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The Medical Literature
August 25, 1999

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

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.