Benefits, Harms, and Costs of Osteoporosis Screening in Male Veterans
Technical Report,30 Sep 2014,29 Sep 2015
Institute for Medical Research Durham United States
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This is a longitudinal cohort study of approximately 5,000,000 screened and non-screened for osteoporosis, older veterans who received care within the VA system during the study period, followed for up to 10 years to measure fracture rates, mortality rates, treatment-related harms, and cost. In the past year variable definitions and data comparisons has been completed. Identification of the screened cohort is complete. The propensity score model has been developed and analysis to estimate the impact of osteoporosis screening and treatment on fracture and mortality rates has been completed. Analyses have begun to determine whether bisphosphonate treatment is associated with a change in fracture rates or mortality. Analysis has begun for treatment-related harms using time to event modeling with receipt of bisphosphonate as the time varying covariate of interest. The process of defining harms variables is complete. Costs will be measured prospectively for all subjects in the cohort, and adjusted for important covariates. A cost differential for screened and unscreened populations will be calculated. To estimate health system costs under varying screening thresholds and conditions we have employed modeling analyses. Cost variables have been defined.