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External Hip Protectors and Risk of Hip Fracture—Reply
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In Reply: In response to Drs Bulat and Quigley, the evidence available at the time we initiated our study was considered insufficient to establish the effectiveness of external hip protectors, and therefore the use of an usual care control group was approved by the ethical review board of our hospital. Several studies supporting the effectiveness of hip protectors were published while we were collecting data. Most, however, were small or used cluster randomization, which may compromise validity.
Bulat and Quigley are concerned about our use of a calendar to assess falls and fractures, and they raise the possibility that the hip protectors may have lost effectiveness during the 12 months of our trial. The calendar was completed by a nurse when the participant was cognitively impaired. Because this is a prospective method, it is the most reliable method available. According to the manufacturer of the hip protectors, the devices may . . . [Full Text of this Article]
Natasia M. van Schoor, MSc;
Johannes H. Smit, PhD;
Jos W. R. Twisk, PhD;
Lex M. Bouter, PhD;
Paul Lips, MD, PhD
Vrije University Medical Center
Amsterdam, the Netherlands
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