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A randomized trial of comprehensive geriatric assessment in the care of hospitalized patients
Reuben DB, Borok GM, Wolde-Tsadik G, Ershoff DH, Fishman LK, Ambrosini VL, Liu Y, Rubenstein LZ et al.. The New England journal of medicine, 1995-05-01
Topic: Risk, prevention and care in population studies
Background Although many studies describe benefits from the comprehensive assessment of elderly patients by an interdisciplinary team (comprehensive geriatric assessment), the most supportive evidence for the process has come from programs that rely on specialized inpatient units and long hospital stays. We examined whether an inpatient geriatric consultation service might also be beneficial in a trial involving four medical centers of a group-practice health maintenance organization (HMO). Methods We conducted a randomized clinical trial with 2353 hospitalized patients 65 years of age or older in whom at least 1 of 13 screening criteria were present: stroke, immobility, impairment in any basic activity of daily living, malnutrition, incontinence, confusion or dementia, prolonged bed rest, recent falls, depression, social or family problems, an unplanned readmission to the hospital within three months of a previous hospital stay, a new fracture, and age of 80 years or older. Of the 1337 patients assigned to the experimental group, 1261 (94 percent) received a comprehensive geriatric assessment in the form of a consultation, with limited follow-up; the 1016 patients assigned to the control group received usual care. The functional and health status of the patients was measured at base line and 3 and 12 months later; survival was assessed at 12 months. Subgroups of patients who might be presumed to benefit from comprehensive assessment were also studied. Results The survival rate at 12 months was 74 percent in the experimental group and 75 percent in the control group. At base line, 3 months, and 12 months the scores of the two groups on measures of functional and health status were similar. The analysis of 16 subgroups did not identify any with either clearly improved functional status or improved survival. Conclusions In this HMO, comprehensive geriatric assessment by a consultation team, with limited follow-up, did not improve the health or survival of hospitalized patients selected on the basis of screening criteria.
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APA 7th
Reuben, D. B., Borok, G. M., Wolde-Tsadik, G., Ershoff, D. H., Fishman, L. K., Ambrosini, V. L., et al. (1995). A randomized trial of comprehensive geriatric assessment in the care of hospitalized patients. The New England journal of medicine. https://doi.org/10.1056/nejm199505183322007
Vancouver
Reuben DB, Borok GM, Wolde-Tsadik G, Ershoff DH, Fishman LK, Ambrosini VL, et al. A randomized trial of comprehensive geriatric assessment in the care of hospitalized patients. The New England journal of medicine. 1995. doi:10.1056/nejm199505183322007. PMID: 7715645.
BibTeX
@article{reuben1995-7715645,
author = {Reuben, D. B. and Borok, G. M. and Wolde-Tsadik, G. and Ershoff, D. H. and Fishman, L. K. and Ambrosini, V. L. and Liu, Y. and Rubenstein, L. Z. and others},
title = {{A randomized trial of comprehensive geriatric assessment in the care of hospitalized patients}},
journal = {The New England journal of medicine},
year = {1995},
doi = {10.1056/nejm199505183322007},
pmid = {7715645},
url = {https://doi.org/10.1056/nejm199505183322007}
}
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Key findings
- Results The survival rate at 12 months was 74 percent in the experimental group and 75 percent in the control group.
Study details
- Participants1,337
- Evidence strengthHigh
How this study scored 61/100
Published in a top-tier journal. Scored zero for study design and effect reported because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record and institution's track record, so those were left out: it earned 37 of the 61 points we could judge it on, which is 61 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 10 / 10 | Tier 1 — top-tier general journal (The New England journal of medicine) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 1995 — older than 20 years, still counted |
| Sample size | 3 / 4 | 1,337 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 1 / 2 | Randomised (as stated in the record) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | 2 / 3 | PubMed indexes it as a multicentre study |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 7715645) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 37 / 61 | Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 37 of the 61 points we could judge it on is 61 out of 100. |
| Total | 61 / 100 | — |
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