Skip Navigation
Menu
Letters |17 December 2013

Vitamin D and Calcium Supplementation to Prevent Fractures in Adults

Marcus M. Reidenberg, MD

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
  • From Weill Cornell Medical College, New York, New York.

    Potential Conflicts of Interest: Board membership: Aminopterin; Patents (planned, pending, or issued): National Institutes of Health; Royalties: National Institutes of Health; Stock/stock options: Ascenta; Travel/accommodations/meeting expenses unrelated to activities listed: United States Pharmacopoeia, U.S. Food and Drug Administration Expert Committee.

×
FULL TEXT
TO THE EDITOR:
I read the USPSTF's guideline (1) with great interest. Both the Institute of Medicine report (2) cited in the editorial (3) and the WHI (Women's Health Initiative) study noted in the guideline as the largest trial of fracture outcomes reported that many persons in the United States are already receiving supplements. Thus, the conclusions refer to persons already having vitamin D and calcium intake at or close to the recommended daily allowance of each, often because they are receiving supplements. Furthermore, the WHI study used the statistical significance value for the intention-to-treat analysis.
I recognize the issue of selective withdrawal during a trial so that the groups at the end may not be as comparable as they were at the beginning. In the WHI study, only 59% of the treated participants were receiving the prescribed dose of vitamin D and calcium. As a pharmacologist, I know that if I want to learn a drug's effects, I have to give the drug and not just intend to do so. One must be cautious in assuming that lack of statistically significant evidence, especially with intention-to-treat analysis with many withdrawals, is evidence of lack of effect.
FULL TEXT
PDF
Not Available
Citations
Citation

Reidenberg MM. Vitamin D and Calcium Supplementation to Prevent Fractures in Adults. Ann Intern Med. ;159:856. doi: 10.7326/0003-4819-159-12-201312170-00015

Download citation file:

© 2019

×
Permissions

Published: Ann Intern Med. 2013;159(12):856.

DOI: 10.7326/0003-4819-159-12-201312170-00015

1 Citations
CONTINUE WITH LIMITED ACCESS
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
acp link acp
silverchair link silverchair

Copyright © 2019 American College of Physicians. All Rights Reserved.

Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Privacy Policy

|

Conditions of Use

This site uses cookies. By continuing to use our website, you are agreeing to our privacy policy. | Accept
×

You need a subscription to this content to use this feature.

×
PDF Downloads Require Access to the Full Article.
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
Access to this Free Content Requires Users to be Registered and Logged In. Please Choose One of the Following Options
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×