Table 3.
Responses to Knowledge Questions by Postgraduate Year (PGY)
| Item no. | Topic | Response a | Prevalence of selecting response (n [%]) | |||
|---|---|---|---|---|---|---|
| Overall sample (n = 578) | PGY <3 (n = 393) | PGY ≥3 (n = 185) | p Value b | |||
| 1 | T‐score threshold for diagnosis of osteoporosis | T‐score ≤ −2.5 | 444 (77%) | 302 (77%) | 142 (77%) | 0.98 |
| T‐score < −1 | 8 (1%) | 6 (2%) | 2 (1%) | |||
| Z‐score < −1 | 1 (0%) | 0 (0%) | 1 (1%) | |||
| Z‐score < −2.5 | 124 (21%) | 84 (21%) | 40 (22%) | |||
| Missing | 1 (0%) | 1 (0%) | 0 (0%) | |||
| 2 | Prevalence of osteoporosis‐related fractures in older women | 10% | 128 (22%) | 80 (20%) | 48 (26%) | |
| 20% | 358 (62%) | 251 (64%) | 107 (58%) | |||
| 50% | 90 (16%) | 60 (15%) | 30 (16%) | 0.77 | ||
| Missing | 2 (0%) | 2 (1%) | 0 (0%) | |||
| 3 | Mortality after hip fracture | Greater in women than in men | 372 (64%) | 248 (63%) | 124 (67%) | |
| Greater in men than in women | 57 (10%) | 37 (9%) | 20 (11%) | 0.6 | ||
| Equal in men and women | 148 (26%) | 107 (27%) | 41 (22%) | |||
| Missing | 1 (0%) | 1 (0%) | 0 (0%) | |||
| 4 | Proportion of hip fracture patients who regain pre‐fracture level of independence | 5% | 185 (32%) | 121 (31%) | 64 (35%) | |
| 20% | 273 (47%) | 186 (47%) | 87 (47%) | |||
| 40% | 119 (21%) | 85 (22%) | 34 (18%) | 0.37 | ||
| Missing | 1 (0%) | 1 (0%) | 0 (0%) | |||
| 5 | Age to begin routine bone density screening in women (United States Preventive Services Task Force) | When they begin their menopausal transition | 9 (2%) | 8 (2%) | 1 (1%) | |
| One year after the menopausal transition | 33 (6%) | 22 (6%) | 11 (6%) | |||
| At age 65 years | 468 (81%) | 311 (79%) | 157 (85%) | 0.1 | ||
| At age 50 years | 65 (11%) | 50 (13%) | 15 (8%) | |||
| Missing | 3 (1%) | 2 (1%) | 1 (1%) | |||
| 6 | Osteoporosis screening in men (United States Preventive Services Task Force) | Screen beginning at age 50 years | 10 (2%) | 6 (2%) | 4 (2%) | |
| Screen beginning at age 70 years | 77 (13%) | 52 (13%) | 25 (14%) | |||
| Insufficient evidence to recommend for or against screening | 430 (74%) | 292 (74%) | 138 (75%) | 0.94 | ||
| None of the above | 60 (10%) | 42 (11%) | 18 (10%) | |||
| Missing | 1 (0%) | 1 (0%) | 0 (0%) | |||
| 7 | Minimal‐trauma hip fracture is diagnostic of osteoporosis | Osteoporosis | 116 (20%) | 62 (16%) | 54 (29%) | <0.001 |
| Osteopenia | 39 (7%) | 30 (8%) | 9 (5%) | |||
| Unclear, requires further studies | 422 (73%) | 300 (76%) | 122 (66%) | |||
| Missing | 1 (0%) | 1 (0%) | 0 (0%) | |||
| 8 | Osteoporosis medications demonstrated in clinical trials to decrease hip fracture risk | Calcitonin | 30 (5%) | 25 (6%) | 5 (3%) | |
| Raloxifene | 229 (40%) | 152 (39%) | 77 (42%) | |||
| Abaloparatide | 109 (19%) | 69 (18%) | 40 (22%) | |||
| None of the above | 209 (36%) | 146 (37%) | 63 (34%) | 0.47 | ||
| Missing | 1 (0%) | 1 (0%) | 0 (0%) | |||
| 9 | First‐line therapy for osteoporosis (American College of Physicians guidelines) | Raloxifene | 139 (24%) | 103 (26%) | 36 (19%) | |
| Estrogen therapy | 27 (5%) | 20 (5%) | 7 (4%) | |||
| Calcitonin | 25 (4%) | 18 (5%) | 7 (4%) | |||
| None of the above | 386 (67%) | 251 (64%) | 135 (73%) | 0.03 | ||
| Missing | 1 (0%) | 1 (0%) | 0 (0%) | |||
| 10 | Optimal duration of osteoporosis pharmacotherapy | Optimal duration of treatment is unclear | 364 (63%) | 239 (61%) | 125 (68%) | 0.12 |
| Treatment duration is usually 10 years | 93 (16%) | 70 (18%) | 23 (12%) | |||
| Adverse effects are not duration‐dependent | 41 (7%) | 30 (8%) | 11 (6%) | |||
| None of the above | 78 (13%) | 52 (13%) | 26 (14%) | |||
| Missing | 2 (0%) | 2 (1%) | 0 (0%) | |||
| 11 | Drug holiday definition | A switch from one osteoporosis medication to another | 9 (2%) | 7 (2%) | 2 (1%) | |
| A temporary discontinuation of pharmacotherapy | 445 (77%) | 307 (78%) | 138 (75%) | 0.35 | ||
| All of the above | 123 (21%) | 78 (20%) | 45 (24%) | |||
| Missing | 1 (0%) | 1 (0%) | 0 (0%) | |||
| 12 | Most rapid bone density decline after discontinuation | Denosumab | 231 (40%) | 164 (42%) | 67 (36%) | 0.21 |
| Risedronate | 78 (13%) | 54 (14%) | 24 (13%) | |||
| Alendronate | 264 (46%) | 170 (43%) | 94 (51%) | |||
| Missing | 5 (1%) | 5 (1%) | 0 (0%) | |||
| 13 | Medications associated with osteonecrosis of the jaw | Denosumab | 107 (19%) | 80 (20%) | 27 (15%) | |
| Alendronate | 383 (66%) | 260 (66%) | 123 (66%) | |||
| All of the above | 87 (15%) | 52 (13%) | 35 (19%) | 0.07 | ||
| Missing | 1 (0%) | 1 (0%) | 0 (0%) | |||
| 14 | Characteristics of bisphosphonate‐associated atypical femoral fractures | They are associated with use of raloxifene | 47 (8%) | 32 (8%) | 15 (8%) | |
| They are duration‐dependent | 242 (42%) | 171 (44%) | 71 (38%) | 0.24 | ||
| They occur in 10% of patients | 157 (27%) | 108 (27%) | 49 (26%) | |||
| None of the above | 127 (22%) | 78 (20%) | 49 (26%) | |||
| Missing | 5 (1%) | 4 (1%) | 1 (1%) | |||
a
Boldface indicates correct responses.
b
The p values are calculated using chi‐square tests for comparison of correct answers between PGY <3 and PGY ≥3 residents.