Evidence map›Paper›PMID 29402228›Full record

Trial reportBMC geriatrics2018

Economic evaluation of an extended nutritional intervention in older Australian hospitalized patients: a randomized controlled trial.

Yogesh Sharma, Campbell Thompson, Michelle Miller, Rashmi Shahi, Paul Hakendorf, Chris Horwood, Billingsley Kaambwa

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC geriatrics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 22% of its field
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

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Addressing Malnutrition in Australian Hospitals: A Scoping Review to Inform Systems Thinking.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2026
    Article
  4. Article
  5. Review
  6. 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

7 authors at 3 institutions in 1 country.

Yogesh SharmaDepartment of General Medicine, Flinders Medical Centre, Adelaide, South Australia, Australia. Yogesh.Sharma@sa.gov.au.ORCID 0000-0002-7716-2599
Campbell ThompsonDiscipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia.
Michelle MillerDepartment of Nutrition & Dietetics, Flinders University, Adelaide, South Australia, Australia.
Rashmi ShahiFaculty of Health Sciences, Flinders University, Adelaide, South Australia, Australia.
Paul HakendorfDepartment of Clinical Epidemiology, Flinders Medical Centre, Adelaide, South Australia, Australia.
Chris HorwoodDepartment of Clinical Epidemiology, Flinders Medical Centre, Adelaide, South Australia, Australia.
Billingsley KaambwaHealth Economics Unit, Flinders University, Adelaide, South Australia, Australia.
Flinders University · AUFlinders Medical Centre · AUThe University of Adelaide · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrevalence of malnutrition in older hospitalized patients is 30%. Malnutrition is associated with poor clinical outcomes in terms of high morbidity and mortality and is costly for hospitals. Extended nutrition interventions improve clinical outcomes but limited studies have investigated whether these interventions are cost-effective.

methodsIn this randomized controlled trial, 148 malnourished general medical patients ≥60 years were recruited and randomized to receive either an extended nutritional intervention or usual care. Nutrition intervention was individualized and started with 24 h of admission and was continued for 3 months post-discharge with a monthly telephone call whereas control patients received usual care. Nutrition status was confirmed by Patient generated subjective global assessment (PG-SGA) and health-related quality of life (HRQoL) was measured using EuroQoL 5D (EQ-5D-5 L) questionnaire at admission and at 3-months follow-up. A cost-effectiveness analysis was conducted for the primary outcome (incremental costs per unit improvement in PG-SGA) while a cost-utility analysis (CUA) was undertaken for the secondary outcome (incremental costs per quality adjusted life year (QALY) gained).

resultsNutrition status and HRQoL improved in intervention patients. Mean per included patient Australian Medicare costs were lower in intervention group compared to control arm (by $907) but these differences were not statistically significant (95% CI: -$2956 to $4854). The main drivers of higher costs in the control group were higher inpatient ($13,882 versus $13,134) and drug ($838 versus $601) costs. After adjusting outcomes for baseline differences and repeated measures, the intervention was more effective than the control with patients in this arm reporting QALYs gained that were higher by 0.0050 QALYs gained per patient (95% CI: -0.0079 to 0.0199). The probability of the intervention being cost-effective at willingness to pay values as low as $1000 per unit improvement in PG-SGA was > 98% while it was 78% at a willingness to pay $50,000 per QALY gained.

conclusionThis health economic analysis suggests that the use of extended nutritional intervention in older general medical patients is likely to be cost-effective in the Australian health care setting in terms of both primary and secondary outcomes.

trial registrationACTRN No. 12614000833662 . Registered 6 August 2014.

Indexed as

Quality-Adjusted Life YearsQuality of LifeAgedAged, 80 and overAustraliaCost-Benefit AnalysisFemaleHospitalizationHumansMaleMalnutritionPatient DischargePrevalenceSurveys and QuestionnairesEconomic evaluationHealth related quality of lifeMalnutritionOlder patientsQuality adjusted life years

Identifiers

PMID29402228
PMCPMC5799921
OpenAlexW2790629124

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.