Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
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.2- 4 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.
Bulat T, Quigley P. External Hip Protectors and Risk of Hip Fracture—Reply. JAMA. 2003;290(7):883. doi:10.1001/jama.290.7.883-a