Too Fit to Fracture: A Consensus on Future Research Priorities in Osteoporosis and Exercise

Giangregorio et al. (2014) full text summary PDF

For which topic were research priorities identified?


In which location was the research priority setting conducted?

Australia - Australia; Europe - Belgium; Europe - Finland; Europe - Germany; Europe - Switzerland; North America - Canada; North America - USA

Why was it conducted at all?

Osteoporosis-related fractures are a serious source of morbidity and mortality and impose a substantial economic burden. Determining future directions for research in osteoporosis and exercise can inform the design of clinical trials, but may also inform the development of exercise recommendations and facilitate enhanced patient engagement. The Too Fit To Fracture initiative was established to synthesize knowledge around exercise for individuals with osteoporosis with and without osteoporotic vertebral fracture, to establish practice recommendations, and to identify future research priorities.

What was the objective?

to identify future research priorities related to exercise for people with osteoporosis with and without osteoporotic spine fracture via international consensus

What was the outcome?

a list of 4 research topics

How long did the research prioritization take?

No information provided.

Which methods were used to identify research priorities?

focus group; meeting; survey

How were the priorities for research identified exactly?

Step 1: forming expert panel. Step 2: survey: participants were asked: What should our future research priorities be in the area of osteoporosis and exercise? What research questions, if answered, would have a large impact on the field?, participants were thereby asked to consider the need for knowledge, curiosity-driven research needs, gaps in evidence to inform clinical practice and impact of research on policy decisions. Step 3: focus group: during discussion emerging themes/concepts were documented, summarized, and repeated back to participants to confirm that the interpretation was correct, final summary was agreed upon by all participants. Step 4: research priorities consensus meeting: participants were then presented with the research priorities identified, small group discussions by using nominal group technique and small group rankings, small group rankings combined, consensus in plenary session, during last round of small group discussions small groups tasked with identifying strategies to accomplish the research priorities and barriers to research. Step 5: first draft of report circulated to expert panel and all participants for review

Which stakeholders took part?

Researchers, clinicians, patient advocates. Survey: 43 participants: 25 academics, 7 physical therapists, 3 kinesiologists, 3 family physicians, 4 geriatricians, 3 dietitians, 1 rheumatologist, 1 endocrinologist, 1 epidemiologist and health economist, 1 biomechanist, 1 exercise specialist, 1 orthopedic surgeon, 1 nurse practitioner, 1 patient advocate and osteoporosis counselor, and 2 academic trainees. Focus group: 4 patient advocates. Meeting: 33 participants: 18 academics, 6 exercise scientists, 3 family physicians, 1 geriatrician, 2 internal medicine physicians, 6 physical therapists, 3 epidemiologists, 1 endocrinologist, 1 biomechanist, 2 dietitians, 1 medical physicist, 1 health economist, 3 trainees, 1 National Osteoporosis Foundation representative, 1 International Osteoporosis Foundation representative, 1 advocate from the Canadian Osteoporosis Patient Network, and 4 representatives from Osteoporosis Canada.

How were stakeholders recruited?

Researchers and clinicians were identified based on a history of high-quality research on osteoporosis and exercise in older adults or recognized clinical expertise in exercise and osteoporosis. A list of 75 researchers, clinicians, and stakeholder representatives to be invited to participate was agreed upon. Four patient advocates with osteoporosis or vertebral fractures (one male, three females) were identified by the Canadian Osteoporosis Patient Network.

Were stakeholders actively involved or did they just participate?

Stakeholders were mere participants of the research prioritization process; they were not actively involved in the process.