Evidence map›Paper›PMID 32059687›Full record

ArticleTrials2020

Identifying treatment effects of an informal caregiver education intervention to increase days in the community and decrease caregiver distress: a machine-learning secondary analysis of subgroup effects in the HI-FIVES randomized clinical trial.

Megan Shepherd-Banigan, Valerie A Smith, Jennifer H Lindquist, Michael Paul Cary, Katherine E M Miller, Jennifer G Chapman, Courtney H Van Houtven

Registry-linked trialOpen access · goldAbstract read
In one paragraph

Article in Trials, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01777490 (Helping Invested Families Improve Veterans Experiences Study), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.8field-weighted citation impact, top 11% 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.

NCT01777490 nacompletednot on this map

Helping Invested Families Improve Veterans Experiences Study (HI-FIVES)

TypeinterventionalSponsorVA Office of Research and DevelopmentRan2014 to 2017Enrolled484ConditionsCaregiver, Disabled Veterans, Referred to Long-term Care, Residing at HomeArmsHelping Invested Families Improve Veterans Experiences - Control, Helping Invested Families Improve Veterans Experiences - HI FIVES
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 10 citations in OpenAlex.

  1. Trial
  2. Article
  3. 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.

Megan Shepherd-BaniganDurham VA HSR&D ADAPT, Durham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA. megan.shepherd-banigan@va.gov.ORCID http://orcid.org/0000-0002-4020-8936
Valerie A SmithDurham VA HSR&D ADAPT, Durham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA.
Jennifer H LindquistDurham VA HSR&D ADAPT, Durham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA.
Michael Paul CarySchool of Nursing, Duke University, 307 Trent Drive, Durham, NC, 27710, USA.
Katherine E M MillerDurham VA HSR&D ADAPT, Durham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA.
Jennifer G ChapmanDurham VA HSR&D ADAPT, Durham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA.
Courtney H Van HoutvenDurham VA HSR&D ADAPT, Durham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA.
Duke University · USDurham VA Health Care System · USUniversity of North Carolina at Chapel Hill · US

Funding

Institutional Career Development CoreKL2TR002554 · NCATS · DUKE UNIVERSITY · PI SVETKEY, LAURA P · 2018 to 2022
$8.2M
HSRD VA CIN 13-410NCATS NIH HHS KL2 TR002554
6 · The paper itself

Abstract

backgroundInformal caregivers report substantial burden and depressive symptoms which predict higher rates of patient institutionalization. While caregiver education interventions may reduce caregiver distress and decrease the use of long-term institutional care, evidence is mixed. Inconsistent findings across studies may be the result of reporting average treatment effects which do not account for how effects differ by participant characteristics. We apply a machine-learning approach to randomized clinical trial (RCT) data of the Helping Invested Family Members Improve Veteran's Experiences Study (HI-FIVES) intervention to explore how intervention effects vary by caregiver and patient characteristics.

methodsWe used model-based recursive partitioning models. Caregivers of community-residing older adult US veterans with functional or cognitive impairment at a single VA Medical Center site were randomized to receive HI-FIVES (n = 118) vs. usual care (n = 123). The outcomes included cumulative days not in the community and caregiver depressive symptoms assessed at 12 months post intervention. Potential moderating characteristics were: veteran age, caregiver age, caregiver ethnicity and race, relationship satisfaction, caregiver burden, perceived financial strain, caregiver depressive symptoms, and patient risk score.

resultsThe effect of HI-FIVES on days not at home was moderated by caregiver burden (p < 0.001); treatment effects were higher for caregivers with a Zarit Burden Scale score ≤ 28. Caregivers with lower baseline Center for Epidemiologic Studies Depression Scale (CESD-10) scores (≤ 8) had slightly lower CESD-10 scores at follow-up (p < 0.001).

conclusionsFamily caregiver education interventions may be less beneficial for highly burdened and distressed caregivers; these caregivers may require a more tailored approach that involves assessing caregiver needs and developing personalized approaches.

trial registrationClinicalTrials.gov, ID:NCT01777490. Registered on 28 January 2013.

Indexed as

Machine LearningAgedAged, 80 and overAge FactorsCaregiversCognitive DysfunctionData Interpretation, StatisticalDepressionFamilyFemaleFollow-Up StudiesHumansInstitutionalizationLong-Term CareMaleMiddle AgedCaregiver depressionClinical trialFamily caregiver interventionHeterogeneous treatment effectsInstitutionalization

Identifiers

PMID32059687
PMCPMC7023677
OpenAlexW3012721336

What OpenQuestion holds

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LicenceCC BY
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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.