Margaret Lloyd

Effect of Late Night Calcium Supplements on Overnight Urinary Calcium Excretion in Premenopausal and Postmenopausal Women

The overnight urinary calcium/creatinine ratio is higher in the early years after the menopause than before it. However, the increment of urinary calcium/creatinine after a late evening calcium supplement is less in early postmenopausal than in premenopausal women. It is suggested that calcium therapy in postmenopausal osteoporosis may be best administered as a single late evening dose rather than in divided doses throughout the day.

Evidence based general practice. Studies using more sophisticated methods are needed.

EDITOR,—P Gill and colleagues1 to respond to the challenge posed by Ellis et al2 to assess the extent to which evidence forms the basis of practice in settings other than acute hospitals. They comment on the challenges of identifying the evidence and express concerns about its generalisability and applicability. It is not clear from their methodology, however, whether they assessed the quality of the evidence they identified, though they comment generally on …