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Deborah R. Shapiro, DrPH; Arthur C. Santora II, MD, PhD
Merck Research Laboratories Rahway, NJ

David B. Karpf, MD
Roche Global Development Palo Alto, Calif

JAMA. 1997;278(8):631-632.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—Dr Ross has expressed several concerns about the meta-analysis that we believe are not justified. Our article states that data were derived from all studies of the treatment of osteoporosis with oral alendronate that were of at least 2 years' duration and were completed in 1995 when the analysis was performed—no eligible studies were excluded. Alendronate, a proprietary drug, was not marketed at the time the meta-analysis was conducted; therefore we are certain there were no other data. Ross states that there is no evidence that a review protocol was written a priori. As we reported, the decision to conduct a meta-analysis of nonvertebral fracture was post hoc (originally undertaken in response to regulatory agencies); however, the conservative analytical ground rules were defined a priori (before the examination of fracture data). We did not restrict the analysis to patients receiving the optimal dose or to a high-risk subpopulation that may . . . [Full Text PDF of this Article]

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