The causes of these discrepancies remain unknown

The gap

Evidence profile

Sourced from the limitations section and limitations and discussion of the source papers, classified as general, spanning 3 journals. Those papers have been cited 2 times in total.

Supporting evidence — 3 representative gaps

• Bone Health and Anti-Osteoporotic Medication Eligibility in Postmenopausal Women Undergoing Bariatric Surgery: The Impact of Age and Modifiable Risk Factors (2026) · Calcified Tissue International · cited 1× · doi

  retrospective analysis may have introduced recall bias and missing data, particularly regarding fracture history or specific risk factors - not all biochemical markers were systematically or recently assessed, potentially limiting interpretation - alcohol and smoking were self-reported, which may have led to underestimation - referral bias may have led to overrepresentation of postmenopausal bariatric women at higher fracture risk, potentially overestimating the prevalence of AOM eligibility - the monocentric design and the high proportion of previously operated patients (> 75%) may limit generalizability to other settings - the lack of a non-bariatric control group, limiting assessment of whether prevalence deviates from age-adjusted expectations

  generallimitations section
  Keywords: retrospective analysis have introduced recall bias missing data
• Impact of fracture patterns and patient factors on distal interlocking screw backout after retrograde femoral nailing (2026) · World Journal of Orthopedics · doi

  The major strength of this study is the large number of included patients within a complete national cohort that allowed for detailed and unbiased comparisons between the different fractures. Moreover, the included patient population was unselected and thus any regional, ethnic, or socioeco- nomic bias was minimized. The main limitation is potential misclassification in the registry data. Still, the NPR data has been reported to be of high quality and any misclassification should most likely be accidental and therefore any correlation biased “toward the null.” Another limitation concerns lack of information on comorbidities and cause of death, which could not be retrieved from the NPR register. The absence of this data might influence the comparability of the patient cohorts. The stratification in age and sex intervals of the whole popu- lation in each year allowed the unique comparison between different fracture sites among the very same individuals in Sweden for that year. Regarding the demographics of our population, we found the total male–female ratio to be stable throughout the study years, and the different age groups con- stituted a similar proportion of the entire population, with changes smaller than 3% increase or decrease across the 16 328 Acta Orthopaedica 2021; 92 (3): 323–328 years. Moreover, incidence calculations by each year used the exact number of Swedish males or females in that year for comparison.

  generallimitationsevidence 5/5
  Keywords: year different population number included allowed patient limitation misclassification comparison years major strength large patients
• Validation of self-reported fractures in a follow-up survey of the Japan Multi-Institutional Collaborative Cohort study (2026) · Annals of Clinical Epidemiology · cited 1× · doi

  The causes of these discrepancies remain unknown; however, possible factors may include insufficient statistical power due to stratification by various fracture sites, decline in cognitive function due to aging, low levels of health consciousness related to smoking and obesity, and lack of understanding due to low education levels. Although multisite fractures and multiple fractures have rarely been investigated in previous studies, they are considered important14).

  generaldiscussionevidence 5/5
  Keywords: levels fractures causes discrepancies remain unknown possible factors include insufficient statistical power stratification various fracture

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