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El-Rabbany M, Blanas N, Sutherland S, Shah PS, Lam DK, Azarpazhooh A. Development and evaluation of the clinimetric properties of the Medication-Related Osteonecrosis of the Jaw Quality of Life Questionnaire (MRONJ-QoL). Int J Oral Maxillofac Surg 2021; 51:768-775. [PMID: 34924268 DOI: 10.1016/j.ijom.2021.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/10/2021] [Accepted: 11/12/2021] [Indexed: 12/14/2022]
Abstract
The purpose of this study was to develop a self-administered questionnaire (MRONJ-QoL) to assess the quality of life (QoL) of patients with medication-related osteonecrosis of the jaw (MRONJ). A prospective study was performed to develop and evaluate the questionnaire. The MRONJ-QoL was formulated through a review of the literature and interviews of experts and patients. Following development, it was administered to 60 patients with a diagnosis of MRONJ. The sensibility of the questionnaire was assessed by evaluating feasibility (via interviews of patients), face validity (via interviews of patients and experts), and content validity (via evaluation of internal consistency, floor/ceiling effects, and factor analysis). Reliability was evaluated by measuring intra-rater reliability. Construct validity of the questionnaire was evaluated by both cross-sectional and longitudinal comparisons, including comparing scores of the MRONJ-QoL to disease resolution at 6 months. The final MRONJ-QoL questionnaire consisted of 14 questions, demonstrating high internal consistency (Cronbach's alpha of 0.85) and good reliability (weighted kappa score of 0.65). At the 6-month follow-up, disease resolution was found to be significantly associated with improved MRONJ-QoL scores, suggesting validity of the questionnaire (P < 0.01). Therefore, this is a sensible, reliable, and valid questionnaire for evaluating the QoL of patients with MRONJ.
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Affiliation(s)
- M El-Rabbany
- Florida Craniofacial Institute, Tampa, Florida, USA
| | - N Blanas
- Department of Dentistry, Sunnybrook Hospital, Toronto, Ontario, Canada; Department of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - S Sutherland
- Department of Dentistry, Sunnybrook Hospital, Toronto, Ontario, Canada; Department of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - P S Shah
- Department of Pediatrics, Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada; Institute of Health, Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - D K Lam
- Department of Oral and Maxillofacial Surgery, Stony Brook School of Dental Medicine, Stony Brook, New York, USA; Department of Surgery, Stony Brook School of Medicine, Stony Brook, New York, USA; Stony Brook Cancer Center, Stony Brook, New York, USA
| | - A Azarpazhooh
- Department of Dentistry, University of Toronto, Toronto, Ontario, Canada; Divisions of Endodontics and Research, Department of Dentistry, Mount Sinai Hospital, Toronto, Ontario, Canada.
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Konstantelos N, Rzepka AM, Cadarette SM. Fracture outcome definitions in observational osteoporosis drug effects studies: a scoping review protocol. JBI Evid Synth 2021; 20:907-916. [PMID: 34636342 DOI: 10.11124/jbies-20-00509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this review is to describe fracture outcome definitions in observational osteoporosis drug effects studies from Canada and the United States of America. INTRODUCTION Health care administrative data are commonly utilized in pharmacoepidemiologic studies. These data are used to define outcomes, such as fractures, and are critical to determining real-world safety and effectiveness of medications. However, there is no current standard for fracture outcome definitions in observational studies. As a result, fractures are inconsistently defined. To inform future research, a synthesis of how fractures are defined in observational studies using health care administrative claims data is needed. Providing clarity on how fractures are defined will provide guidance for future research. INCLUSION CRITERIA We will include observational studies from the United States and Canada published in English from 2000 to the present that consider the impact of osteoporosis pharmacotherapies on fracture risk and leverage health care administrative data. METHODS This review will follow the three-step JBI methodology for scoping reviews. We will search MEDLINE (Ovid), Embase (Ovid), and CINAHL (EBSCO). Following de-duplication, titles and abstracts will be screened independently by two reviewers. We will then conduct full-text screening for eligible studies. In addition, Canadian and American government pharmacovigilance websites will be searched to identify gray literature. Data extraction will be completed by two reviewers. Results will be presented in figures and tabular form.
