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. Author manuscript; available in PMC: 2017 Sep 1.
Published in final edited form as: J Am Med Dir Assoc. 2016 Jun 24;17(9):852–859. doi: 10.1016/j.jamda.2016.05.011

Table 1.

Consensus Process and Methods

Aim: To update previous recommendations for the clinical management of osteoporosis in residential aged care facilities.12
Source: The participants included experts in the field of osteoporosis, geriatric medicine, and rehabilitation (n = 5) who acted as moderators of the small groups and as speakers at the plenary sessions. In addition, geriatricians and general practitioners practicing at the residential aged care level (n = 45) from all over Australia acted as participants at the workshops and plenary sessions.
Methods: A search of peer-reviewed journals was conducted using MEDLINE (1966–15 November 2014). Relevant articles were identified using combinations of the subject headings “osteoporosis,” “nursing homes,” “residential care,” “long-term care,” “fractures,” “fracture prevention,” “calcium,” “vitamin D,” “bisphosphonates,” “antiresorptives,” “denosumab,” “strontium ranelate,” “teriparatide,” “hip protectors,” “falls,” and “falls prevention.”
Levels of evidence: Articles retrieved were graded according to their level of evidence based on the NHMRC levels of evidence:
Level I: A systematic review of level II studies
Level II: A randomized controlled trial
Level III-1: A pseudorandomized controlled trial (ie, alternate allocation or some other method)
Level III-2: A comparative study with concurrent controls:

  • Nonrandomized, experimental trial

  • Cohort study

  • Case-control study

  • Interrupted time series with a control group

Level III-3: A comparative study without concurrent controls:

  • Historical control study

  • Two or more single-arm study

  • Interrupted time series without a parallel control group

Level IV: Case series with either posttest of pretest/posttest outcomes
When an NHMRC level of evidence for a clinically relevant aspect of fracture and fall prevention in the aged cared residential setting was lacking, consensus expert opinion (designated evidence V) was applied.
Final recommendations: Comments from all participants (experts and participants) on the draft position statement were received and considered. Final clinical recommendations were prepared by the small groups and approved at the final plenary.

NHMRC, National Health and Medical Research Council.