So to start with, could you briefly summarize what the study actually found? And in particular, was it looking simply at primary prevention in general or patients at high risk of fractures or patients on osteoporosis treatment too or maybe some combination of those? I'm confused.

Okay.

So, um, as you say, this was a systematic review and meta-analysis of 69 trials that compared calcium, vitamin D or a combination of the two against placebo or no treatment, importantly in adults not receiving drug treatment for osteoporosis.

So they excluded studies of people receiving steroids, re- receiving hormone replacement therapy, and the vast majority of the participants in the trials were community-dwelling people at low fracture risk.

So they define that as people under the age of 80 who'd never had a prior fracture or fall, who didn't have osteoporosis and didn't have vitamin D deficiency.

In fact, only four out of the 69 trials included anyone with a prior fracture, so this is really about primary prevention to answer your question.Um, what they found was that calcium alone didn't reduce fracture risk.

No great surprise there.

Should we be doing more about these, uh, where we're kind of ongoing prescribing without a clear reason? Does this meta-analysis make that more important or urgent, or should it just be reviewed in the normal way?