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Affiliation(s)
- Natalia Konstantelos
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada ICES, Toronto, ON, Canada Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA WHO Collaborating Center for Governance, Accountability and Transparency in the Pharmaceutical Sector, University of Toronto, Toronto, ON, Canada
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Cadarette SM, Lévesque L, Mamdani M, Perreault S, Juurlink DN, Paterson JM, Carney G, Gunraj N, Hawker GA, Tadrous M, Wong L, Dormuth CR. Comparison of orally administered bisphosphonate drugs in reducing the risk of hip fracture in older adults: a population-based cohort study. CMAJ Open 2013; 1:E97-E105. [PMID: 25077113 PMCID: PMC3986012 DOI: 10.9778/cmajo.20130036] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Orally administered bisphosphonate drugs (i.e., alendronate, etidronate, risedronate) can reduce the risk of vertebral fracture. However, only alendronate and risedronate have proven efficacy in reducing the risk of hip fracture. We sought to examine the comparative effectiveness of orally administered bisphosphonate drugs in reducing hip fractures among older adults. METHODS We identified new users of orally administered bisphosphonate drugs in British Columbia and Ontario between 2001 and 2008. We used province- and sex-specific propensity score-matching strategies to maximize comparability between exposure groups. We used Cox proportional hazards models to compare time-to-hip fracture within 1 year of treatment between exposures by sex in each province. Our secondary analyses considered hip fracture rates within 2 and 3 years' follow-up. We used alendronate as the reference for all comparisons and pooled provincial estimates using random effects variance-weighted meta-analysis. RESULTS We identified 321 755 patients who were eligible for inclusion in the study. We found little difference in fracture rates between men (pooled hazard ratio [HR] 0.94, 95% confidence interval [CI] 0.74-1.14) or women (pooled HR 1.15, 95% CI 0.73-1.56) taking risedronate and those taking alendronate. We similarly identified little difference in fracture rates between women taking etidronate and those taking alendronate (pooled HR 1.00, 95% CI 0.82-1.18). However, we identified lower rates of hip fracture among men taking etidronate relative to alendronate (pooled HR 0.77, 95% CI 0.60-0.94). Results extended to 2 and 3 years' follow-up were similar. However, with 3 years' follow-up, rates of hip fracture were lower among women in British Columbia who had taken alendronate. INTERPRETATION We identified little overall difference between alendronate and risedronate in reducing the risk of hip fracture in men or women. Our finding that etidronate is associated with lower fracture risk among men is likely due to selection bias. The long-term comparative effects of orally administered bisphosphonate drugs warrant further study.
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Affiliation(s)
- Suzanne M. Cadarette
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ont
- Institute for Clinical Evaluative Sciences, Toronto, Ont
| | - Linda Lévesque
- Institute for Clinical Evaluative Sciences, Toronto, Ont
- Department of Community Health and Epidemiology, Queen’s University, Kingston, Ont
| | - Muhammad Mamdani
- Institute for Clinical Evaluative Sciences, Toronto, Ont
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ont
| | | | | | - J. Michael Paterson
- Institute for Clinical Evaluative Sciences, Toronto, Ont
- Department of Family Medicine, McMaster University, Hamilton, Ont
| | - Greg Carney
- Therapeutics Initiative, University of British Columbia, Victoria, BC
| | - Nadia Gunraj
- Institute for Clinical Evaluative Sciences, Toronto, Ont
| | - Gillian A. Hawker
- Institute for Clinical Evaluative Sciences, Toronto, Ont
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ont
| | - Mina Tadrous
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ont
| | - Lindsay Wong
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ont
| | - Colin R. Dormuth
- Therapeutics Initiative, University of British Columbia, Victoria, BC
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