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Related Experiment Videos

Hip protectors decrease hip fracture risk in elderly nursing home residents: a Bayesian meta-analysis.

Anna M Sawka1, Pauline Boulos, Karen Beattie

  • 1Division of Endocrinology and Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada. sawkaam@yahoo.com

Journal of Clinical Epidemiology
|March 10, 2007
PubMed
Summary

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Hip protectors significantly reduce hip fracture risk in elderly nursing home residents. A Bayesian random effects model effectively pooled data from cluster randomized trials (CRTs) and individually randomized trials (IRTs).

Area of Science:

  • Gerontology
  • Biostatistics
  • Epidemiology

Background:

  • Falls and subsequent hip fractures are a major concern for elderly nursing home residents.
  • Existing evidence on the effectiveness of hip protectors is mixed, necessitating robust meta-analytic approaches.

Purpose of the Study:

  • To develop and apply a Bayesian random effects model for meta-analysis of binary outcome data from both cluster randomized trials (CRTs) and individually randomized trials (IRTs).
  • To determine the effectiveness of hip protectors in reducing hip fracture risk among elderly individuals residing in nursing homes.

Main Methods:

  • A systematic literature search was conducted across eight electronic databases.
  • Data from four randomized controlled trials involving 1,922 participants were included, with three trials being CRTs.

Related Experiment Videos

  • A Bayesian random effects model was employed to calculate the pooled mean odds ratio (OR) for hip fracture.

    • Main Results:

    • The pooled odds ratio (OR) for hip fracture among elderly nursing home residents allocated to hip protectors was 0.40 (95% credibility interval [CRI] 0.25, 0.61).
    • The Bayesian model demonstrated robustness across various sensitivity analyses, including alternative intracluster correlation coefficient values.

    Conclusions:

    • The developed Bayesian approach is suitable for meta-analyses combining data from both IRTs and CRTs.
    • Hip protectors are effective in decreasing the risk of hip fracture in this vulnerable population.
    • Potential methodologic limitations of the included trials and a possible herd effect in CRTs warrant consideration.