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Vitamin D supplementation and falls: a trial sequential meta-analysis.

The lancet. Diabetes & endocrinology
July 1, 2014
Mark J Bolland et al. (4 authors)
Journal ArticleMeta-AnalysisHuman Study
Study Details

Study Goal

The researchers aimed to determine whether vitamin D supplementation, with or without calcium, reduces the risk of falls by at least 15%.

Results Summary

The study found that vitamin D supplementation, with or without calcium, does not reduce falls by 15% or more, and further trials are unlikely to change this conclusion.

Population

Adults (n=29,535) across 20 randomized controlled trials.

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (3)
InterventionDirectionEndpointPopulationDosageImpactClaim #
vitamin D supplements
no change
falls
participants in 20 existing randomised controlled trials
15% or more
does not alter the relative risk by 15% or more
#1
vitamin D supplementation
no change
falls
-
15% or more
does not reduce falls by 15% or more
#2
vitamin D with calcium
no change
falls
-
15% or more
does not reduce falls by 15% or more
#3
Abstract

BACKGROUND: Vitamin D supplementation is often recommended to prevent falls, although vitamin D trials and meta-analyses of these trials have reported conflicting results for this outcome. We aimed to assess if there was a need for further research. METHODS: We explored the value of doing further randomised controlled trials assessing the effects of vitamin D supplements on falls with trial sequential analysis with a risk reduction threshold of 15%. All analyses were done using the numbers of participants who had a fall in intention-to-treat analyses. Trial sequential analysis performs a cumulative meta-analysis, but reduces the risk of false-positive results from repetitive statistical testing by maintaining the overall risk of type 1 error at 5%. FINDINGS: In 20 existing randomised controlled trials (n=29,535), the effect estimate for vitamin D with or without calcium on falls lay within the futility boundary, providing evidence that vitamin D supplementation does not alter the relative risk by 15% or more. In a sensitivity analysis using a risk reduction threshold of 10%, the effect estimate also lay within the futility boundary. In subgroup analyses using a risk reduction threshold of 15%, the effect estimate also lay within the futility boundary for trials of vitamin D supplementation (16 trials, n=22,291) and trials of vitamin D with calcium (six trials, n=9919). INTERPRETATION: In pooled analyses, supplementation with vitamin D, with or without calcium, does not reduce falls by 15% or more. Future trials with similar designs are unlikely to alter these conclusions. At present, there is little justification for prescribing vitamin D supplements to prevent falls. FUNDING: Health Research Council of New Zealand.

Medical Subject Headings (MeSH)
Accidental FallsAgedAged, 80 and overCalcium, DietaryDietary SupplementsFemaleHumansMaleRandomized Controlled Trials as TopicVitamin D
Study Links
Quality Scores
SafetyNot Assessed
Efficacy20/10
Quality85/10
Citation Metrics
Total Citations117
Citations/Year10.6
Relative Citation Ratio4.74
NIH Percentile92.4%
Research Impact Scores
APT Score0.95
Weight Score1.92
Normalized Score0.45
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