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Open AccessReview

Design Features of Randomized Clinical Trials of Vitamin D and Falls: A Systematic Review

by Olive Tang 1,2, Stephen P. Juraschek 1,2,3,4,5 and Lawrence J. Appel 1,2,3,4,5,*
1
Johns Hopkins School of Medicine, Baltimore, MD 21287, USA
2
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21287, USA
3
The Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD 21287, USA
4
Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
5
Harvard Medical School, Boston, MA 02115, USA
*
Author to whom correspondence should be addressed.
Nutrients 2018, 10(8), 964; https://doi.org/10.3390/nu10080964
Received: 1 June 2018 / Revised: 20 July 2018 / Accepted: 24 July 2018 / Published: 26 July 2018
Recent guidelines have advocated against the use of vitamin D supplementation as a means to prevent falls in older adults. However, meta-analyses of the available trials have reached divergent conclusions, and the key design features of these trials have not been well characterized. We conducted a systematic review of 30 randomized trials that reported the effects of vitamin D supplements on falls. Trials were identified by reviewing references of published meta-analyses and updated with a systematic PubMed search. We assessed three key design features: (1) recruitment of participants with vitamin D deficiency or insufficiency; (2) provision of daily oral vitamin D supplementation; and (3) utilization of highly sensitive at-event falls ascertainment. The trials enrolled a median of 337 (IQR: 170-1864) participants. Four (13.3%) trials restricted enrollment to those who were at least vitamin D insufficient, 18 (60.0%) included at least one arm providing daily supplementation, and 16 (53.3%) used at-event reporting. There was substantial heterogeneity between trials, and no single trial incorporated all three key design features. Rather than concluding that vitamin D is ineffective as a means to prevent falls, these findings suggest that existing trial evidence is insufficient to guide recommendations on the use of vitamin D supplements to prevent falls. View Full-Text
Keywords: vitamin D; falls prevention; trials vitamin D; falls prevention; trials
MDPI and ACS Style

Tang, O.; Juraschek, S.P.; Appel, L.J. Design Features of Randomized Clinical Trials of Vitamin D and Falls: A Systematic Review. Nutrients 2018, 10, 964.

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