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External Hip Protectors and Risk of Hip Fracture
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To the Editor: We have 2 concerns about the study by Ms van Schoor and colleagues.1 First, many participants were lost to follow-up, potentially creating differences between the intervention and control groups that might have biased the results. Second, many participants assigned to wear the hip protectors stopped doing so during the trial. This dilution of the intervention group with nonusers decreases the power of the study to detect any possible benefit of hip protectors that were actually worn.
These problems could have been addressed by randomizing hips rather than individuals. Each participant would be randomly assigned to wear a single protector on either the right or left side. This design would result in intervention and control hips that would be similar in regard to risk factors for a hip fracture, such as bone strength or propensity for a fall. When participants are lost to follow-up, both of their hips . . . [Full Text of this Article]
Peter Cummings, MD, MPH;
Noel S. Weiss, MD, DPH
Department of Epidemiology
University of Washington
Seattle
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