Pragmatic Clinical Trials in Osteoporosis

  • Giovanni Adami
  • Kenneth G. SaagEmail author
  • Maria I. Danila
Quality of Care in Osteoporosis (S Silverman and J Curtis, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Quality of Care in Osteoporosis


Purpose of Review

In this review, we present the application of pragmatic clinical trials for evaluating interventions in osteoporosis, and we discuss methodological considerations for designing and conducting a pragmatic clinical trial compared with a classical randomized clinical trial.

Recent Findings

Pragmatic clinical trials are a popular study design testing effectiveness of health interventions and are intended to address the limitations associated with traditional explanatory randomized clinical trials testing efficacy of interventions. To date, only few pragmatic clinical trials have been conducted in osteoporosis.


Pragmatic clinical trials are conducted under routine clinical practice setting and are intended to inform policy makers and clinical decisions. Osteoporosis is a chronic disease well-suited to this particular study design given the existence of a clear and specific natural endpoint, namely fracture occurrence, and the availability of several treatments to prevent fractures.


Osteoporosis Pragmatic clinical trials Effectiveness Randomized clinical trials 


Compliance with Ethical Standards

Conflict of Interest

Giovanni Adami, Kenneth G. Saag, and Maria I. Danila declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Giovanni Adami
    • 1
    • 2
  • Kenneth G. Saag
    • 1
    Email author
  • Maria I. Danila
    • 1
  1. 1.Division of Clinical Immunology and RheumatologyUniversity of Alabama at BirminghamBirminghamUSA
  2. 2.Rheumatology UnitUniversity of VeronaVeronaItaly

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