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August 20, 2003

External Hip Protectors and Risk of Hip Fracture—Reply

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;290(7):883. doi:10.1001/jama.290.7.883-a

To the Editor: Ms van Schoor and colleagues1 found that external hip protectors did not decrease the risk of hip fractures among elderly individuals with low bone density and at high risk for fractures. Other studies, however, have found that hip protectors are effective when properly worn.24 We believe that the ethical principle of beneficence demands that research studies should be aimed at improving adherence with use of external hip protectors, which is critical to their effectiveness.5,6 In the study by van Schoor et al, adherence was assessed in a minimal way by random site visits at 1, 6, and 12 months. Furthermore, of the 18 hip fractures in the intervention group, 78% occurred when patients were not wearing hip protectors. Similarly, 77% of the intervention group had either ceased wearing the hip protectors or were lost to follow-up at 12 months.

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