{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T17:44:40Z","timestamp":1777916680585,"version":"3.51.4"},"reference-count":25,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2009,6,9]],"date-time":"2009-06-09T00:00:00Z","timestamp":1244505600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Med Decis Making"],"published-print":{"date-parts":[[2009,11]]},"abstract":"<jats:p>Purpose. Five years of bisphosphonate treatment have proven efficacy in reducing fractures. Concerns exist that long-term bisphosphonate treatment may actually result in an increased number of fractures. This study evaluates, in the context of England and Wales, whether it is cost-effective to conduct a randomized controlled trial (RCT) and what sample size may be optimal to estimate the efficacy of bisphosphonates in fracture prevention beyond 5 years. Method. An osteoporosis model was constructed to evaluate the cost-effectiveness of extending bisphosphonate treatment from 5 years to 10 years. Two scenarios were run. The 1st uses long-term efficacy data from published literature, and the 2nd uses distributions elicited from clinical experts. Results of a proposed RCT were simulated. The expected value of sample information technique was applied to calculate the expected net benefit of sampling from conducting such an RCT at varying levels of participants per arm and to compare this with proposed trial costs. Results. Without further information, the better duration of bisphosphonate treatment was estimated to be 5 years using the published data but 10 years using the elicited expert opinions, although in both cases uncertainty was substantial. The net benefit of sampling was consistently high when between 2000 and 5000 participants per arm were recruited. Conclusions. An RCT to evaluate the long-term efficacy of bisphosphonates in fracture prevention appears to be cost-effective for informing decision making in England and Wales.<\/jats:p>","DOI":"10.1177\/0272989x09336077","type":"journal-article","created":{"date-parts":[[2009,6,9]],"date-time":"2009-06-09T23:13:31Z","timestamp":1244589211000},"page":"678-689","source":"Crossref","is-referenced-by-count":17,"title":["The Cost-Effectiveness of an RCT to Establish Whether 5 or 10 Years of Bisphosphonate Treatment Is the Better Duration for Women With a Prior Fracture"],"prefix":"10.1177","volume":"29","author":[{"given":"Matt D.","family":"Stevenson","sequence":"first","affiliation":[{"name":"School of Health and Related Research, University of Sheffield, Sheffield, UK,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy E.","family":"Oakley","sequence":"additional","affiliation":[{"name":"Department of Probability and Statistics, University of Sheffield, Sheffield, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myfawny","family":"Lloyd Jones","sequence":"additional","affiliation":[{"name":"School of Health and Related Research, University of Sheffield, Sheffield, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Brennan","sequence":"additional","affiliation":[{"name":"School of Health and Related Research, University of Sheffield, Sheffield, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juliet E.","family":"Compston","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Cambridge, School of Clinical Medicine and Addenbrooke's NHS Trust, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugene V.","family":"McCloskey","sequence":"additional","affiliation":[{"name":"Academic Unit of Bone Metabolism, Metabolic Bone Centre, University of Sheffield, Sheffield, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter L.","family":"Selby","sequence":"additional","affiliation":[{"name":"Department of Medicine, Manchester Royal Infirmary, Oxford Road, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2009,6,9]]},"reference":[{"key":"atypb1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(91)90512-V"},{"key":"atypb2","doi-asserted-by":"publisher","DOI":"10.1007\/s001980050281"},{"key":"atypb3","doi-asserted-by":"publisher","DOI":"10.3310\/hta11040"},{"key":"atypb4","unstructured":"National Institute for Health and Clinical Excellence. The Clinical Effectiveness and Cost Effectiveness of Technologies for the Secondary Prevention of Osteoporotic Fractures in Postmenopausal Women. Available from: http:\/\/guidance.nice.org.uk\/TA87 . 5."},{"key":"atypb5","volume-title":"Osteoporosis--Secondary Prevention (Final Appraisal Determination)","author":"National Institute for Health and Clinical Excellence.","year":"2007"},{"key":"atypb6","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-0952"},{"key":"atypb7","doi-asserted-by":"publisher","DOI":"10.3310\/hta9220"},{"key":"atypb8","volume-title":"Guide to the Methods of Technology Appraisals","author":"National Institute for Health and Clinical Excellence.","year":"2008"},{"key":"atypb9","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.316.7133.736"},{"key":"atypb10","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-003-1463-7"},{"key":"atypb11","volume-title":"Interim Life Tables","author":"The Government Actuary Department.","year":"2007"},{"key":"atypb12","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.2000.15.4.721"},{"key":"atypb13","volume-title":"Matt Stevenson BSc (Lancaster), PhD (Lancaster)","author":"University of Sheffield."},{"key":"atypb14","volume-title":"Electronic Drug Tariff","author":"National Health Service England and Wales.","year":"2007"},{"key":"atypb15","volume-title":"Analyses of the cost-effectiveness of pooled alendronate and risedronate, compared with strontium ranelate, raloxifene, etidronate and teriparatide","author":"Stevenson M.","year":"2006"},{"key":"atypb16","doi-asserted-by":"publisher","DOI":"10.1383\/wohm.2006.3.4.149"},{"key":"atypb17","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-003-1516-y"},{"key":"atypb18","doi-asserted-by":"publisher","DOI":"10.1001\/jama.296.24.2927"},{"key":"atypb19","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)07088-2"},{"key":"atypb20","unstructured":"British National Formulary. BNF 54 http:\/\/www.bnf.org\/bnf\/ bnf\/54\/36237.htm?q = %22alendronate%22. Accessed January 2008. 21. O\u2019Hagan A, Buck CE, Daneshkhah A, et al. Uncertain Judgements: Eliciting Experts\u2019 Probabilities. Chichester, UK: John Wiley and Sons; 2006."},{"key":"atypb21","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X04263162"},{"key":"atypb22","volume-title":"A two level Monte Carlo approach to calculation expected value of sample information: how to value a research design [Discussion paper]","author":"Brennan A.","year":"2002"},{"key":"atypb23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2006.06.002"},{"key":"atypb24","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X98018002S09"},{"key":"atypb25","volume-title":"Adverse events and persistence with therapy in patients taking oral alendronate, etidronate or risedronate: systematic reviews","author":"Lloyd Jones M.","year":"2006"}],"container-title":["Medical Decision Making"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0272989X09336077","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0272989X09336077","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T17:54:08Z","timestamp":1777658048000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0272989X09336077"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,6,9]]},"references-count":25,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2009,11]]}},"alternative-id":["10.1177\/0272989X09336077"],"URL":"https:\/\/doi.org\/10.1177\/0272989x09336077","relation":{},"ISSN":["0272-989X","1552-681X"],"issn-type":[{"value":"0272-989X","type":"print"},{"value":"1552-681X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,6,9]]}}}