There are not any intentions to include people in dissemination
Patient wedding
No people was employed in mode the analysis concern or perhaps the benefit tips, nor have been it mixed up in construction and utilization of the fresh new investigation.
Investigation solutions
Provided knowledge was randomised controlled products when you look at the players aged >50 at the standard that have BMD measured because of the twin times x-ray absorptiometry (DXA) or forerunner technology particularly photon absorptiometry. I incorporated knowledge that advertised limbs nutrient stuff (BMC) as BMD was gotten by the isolating BMC by limbs city and you can while the several try extremely coordinated. Training where really participants at baseline had a major systemic cystic apart from osteoporosis, including renal incapacity otherwise most cancers, was indeed excluded. I integrated training of calcium supplements used with other medication provided others cures received to both arms (such calcium in addition to supplement K instead of placebo along with supplement K), and degree regarding co-administered calcium supplements and you can vitamin D products (CaD). Randomised regulated examples off hydroxyapatite as the a dietary way to obtain calcium had been incorporated since it is produced from bones possesses most other nutrients, hormone, proteins, and you will proteins and calcium supplements. One to author (WL otherwise MB) processed titles and you may abstracts, and two experts (WL, MB, or VT) individually processed a full text off possibly related education. The brand new move out of posts was found for the shape A beneficial for the appendix 2.
Study removal and you will synthesis
I extracted advice regarding for each study on participants’ services, investigation structure, resource origin and you can issues interesting, and BMD on lumbar back, femoral neck, total hip, forearm, and you can full body. BMD can be measured from the multiple web sites about forearm, as the 33% (1/3) distance is mostly put. Per research, we utilized the said investigation with the forearm, aside from site. In the event the multiple webpages try reported, i used the data towards the web site closest to your 33% distance. A single creator (VT) extracted studies, which were featured because of the a second author (MB). Threat of prejudice are analyzed just like the necessary on Cochrane Manual.11 Any inaccuracies have been fixed courtesy dialogue.
The primary endpoints were the percentage changes in BMD from baseline at the five BMD sites. We categorised the studies into three groups by duration: one year was duration <18 months; two years was duration ?18 months and ?2.5 years; and others were studies lasting more than two and a half years. For studies that presented absolute data rather than percentage change from baseline, we calculated the mean percentage change from the raw data and the standard deviation of the percentage change using the approach described in the Cochrane Handbook.11 When data were presented only in figures, we used digital callipers to extract data. In four studies that reported mean data but not measures of spread,12 13 14 15 we imputed the standard deviation for the percentage change in BMD for each site from the average site and duration specific standard deviations of all other studies included in our review. We prespecified subgroup analyses based on the following variables: dietary calcium intake v calcium supplements; risk of bias; calcium monotherapy v CaD; baseline age (<65); sex; community v institutionalised participants; baseline dietary calcium intake <800 mg/day; baseline 25-hydroxyvitamin D <50 nmol/L; calcium dose (?500 v >500 mg/day and <1000 v ?1000 mg/day); and vitamin D dose <800 IU/day.
Statistics
We pooled the data using random effects meta-analyses and assessed for heterogeneity between studies using the I 2 statistic (I 2 >50% was considered significant heterogeneity). Funnel plots and Egger’s regression model were used to assess for the likelihood of systematic bias. We included randomised controlled trials of calcium with or without vitamin D in the primary analyses. Randomised controlled trials in which supplemental vitamin D was provided to both treatment groups, so that the groups differed only in treatment by calcium, were included in calcium monotherapy subgroup analyses, while those comparing co-administered CaD with placebo or controls were included in the CaD subgroup analyses. We included all available data from trials with factorial designs or multiple arms. Thus, for factorial randomised controlled trials we included all study arms involving a comparison of calcium versus no calcium in the primary analyses and the calcium monotherapy subgroup analysis, but only arms comparing CaD with controls in the CaD subgroup analysis. For multi-arm randomised controlled trials, we pooled data from the separate treatment arms for the primary analyses, but each treatment arm was used only once. We undertook analyses of prespecified subgroups using a random effects model when there were 10 or more studies in the analysis and three or more studies in each subgroup and performed relations Г l’extГ©rieur a test for interaction between subgroups. All tests were two tailed, and P<0.05 was considered significant. All analyses were performed with Comprehensive Meta-Analysis (version 2, Biostat, Englewood, NJ).
