Comprehensive geriatric assessment: a meta-analysis of controlled trials
Summary There is disagreement on the usefulness of comprehensive geriatric assessment (CGA) due to conflicting results from individual trials. We did a meta-analysis on 28 controlled trials comprising 4959 subjects allocated to one of five CGA types and 4912 controls. Published data were supplemente...
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| Veröffentlicht in: | The Lancet (British edition) 1993-10, Vol.342 (8878), p.1032-1036 |
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| container_title | The Lancet (British edition) |
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| creator | Stuck, A.E Siu, A.L Wieland, G.D Rubenstein, L.Z Adams, J |
| description | Summary
There is disagreement on the usefulness of comprehensive geriatric assessment (CGA) due to conflicting results from individual trials. We did a meta-analysis on 28 controlled trials comprising 4959 subjects allocated to one of five CGA types and 4912 controls.
Published data were supplemented with reanalysed data provided by the original investigators. We calculated combined odds ratios of important outcomes by pooling data from individual trials with multivariate logistic regression. Combined odds ratio (95% confidence interval) of living at home at follow-up was 1·68 (1·17-2 41) for geriatric evaluation and management units, 1·49 (1·12-1·98) for hospital-home assessment services, and 1·20 (1·05-1·37) for home assessment services. Covariate analysis showed that programmes with control over medical recommendations and extended ambulatory follow-up were more likely to be effective. Our analysis suggests that CGA programmes linking geriatric evaluation with strong long-term management are effective for improving survival and function in older persons. |
| doi_str_mv | 10.1016/0140-6736(93)92884-V |
| format | Article |
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There is disagreement on the usefulness of comprehensive geriatric assessment (CGA) due to conflicting results from individual trials. We did a meta-analysis on 28 controlled trials comprising 4959 subjects allocated to one of five CGA types and 4912 controls.
Published data were supplemented with reanalysed data provided by the original investigators. We calculated combined odds ratios of important outcomes by pooling data from individual trials with multivariate logistic regression. Combined odds ratio (95% confidence interval) of living at home at follow-up was 1·68 (1·17-2 41) for geriatric evaluation and management units, 1·49 (1·12-1·98) for hospital-home assessment services, and 1·20 (1·05-1·37) for home assessment services. Covariate analysis showed that programmes with control over medical recommendations and extended ambulatory follow-up were more likely to be effective. Our analysis suggests that CGA programmes linking geriatric evaluation with strong long-term management are effective for improving survival and function in older persons.</description><identifier>ISSN: 0140-6736</identifier><identifier>EISSN: 1474-547X</identifier><identifier>DOI: 10.1016/0140-6736(93)92884-V</identifier><identifier>PMID: 8105269</identifier><identifier>CODEN: LANCAO</identifier><language>eng</language><publisher>London: Elsevier Ltd</publisher><subject>Activities of Daily Living ; Aftercare ; Aged ; Assessment ; Biological and medical sciences ; Clinical Trials as Topic ; Cognition ; Effectiveness ; Elderly people ; Follow-Up Studies ; Geriatric Assessment ; Geriatrics ; Health care ; Home Care Services ; Hospital Units ; Humans ; Medical research ; Medical sciences ; Meta-analysis ; Mortality ; Older people ; Patient Admission ; Patient Readmission ; Prevention and actions ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Referral and Consultation ; Specific populations (family, woman, child, elderly...) ; Systematic review</subject><ispartof>The Lancet (British edition), 1993-10, Vol.342 (8878), p.1032-1036</ispartof><rights>1993</rights><rights>1994 INIST-CNRS</rights><rights>Copyright Lancet Ltd. Oct 23, 1993</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c476t-1f3a2e2f1ca44937a27bffcc82d749e8511cc34a1c7c2b728573b938dfef0c83</citedby><cites>FETCH-LOGICAL-c476t-1f3a2e2f1ca44937a27bffcc82d749e8511cc34a1c7c2b728573b938dfef0c83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/198954918?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,31000,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3780201$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8105269$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Stuck, A.E</creatorcontrib><creatorcontrib>Siu, A.L</creatorcontrib><creatorcontrib>Wieland, G.D</creatorcontrib><creatorcontrib>Rubenstein, L.Z</creatorcontrib><creatorcontrib>Adams, J</creatorcontrib><title>Comprehensive geriatric assessment: a meta-analysis of controlled trials</title><title>The Lancet (British edition)</title><addtitle>Lancet</addtitle><description>Summary
There is disagreement on the usefulness of comprehensive geriatric assessment (CGA) due to conflicting results from individual trials. We did a meta-analysis on 28 controlled trials comprising 4959 subjects allocated to one of five CGA types and 4912 controls.
