Using the RAND™/UCLA Appropriateness Method (RAM), a multispecialty expert panel established a comprehensive clinical care pathway for VCF management.
This framework is intended to guide clinicians in making informed and reasoned VCF management decisions. The pathway may be used in many healthcare settings and may be helpful to reduce undesirable practice variations and improve quality of care.1
The VCF clinical care pathway includes guidance on:
Watch Dr. Joshua Hirsch and Elizabeth Thompson of the National Osteoporosis Foundation discuss the benefits of personalized care using the VCF care pathway.
RAM provides a highly structured approach to produce patient-specific recommendations by combining best available scientific evidence with the collective judgment of a panel of experts.
This project was supported by a grant from Medtronic. However, Medtronic was not involved in the design or execution of the project, nor the preparation and review of this manuscript. Names of panel members were not disclosed to the sponsor, and panel members were not informed about the identity of the sponsor before submission of the manuscript.
Limitation: Double-blinded doesn’t mitigate that the panel process was subjective input. It included strict adherence by the multidisciplinary experts to adopt the RAND methodology process, based on published clinical evidence and expertise.
Hirsch JA, Beall DP, Chambers MR et al. Management of vertebral fragility fractures: a clinical care pathway developed by a multispecialty panel using the RAND/UCLA Appropriateness Method. Spine J. 2018 Nov;18(11):2152-2161. doi: 10.1016/j.spinee.2018.07.025.