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The Medical Literature
August 25, 1999

Users' Guides to the Medical Literature: XIX. Applying Clinical Trial Results
A. How to Use an Article Measuring the Effect of an Intervention on Surrogate End Points

Author Affiliations

Author Affiliations: Medizinische Universitäts-Poliklinik, Kantonsspital Basel, Basel, Switzerland (Dr Bucher); Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario (Drs Guyatt, Cook, and Holbrook); and Division of General Internal Medicine, University of Alberta Hospital, Edmonton (Dr McAlister).


Users' Guides to the Medical Literature Section Editor: Drummond Rennie, MD, Deputy Editor (West), JAMA.

JAMA. 1999;282(8):771-778. doi:10.1001/jama.282.8.771

You are a physician seeing a 62-year-old woman with postmenopausal osteoporosis. Her bone mineral density, as measured by dual-energy x-ray absorptiometry, is 2.5 SDs below the mean value in premenopausal women. Although she does not have back pain, a spinal radiograph shows an old vertebral fracture. The patient has not yet experienced problems as a result of her vertebral fracture, but she is disturbed by the prospect that she may end up like her mother whose osteoporotic fractures have resulted in severe, long-term back pain.