Published data were supplemented with reanalysed data provided by the original investigators. We calculated combined odds ratios of important outcomes by pooling data from individual trials with multivariate logistic regression. Combined odds ratio (95% confidence interval) of living at home at follow-up was 1·68 (1·17-2 41) for geriatric evaluation and management units, 1·49 (1·12-1·98) for hospital-home assessment services, and 1·20 (1·05-1·37) for home assessment services. Covariate analysis showed that programmes with control over medical recommendations and extended ambulatory follow-up were more likely to be effective. Our analysis suggests that CGA programmes linking geriatric evaluation with strong long-term management are effective for improving survival and function in older persons.</description><subject>Activities of Daily Living</subject><subject>Aftercare</subject><subject>Aged</subject><subject>Assessment</subject><subject>Biological and medical sciences</subject><subject>Clinical Trials as Topic</subject><subject>Cognition</subject><subject>Effectiveness</subject><subject>Elderly people</subject><subject>Follow-Up Studies</subject><subject>Geriatric Assessment</subject><subject>Geriatrics</subject><subject>Health care</subject><subject>Home Care Services</subject><subject>Hospital Units</subject><subject>Humans</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>Meta-analysis</subject><subject>Mortality</subject><subject>Older people</subject><subject>Patient Admission</subject><subject>Patient Readmission</subject><subject>Prevention and actions</subject><subject>Public health. 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Academic</collection><jtitle>The Lancet (British edition)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stuck, A.E</au><au>Siu, A.L</au><au>Wieland, G.D</au><au>Rubenstein, L.Z</au><au>Adams, J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comprehensive geriatric assessment: a meta-analysis of controlled trials</atitle><jtitle>The Lancet (British edition)</jtitle><addtitle>Lancet</addtitle><date>1993-10-23</date><risdate>1993</risdate><volume>342</volume><issue>8878</issue><spage>1032</spage><epage>1036</epage><pages>1032-1036</pages><issn>0140-6736</issn><eissn>1474-547X</eissn><coden>LANCAO</coden><abstract>Summary
There is disagreement on the usefulness of comprehensive geriatric assessment (CGA) due to conflicting results from individual trials. We did a meta-analysis on 28 controlled trials comprising 4959 subjects allocated to one of five CGA types and 4912 controls.
Published data were supplemented with reanalysed data provided by the original investigators. We calculated combined odds ratios of important outcomes by pooling data from individual trials with multivariate logistic regression. Combined odds ratio (95% confidence interval) of living at home at follow-up was 1·68 (1·17-2 41) for geriatric evaluation and management units, 1·49 (1·12-1·98) for hospital-home assessment services, and 1·20 (1·05-1·37) for home assessment services. Covariate analysis showed that programmes with control over medical recommendations and extended ambulatory follow-up were more likely to be effective. Our analysis suggests that CGA programmes linking geriatric evaluation with strong long-term management are effective for improving survival and function in older persons.</abstract><cop>London</cop><pub>Elsevier Ltd</pub><pmid>8105269</pmid><doi>10.1016/0140-6736(93)92884-V</doi><tpages>5</tpages></addata></record> |
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| ispartof | The Lancet (British edition), 1993-10, Vol.342 (8878), p.1032-1036 |
| issn | 0140-6736 1474-547X |
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| subjects | Activities of Daily Living Aftercare Aged Assessment Biological and medical sciences Clinical Trials as Topic Cognition Effectiveness Elderly people Follow-Up Studies Geriatric Assessment Geriatrics Health care Home Care Services Hospital Units Humans Medical research Medical sciences Meta-analysis Mortality Older people Patient Admission Patient Readmission Prevention and actions Public health. Hygiene Public health. Hygiene-occupational medicine Referral and Consultation Specific populations (family, woman, child, elderly...) Systematic review |
| title | Comprehensive geriatric assessment: a meta-analysis of controlled trials |
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