Effectiveness of hip protectors

doi:10.1136/bmj.326.7395.930

BMJ 2003;326:930 ( 26 April )

Letters

Effectiveness of hip protectors

Results may not be generalisable to the community

Effectiveness of studied hip protector was uncertain

Some clarifications would be useful

Authors' reply

Results may not be generalisable to the community

The first 150 words of the full text of this article appear below.

EDITOR $---$ The hip protector trial reported by Meyer et al is methodologically a notable improvement on previous hip protectortrials.¹ However, some methodological shortcomings affect thestudy, and issues arise about its generalisability to people athigh risk who are not resident in nursing homes.

An important problem, not noted by the authors, is that the study groups have differential loss to follow up. In the interventiongroup 64% of the participants completed the 18 month follow upcompared with only 57% of the controls (P=0.04). This differencecan introduce selection bias and could give a false estimate ofeffectiveness. In addition, there seems to be some evidence thatthe control group may have been frailer than the interventiongroup as the death rate was somewhat greater and this may haveexplained the higher incidence of falls in the control group.These differences could explain some of the apparent effectiveness. . . [Full text of this article]

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Relevant Article

Effect on hip fractures of increased use of hip protectors in nursing homes: cluster randomised controlled trial: Gabriele Meyer, Andrea Warnke, R Bender, and I Mühlhauser
BMJ 2003 326: 76. [Abstract] [Full Text] [PDF]