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Centre for Evidence-
Based Medicine

Systematic Reviews: Clinical Scenario

You are referred a 75 year old man with longstanding ulcerative colitis who has been treated with many recurrent courses of oral steroids. He complains of back and hip pain. Plain X-rays show evidence of marked osteoporosis. He asks if there is anything he can do to help his bone problems.

You formulate the question, in a man with steroid-induced osteoporosis, does treatment with bisphosphonates reduce bone pain, fracture rate and improve bone mineral density? You search the Cochrane Library using the terms "steroid" and "osteoporosis" and find the following systematic review: Bisphosphonates for steroid induced osteoporosis (CDSR 1999;issue 1)

Read the article and decide:

  1. Is the evidence from this systematic review valid?
  2. Is this valid evidence from this systematic review important?
  3. Can you apply this valid and important evidence from this systematic review in caring for your patient?

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