Evidence map›Paper›PMID 29155445›Full record

ArticleJournal of the American Geriatrics Society2018

Individualizing Prevention for Older Adults.

Sei J Lee, Christine M Kim

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Geriatrics Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 1 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Trial
  4. Article
  5. Article
  6. Review
  7. Review
  8. Review
  9. Age is just a number: the concept of time to benefit in older adults.European journal of hospital pharmacy : science and practice · 2023
    Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Factors Associated with the Detection of Inappropriate Prescriptions in Older People: A Prospective Cohort.International journal of environmental research and public health · 2021
    Observational
  16. Trajectories of Frailty in the 5 Years Prior to Death Among U.S. Veterans Born 1927-1934.The journals of gerontology. Series A, Biological sciences and medical sciences · 2021
    Article
  17. Review
  18. Review
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Sei J LeeSan Francisco Veterans Affairs Medical Center, University of California, San Francisco.
Christine M KimHelen Diller Comprehensive Cancer Center, University of California, San Francisco.

Funding

Developing prognostic models for life expectancy and geriatric outcomesR01AG047897 · NIA · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · PI LEE, SEI, SMITH, ALEXANDER KELIIMOEANU · 2015 to 2018
$1.7M
HSRD VA I01 HX002135NIA NIH HHS R01 AG047897
6 · The paper itself

Abstract

Prevention can help older adults avoid illness by identifying and addressing conditions before they cause symptoms, but prevention can also harm older adults if conditions that are unlikely to cause symptoms in the individual's lifetime are identified and treated. To identify older adults who preventive interventions are most likely to benefit (and most likely to harm), we propose a framework that compares an individual's life expectancy (LE) with the time to benefit (TTB) for an intervention. If LE is less than the TTB, the individual is unlikely to benefit but is exposed to the risks of the intervention, and the intervention should generally NOT be recommended. If LE is longer than the TTB, the individual could benefit, and the intervention should generally be recommended. If LE is similar to the TTB, the individual's values and preferences should be the major determinant of the decision. To facilitate the use of this framework in routine clinical care, we explored ways to estimate LE, identified the TTB for common preventive interventions, and developed strategies for communicating with individuals. We have synthesized these strategies and demonstrate how they can be used to individualize prevention for a hypothetical beneficiary in the setting of a Medicare annual wellness visit. Finally, we place prevention in the context of curative and symptom-oriented care and outline how prevention should be focused on healthier older adults, whereas symptom-oriented care should predominate in sicker older adults.

Indexed as

Decision MakingLife ExpectancyAgedHumansPreventive MedicineQuality of LifeTime Factorscancer screeninglife expectancypreventiontime to benefit

Identifiers

PMID29155445
PMCPMC5809295

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.