ArticlePloS one2012
Underrepresentation of elderly people in randomised controlled trials. The example of trials of 4 widely prescribed drugs.
Article in PloS one, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 76 papers, 9 of them syntheses that pooled 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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
76 citing papers in PubMed, 9 syntheses or guidelines pooled it, 164 citations in OpenAlex.
- Systematic review of research barriers, facilitators, and stakeholders in long-term care and geriatric settings, and a conceptual mapping framework to build research capacity.BMC geriatrics · 2023Pooled it
- Temporal changes in characteristics and external validity of randomized controlled trials in older people from 2012 to 2019.BMC geriatrics · 2023Pooled it
- Comparing health outcomes between coronary interventions in frail patients aged 75 years or older with acute coronary syndrome: a systematic review.European geriatric medicine · 2022Pooled it
- Efficacy and safety of pharmacotherapy for Alzheimer's disease and for behavioural and psychological symptoms of dementia in older patients with moderate and severe functional impairments: a systematic review of controlled trials.Alzheimer's research & therapy · 2021Pooled it
- A systematic review assessing the under-representation of elderly adults in COVID-19 trials.BMC geriatrics · 2020Pooled it
- Pooled it
- Systematic Review: Representativeness of Participants in RCTs of Acetylcholinesterase Inhibitors.PloS one · 2015Pooled it
- Characteristics of randomized controlled trials designed for elderly: a systematic review.PloS one · 2015Pooled it
- Pooled it
- Monitoring and modifying recruitment and retention strategies for an ongoing randomised clinical trial with venous leg ulcer patients: Overcoming barriers to participation.International wound journal · 2023Trial
- Assessment of Comorbidity Burden and Treatment Response: Reanalysis of the SCD-HEFT Trial.Drugs & aging · 2022Trial
- Recombinant Zoster Vaccine Is Efficacious and Safe in Frail Individuals.Journal of the American Geriatrics Society · 2021Trial
- Association of Statin Use With Disability-Free Survival and Cardiovascular Disease Among Healthy Older Adults.Journal of the American College of Cardiology · 2020Trial
- The Representation of Different Populations in Studies Assessing the Validity of Consumer Wearable Photoplethysmography-Based Measurements: Scoping Review.JMIR mHealth and uHealth · 2026Article
- Participation and Refusal in an Implementation Trial: Insights from the Accelerating Cervical Cancer Elimination through the Integration of Screen-and-Treat Services (ACCESS) Study.Research square · 2026Article
- Clinical Trials in Older Adults with Cardiovascular Multimorbidity: A Perspective on Pragmatic Trial Design.Journal of clinical medicine · 2026Article
- Recruitment of older adults to clinical trials in the Emergency Department: A qualitative study with clinical trial stakeholders.BMC medical research methodology · 2026Article
- GLP-1 Receptor Agonist Therapy in Older Adults with Diabetes: A Qualitative Analysis of Phase 4 ClinicalTrials.gov Studies.Diabetes, metabolic syndrome and obesity : targets and therapy · 2026Article
- Clinical characteristics and BGA-optimized pretest probability of pulmonary embolism in the elderly.Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Article
- Sleep is a therapeutic window for photostimulation of drainage of aging brain.Frontiers of optoelectronics · 2025Article
16 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe aimed to determine the representation of elderly people in published reports of randomized controlled trials (RCTs). We focused on trials of 4 medications--pioglitazone, rosuvastatin, risedronate, and valsartan-frequently used by elderly patients with chronic medical conditions. METHODS AND
findingsWe selected all reports of RCTs indexed in PubMed from 1966 to April 2008 evaluating one of the 4 medications of interest. Estimates of the community-based "on-treatment" population were from a national health insurance database (SNIIR-AM) covering approximately 86% of the population in France. From this database, we evaluated data claims from January 2006 to December 2007 for 1,958,716 patients who received one of the medications of interest for more than 6 months. Of the 155 RCT reports selected, only 3 studies were exclusively of elderly patients (2 assessing valsartan; 1 risedronate). In only 4 of 37 reports (10.8%) for pioglitazone, 4 of 22 (18.2%) for risedronate, 3 of 29 (10.3%) for rosuvastatine and 9 of 67 (13.4%) for valsartan, the proportion of patients aged 65 or older was within or above that treated in clinical practice. In 62.2% of the reports for pioglitazone, 40.9% for risedronate, 37.9% for rosuvastatine, and 70.2% for valsartan, the proportion of patients aged 65 or older was lower than half that in the treated population. The representation of elderly people did not differ by publication date or sample size.
conclusionsElderly patients are poorly represented in RCTs of drugs they are likely to receive.
Indexed as
Identifiers
What OpenQuestion holds
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.