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Hip Protectors and Hip Fracture
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To the Editor: Dr Kiel and colleagues1 conducted a trial in which patients were assigned to wear a protector on 1 hip only. They reported fracture rates for protected and unprotected hips, but not the treatment effect size or its precision. Estimates of effect size and precision are recommended by the Consolidated Standards of Reporting Trials Statement2 and are useful for future meta-analyses.
There were 21 fractures among protected hips and 17 among unprotected hips.1 Since each participant had 1 protected and 1 unprotected hip, a matched cohort analysis is suitable.3-4 Provided no one fractured both hips, the matched risk ratio for fracture of a protected hip, compared with an unprotected hip, was 21/17 = 1.24 with a 95% confidence interval (CI) of 0.65 to 2.34. Since follow-up time was identical for the hips of each participant, the matched rate ratio (and its CI) is the same as the matched risk ratio. . . . [Full Text of this Article]
Peter Cummings, MD, MPH
peterc@u.washington.edu
Department of Epidemiology
University of Washington
Seattle
RELATED LETTER
Hip Protectors and Hip Fracture—Reply
Douglas P. Kiel, Stanley J. Birge, Jay Magaziner, Sheryl Zimmerman, Kathleen M. Brown, and Bruce A. Barton
JAMA. 2007;298(18):2139.
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RELATED ARTICLE
Efficacy of a Hip Protector to Prevent Hip Fracture in Nursing Home Residents: The HIP PRO Randomized Controlled Trial
Douglas P. Kiel, Jay Magaziner, Sheryl Zimmerman, Linda Ball, Bruce A. Barton, Kathleen M. Brown, Judith P. Stone, Dawn Dewkett, and Stanley J. Birge
JAMA. 2007;298(4):413-422.
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