Following the independent Appraisal Committee's meeting on Thursday 12 February at which it discussed the responses received during consultation on the Appraisal Consultation Document (ACD), the Institute has accepted the committee's recommendation to separate this appraisal into two parts, which will be published separately.

The first part will address the treatment of existing osteoporotic fractures in post-menopausal women (secondary prevention), as per the current ACD. The second part will address the prevention of osteoporotic fractures in post-menopausal women who have not yet had a fracture (primary prevention).

As a result of the large amount of information received during the consultation on the ACD, the Appraisal Committee has asked for further analytical work to be carried out to inform their decision-making before it can progress to the next stage of the appraisal on the secondary prevention of osteoporotic fractures. The committee will consider the results of this further analysis at its meeting on 7 April 2004. Consequently the timeline has been further extended for this element of the appraisal and this will be reflected in a revised timetable which the Institute will publish shortly.

In order to determine the clinical and cost-effectiveness of treatments for the primary prevention of osteoporotic fractures, data is needed to enable a proper assessment of the contribution of risk factors for the development of osteoporotic fractures. This will be informed by work currently being undertaken by the World Health Organisation and by the NICE guideline development group on osteoporosis. This data is expected to be received towards the end of the year. The Institute will publish a separate timetable for the development of this part of the guidance.