Efficacy of a Computerized Therapeutic Decision-Making Algorithm in a Fracture Liaison Service Targeting Hip Fracture Patients

Rosenblum, Rachel Chava; Kogan, Arthur; Herzberg, Dana; Najjar, Maysara; Hershkovich, Oded; Twito, Orit; Lotan, Raphael

doi:10.3390/jcm14197062

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Efficacy of a Computerized Therapeutic Decision-Making Algorithm in a Fracture Liaison Service Targeting Hip Fracture Patients

by

Rachel Chava Rosenblum

^1,2

,

Arthur Kogan

³,

Dana Herzberg

^1,2,

Maysara Najjar

^1,2,

Oded Hershkovich

^2,3,*

,

Orit Twito

^1,2,† and

Raphael Lotan

^2,3,†

¹

Endocrinology Unit, Wolfson Medical Center, Holon 58100, Israel

²

The Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 69978, Israel

³

Orthopedic Department, Wolfson Medical Center, Holon 58100, Israel

^*

Author to whom correspondence should be addressed.

^†

These authors contribute equally to this work.

J. Clin. Med. 2025, 14(19), 7062; https://doi.org/10.3390/jcm14197062

Submission received: 12 August 2025 / Revised: 27 September 2025 / Accepted: 5 October 2025 / Published: 6 October 2025

(This article belongs to the Section Geriatric Medicine)

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Abstract

Introduction: This study evaluates the efficacy of a nurse practitioner-managed, computer algorithm-supported institutional fracture liaison service (FLS) that provides treatment recommendations for patients with hip fractures. Methods: A retrospective study included patients hospitalized in the Orthopedic ward with hip fractures between April 1 and October 31. The decision-making algorithm recommends zoledronic acid as the default medication, except for patients younger than 65 years, with estimated glomerular filtration rate (eGFR) <35 or prior osteoporosis therapy, who are ordered to undergo endocrinology consultation. Patients with vitamin D deficiency/insufficiency are given a loading dose. Results: Two hundred and eight hip fracture patients were identified. The cohort was predominantly female (137/208, 65.9%); the mean age was 79.9 ± 9.6 years. Nurse practitioner evaluation was performed in 200/208 patients (96.2%). The algorithm provided a treatment recommendation in 140 out of 200 (70.0%), while 60 out of 200 (30.0%) required an endocrinology consultation. A Vitamin D loading dose was given in 89/99 (89.9%) deficiency and 44/62 (71.0%) insufficiency cases. Conclusions: This simplified algorithm-based FLS model demonstrated practicality and feasibility in providing therapeutic recommendations with minimal physician intervention.

Keywords: osteoporosis; hip fracture; fracture liaison service; Vitamin D

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MDPI and ACS Style

Rosenblum, R.C.; Kogan, A.; Herzberg, D.; Najjar, M.; Hershkovich, O.; Twito, O.; Lotan, R. Efficacy of a Computerized Therapeutic Decision-Making Algorithm in a Fracture Liaison Service Targeting Hip Fracture Patients. J. Clin. Med. 2025, 14, 7062. https://doi.org/10.3390/jcm14197062

AMA Style

Rosenblum RC, Kogan A, Herzberg D, Najjar M, Hershkovich O, Twito O, Lotan R. Efficacy of a Computerized Therapeutic Decision-Making Algorithm in a Fracture Liaison Service Targeting Hip Fracture Patients. Journal of Clinical Medicine. 2025; 14(19):7062. https://doi.org/10.3390/jcm14197062

Chicago/Turabian Style

Rosenblum, Rachel Chava, Arthur Kogan, Dana Herzberg, Maysara Najjar, Oded Hershkovich, Orit Twito, and Raphael Lotan. 2025. "Efficacy of a Computerized Therapeutic Decision-Making Algorithm in a Fracture Liaison Service Targeting Hip Fracture Patients" Journal of Clinical Medicine 14, no. 19: 7062. https://doi.org/10.3390/jcm14197062

APA Style

Rosenblum, R. C., Kogan, A., Herzberg, D., Najjar, M., Hershkovich, O., Twito, O., & Lotan, R. (2025). Efficacy of a Computerized Therapeutic Decision-Making Algorithm in a Fracture Liaison Service Targeting Hip Fracture Patients. Journal of Clinical Medicine, 14(19), 7062. https://doi.org/10.3390/jcm14197062

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Efficacy of a Computerized Therapeutic Decision-Making Algorithm in a Fracture Liaison Service Targeting Hip Fracture Patients

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