Evidence map›Paper›PMID 22235089›Full record

SynthesisJAMA2012

Prognostic indices for older adults: a systematic review.

Lindsey C Yourman, Sei J Lee, Mara A Schonberg, Eric W Widera, Alexander K Smith

2 registry-linked trialsAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in JAMA, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 338 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
338citing papers in PubMed, 10 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02973984 unknown statusnot on this mapstarted 2016, after this paper: background citation

Evaluating the Efficacy and Risks of Anticoagulant Treatments in Multimorbid Frail Older Subjects With Atrial Fibrillation. The European Registry of Older Subjects With Atrial Fibrillation (EUROSAF)

TypeobservationalSponsorAlberto PilottoRan2016 to 2024Enrolled3,000ConditionsAtrial Fibrillation
NCT03609658 nacompletednot on this mapstarted 2018, after this paper: background citation

Integrated Approach to Patient and Family Engagement for Advance Care Planning for Vulnerable Older Adult Within an Accountable Care Organization (ACO)

TypeinterventionalSponsorWake Forest University Health SciencesRan2018 to 2019Enrolled146ConditionsAdvance Care PlanningArmsNurse Navigator Pathway, Usual Care
3 · Its place in the literature

Who cites it

338 citing papers in PubMed, 10 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Guideline
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Practical Assessment and Management of Vulnerabilities in Older Patients Receiving Chemotherapy: ASCO Guideline for Geriatric Oncology.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2018
    Guideline
  10. Pooled it
  11. Trial
  12. Trial
  13. Trial
  14. Trial
  15. Article
  16. Review
  17. Review
  18. Article
  19. Article
  20. Article

278 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Lindsey C YourmanDivision of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, CA 94121, USA.
Sei J Lee
Mara A Schonberg
Eric W Widera
Alexander K Smith

Funding

UCSF CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTEUL1RR024131 · NCRR · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI JOHNSTON, S. CLAIBORNE · 2006 to 2011
$111.2M
CTSA: K12 COMPONENTKL2RR024130 · NCRR · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI JOHNSTON, S. CLAIBORNE · 2006 to 2011
$19.3M
RESEARCH TRAINING IN GERIATRIC MEDICINET32AG000212 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Alexander Keliimoeanu Smith · 1991 to 2026
$7.7M
P0045982 Late Life Disability: Epidemiology, Symptoms, Quality of LifeK23AG040772 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI SMITH, ALEXANDER KELIIMOEANU · 2012 to 2017
$756k
Individualizing Treatment for Nursing Home Residents with Diabetes MellitusK23AG040779 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI LEE, SEI · 2011 to 2013
$526k
NCRR NIH HHS KL2 RR024130NCRR NIH HHS UL1 RR024131NIA NIH HHS 5T32AG000212NIA NIH HHS K23 AG040772NIA NIH HHS K23 AG040779NIA NIH HHS T32 AG000212
6 · The paper itself

Abstract

contextTo better target services to those who may benefit, many guidelines recommend incorporating life expectancy into clinical decisions.

objectiveTo assess the quality and limitations of prognostic indices for mortality in older adults through systematic review. DATA SOURCES: We searched MEDLINE, EMBASE, Cochrane, and Google Scholar from their inception through November 2011. STUDY SELECTION: We included indices if they were validated and predicted absolute risk of mortality in patients whose average age was 60 years or older. We excluded indices that estimated intensive care unit, disease-specific, or in-hospital mortality. DATA EXTRACTION: For each prognostic index, we extracted data on clinical setting, potential for bias, generalizability, and accuracy.

resultsWe reviewed 21,593 titles to identify 16 indices that predict risk of mortality from 6 months to 5 years for older adults in a variety of clinical settings: the community (6 indices), nursing home (2 indices), and hospital (8 indices). At least 1 measure of transportability (the index is accurate in more than 1 population) was tested for all but 3 indices. By our measures, no study was free from potential bias. Although 13 indices had C statistics of 0.70 or greater, none of the indices had C statistics of 0.90 or greater. Only 2 indices were independently validated by investigators who were not involved in the index's development.

conclusionWe identified several indices for predicting overall mortality in different patient groups; future studies need to independently test their accuracy in heterogeneous populations and their ability to improve clinical outcomes before their widespread use can be recommended.

Indexed as

Decision MakingLife ExpectancyMortalityPrognosisAgedAged, 80 and overHumansMiddle AgedPatient CarePredictive Value of TestsRisk

Identifiers

PMID22235089
PMCPMC3792853

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.