)D levels less than 75 nmol/L.
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