There are not any intentions to include people in dissemination
February 22, 2023
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Patient wedding
No people was employed in mode the analysis concern or perhaps the benefit tips, nor have been it mixed up in construction and utilization of the fresh new investigation.
Investigation solutions
Provided knowledge was randomised controlled products when you look at the players aged >50 at the standard that have BMD measured because of the twin times x-ray absorptiometry (DXA) or forerunner technology particularly photon absorptiometry. I incorporated knowledge that advertised limbs nutrient stuff (BMC) as BMD was gotten by the isolating BMC by limbs city and you can while the several try extremely coordinated. Training where really participants at baseline had a major systemic cystic apart from osteoporosis, including renal incapacity otherwise most cancers, was indeed excluded. I integrated training of calcium supplements used with other medication provided others cures received to both arms (such calcium in addition to supplement K instead of placebo along with supplement K), and degree regarding co-administered calcium supplements and you can vitamin D products (CaD). Randomised regulated examples off hydroxyapatite as the a dietary way to obtain calcium had been incorporated since it is produced from bones possesses most other nutrients, hormone, proteins, and you will proteins and calcium supplements. One to author (WL otherwise MB) processed titles and you may abstracts, and two experts (WL, MB, or VT) individually processed a full text off possibly related education. The brand new move out of posts was found for the shape A beneficial for the appendix 2.
Study removal and you will synthesis
I extracted advice regarding for each study on participants’ services, investigation structure, resource origin and you can issues interesting, and BMD on lumbar back, femoral neck, total hip, forearm, and you can full body. BMD can be measured from the multiple web sites about forearm, as the 33% (1/3) distance is mostly put. Per research, we utilized the said investigation with the forearm, aside from site. In the event the multiple webpages try reported, i used the data towards the web site closest to your 33% distance. A single creator (VT) extracted studies, which were featured because of the a second author (MB). Threat of prejudice are analyzed just like the necessary on Cochrane Manual.11 Any inaccuracies have been fixed courtesy dialogue.
The primary endpoints were the percentage changes in BMD from baseline at the five BMD sites. We categorised the studies into three groups by duration: one year was duration <18 months; two years was duration ?18 months and ?2.5 years; and others were studies lasting more than two and a half years. For studies that presented absolute data rather than percentage change from baseline, we calculated the mean percentage change from the raw data and the standard deviation of the percentage change using the approach described in the Cochrane Handbook.11 When data were presented only in figures, we used digital callipers to extract data. In four studies that reported mean data but not measures of spread,12 13 14 15 we imputed the standard deviation for the percentage change in BMD for each site from the average site and duration specific standard deviations of all other studies included in our review. We prespecified subgroup analyses based on the following variables: dietary calcium intake v calcium supplements; risk of bias; calcium monotherapy v CaD; baseline age (<65); sex; community v institutionalised participants; baseline dietary calcium intake <800 mg/day; baseline 25-hydroxyvitamin D <50 nmol/L; calcium dose (?500 v >500 mg/day and <1000 v ?1000 mg/day); and vitamin D dose <800 IU/day.
Statistics
We pooled the data using random effects meta-analyses and assessed for heterogeneity between studies using the I 2 statistic (I 2 >50% was considered significant heterogeneity). Funnel plots and Egger’s regression model were used to assess for the likelihood of systematic bias. We included randomised controlled trials of calcium with or without vitamin D in the primary analyses. Randomised controlled trials in which supplemental vitamin D was provided to both treatment groups, so that the groups differed only in treatment by calcium, were included in calcium monotherapy subgroup analyses, while those comparing co-administered CaD with placebo or controls were included in the CaD subgroup analyses. We included all available data from trials with factorial designs or multiple arms. Thus, for factorial randomised controlled trials we included all study arms involving a comparison of calcium versus no calcium in the primary analyses and the calcium monotherapy subgroup analysis, but only arms comparing CaD with controls in the CaD subgroup analysis. For multi-arm randomised controlled trials, we pooled data from the separate treatment arms for the primary analyses, but each treatment arm was used only once. We undertook analyses of prespecified subgroups using a random effects model when there were 10 or more studies in the analysis and three or more studies in each subgroup and performed relations Г l’extГ©rieur a test for interaction between subgroups. All tests were two tailed, and P<0.05 was considered significant. All analyses were performed with Comprehensive Meta-Analysis (version 2, Biostat, Englewood, NJ).