{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T19:39:29Z","timestamp":1776713969719,"version":"3.51.2"},"reference-count":18,"publisher":"BMJ","issue":"2","funder":[{"DOI":"10.13039\/501100001505","name":"Health Research Council of New Zealand","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001505","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,1,23]]},"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The accuracy of patients' perception of risk is important for decisions about treatment in many diseases. We framed the risk of fracture and benefits of treatment in different ways and assessed the impact on patients' perception of fracture risk and intentions to take medication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Randomised trial of 4 different presentations of fracture risk and likely benefits from osteoporosis treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Academic centre.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>200 patients undergoing bone densitometry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>Presentation that framed the patient's absolute fracture risk either as the chance of having or not having an event, with their likely benefits from osteoporosis treatment in natural frequencies or numbers needed to treat.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes<\/jats:title>\n                    <jats:p>Participants' views about their fracture risk and the need for osteoporosis treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median 5-year fracture risk threshold participants regarded as high enough to consider preventative medication was 50\u201360%, and did not change substantially after the presentation. The median (Q1, Q3) 5-year risk initially estimated by participants was 20% (10, 50) for any fracture and 19% (10, 40) for hip fracture. 61% considered their fracture risk was low or very low, and 59\u201367% considered their fracture risk was lower than average. These participant estimates were 2\u20133 times higher than Garvan calculator estimates for any fracture, and 10\u201320 times higher for hip fracture. Participant estimates of fracture risk halved after the presentation, but remained higher than the Garvan estimates (1.5\u20132 times for any fracture, 5\u201310 times for hip fracture). There was no difference in these outcomes between the randomised groups. Participants' intentions about taking medication to prevent fractures were not substantially affected by receiving information about fracture risk and treatment benefits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Altering the framing of estimated fracture risks and treatment benefits had little effect on participants' perception of the need to take treatment or their individual fracture risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>ACTRN12613001081707; Pre-results.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-013703","type":"journal-article","created":{"date-parts":[[2017,2,10]],"date-time":"2017-02-10T20:40:29Z","timestamp":1486759229000},"page":"e013703","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Randomised trial assessing the impact of framing of fracture risk and osteoporosis treatment benefits in patients undergoing bone densitometry"],"prefix":"10.1136","volume":"7","author":[{"given":"Rama","family":"Kalluru","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Auckland, Auckland, New Zealand"},{"name":"Department of Rheumatology, Greenlane Clinical Centre, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith J","family":"Petrie","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine, University of Auckland, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Grey","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Auckland, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zaynah","family":"Nisa","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Auckland, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne M","family":"Horne","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Auckland, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Greg D","family":"Gamble","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Auckland, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark J","family":"Bolland","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Auckland, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,2,10]]},"reference":[{"key":"2025121600124499000_7.2.e013703.1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.320.7236.659"},{"key":"2025121600124499000_7.2.e013703.2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-0926"},{"key":"2025121600124499000_7.2.e013703.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2008.11.022"},{"key":"2025121600124499000_7.2.e013703.4","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i2452"},{"key":"2025121600124499000_7.2.e013703.5","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7417.741"},{"key":"2025121600124499000_7.2.e013703.6","doi-asserted-by":"publisher","DOI":"10.7326\/M14-0295"},{"key":"2025121600124499000_7.2.e013703.7","doi-asserted-by":"publisher","DOI":"10.1197\/jamia.M2115"},{"key":"2025121600124499000_7.2.e013703.8","doi-asserted-by":"crossref","unstructured":"Akl EA , Oxman AD , Herrin J , et al . Using alternative statistical formats for presenting risks and risk reductions. Cochrane Database Syst Rev 2011;(3):CD006776. doi:10.1002\/14651858.CD006776.pub2","DOI":"10.1002\/14651858.CD006776.pub2"},{"key":"2025121600124499000_7.2.e013703.9","doi-asserted-by":"crossref","unstructured":"Akl EA , Oxman AD , Herrin J , et al . Framing of health information messages. Cochrane Database Syst Rev 2011;(12):CD006777. doi:10.1002\/14651858.CD006777.pub2","DOI":"10.1002\/14651858.CD006777.pub2"},{"key":"2025121600124499000_7.2.e013703.10","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e3996"},{"key":"2025121600124499000_7.2.e013703.11","doi-asserted-by":"crossref","unstructured":"Stacey D , Bennett CL , Barry MJ , et al . Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev 2011;(10):CD001431. doi:10.1002\/14651858.CD001431.pub3","DOI":"10.1002\/14651858.CD001431.pub3"},{"key":"2025121600124499000_7.2.e013703.12","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-011-1823-7"},{"key":"2025121600124499000_7.2.e013703.13","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1007\/s12160-015-9702-7","article-title":"The relationship of perceived risk and biases in perceived risk to fracture prevention behavior in older women","volume":"49","author":"Jones","year":"2015","journal-title":"Ann Behav Med"},{"key":"2025121600124499000_7.2.e013703.14","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1007\/s00198-014-2936-6","article-title":"Self-perceived facture risk: factors underlying women's perception of risk for osteoporotic fractures: the Risk-Stratified Osteoporosis Strategy Evaluation study (ROSE)","volume":"26","author":"Rothmann","year":"2015","journal-title":"Osteoporos Int"},{"key":"2025121600124499000_7.2.e013703.15","doi-asserted-by":"publisher","DOI":"10.1126\/science.2686031"},{"key":"2025121600124499000_7.2.e013703.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2011.01.013"},{"key":"2025121600124499000_7.2.e013703.17","doi-asserted-by":"publisher","DOI":"10.1037\/1089-2680.2.2.175"},{"key":"2025121600124499000_7.2.e013703.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2007.08.008"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2016-013703","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T08:12:55Z","timestamp":1765872775000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2016-013703"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,2]]},"references-count":18,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2017,2,10]]},"published-print":{"date-parts":[[2017,2]]}},"alternative-id":["10.1136\/bmjopen-2016-013703"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2016-013703","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,2]]}}}