Evidence map›Paper›PMID 33413165›Full record

ArticleBMC geriatrics2021

Design and rationale of a routine clinical care pathway and prospective cohort study in older patients needing intensive treatment.

Yara van Holstein, Floor J van Deudekom, Stella Trompet, Iris Postmus, Anna Uit den Boogaard, Marjan J T van der Elst, Nienke A de Glas, Diana van Heemst, Geert Labots, Mariëtte Altena and 7 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC geriatrics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
1.9field-weighted citation impact, top 16% 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

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.

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  11. Functional Performance After Complex Endovascular Aortic Repair: A Single-Center Retrospective Cohort Study.Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists · 2021
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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

17 authors at 4 institutions in 1 country.

Yara van HolsteinDepartment of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, PO box 9600, 2300 RC, Leiden, The Netherlands. Y.van_Holstein@lumc.nl.ORCID 0000-0002-6882-639X
Floor J van DeudekomDepartment of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, PO box 9600, 2300 RC, Leiden, The Netherlands.
Stella TrompetDepartment of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, PO box 9600, 2300 RC, Leiden, The Netherlands.
Iris PostmusDepartment of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, PO box 9600, 2300 RC, Leiden, The Netherlands.
Anna Uit den BoogaardDepartment of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, PO box 9600, 2300 RC, Leiden, The Netherlands.
Marjan J T van der ElstDepartment of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, PO box 9600, 2300 RC, Leiden, The Netherlands.
Nienke A de GlasDepartment of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands.
Diana van HeemstDepartment of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, PO box 9600, 2300 RC, Leiden, The Netherlands.
Geert LabotsDepartment of Internal Medicine, Haga Hospital, The Hague, The Netherlands.
Mariëtte AltenaDepartment of Internal Medicine, Haaglanden Medical Center, The Hague, The Netherlands.
Marije SlingerlandDepartment of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands.
Gerrit Jan LiefersDepartment of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Frederiek van den BosDepartment of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, PO box 9600, 2300 RC, Leiden, The Netherlands.
Jessica M van der BolDepartment of Geriatrics, Reinier de Graaf Hospital, Delft, The Netherlands.
Gerard J BlauwDepartment of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, PO box 9600, 2300 RC, Leiden, The Netherlands.
Johanneke E A PortieljeDepartment of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands.
Simon P MooijaartDepartment of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, PO box 9600, 2300 RC, Leiden, The Netherlands.
Leiden University Medical Center · NLHaga Hospital · NLMedisch Centrum Haaglanden · NLReinier de Graaf Hospital · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTreatment decisions concerning older patients can be very challenging and individualised treatment plans are often required in this very heterogeneous group. In 2015 we have implemented a routine clinical care pathway for older patients in need of intensive treatment, including a comprehensive geriatric assessment (CGA) that was used to support clinical decision making. An ongoing prospective cohort study, the Triaging Elderly Needing Treatment (TENT) study, has also been initiated in 2016 for participants in this clinical care pathway, to study associations between geriatric characteristics and outcomes of treatment that are relevant to older patients. The aim of this paper is to describe the implementation and rationale of the routine clinical care pathway and design of the TENT study.

methodsA routine clinical care pathway has been designed and implemented in multiple hospitals in the Netherlands. Patients aged ≥70 years who are candidates for intensive treatments, such as chemotherapy, (chemo-)radiation therapy or major surgery, undergo frailty screening based on the Geriatric 8 (G-8) questionnaire and the Six-Item Cognitive Impairment Test (6CIT). If screening reveals potential frailty, a CGA is performed. All patients are invited to participate in the TENT study. Clinical data and blood samples for biomarker studies are collected at baseline. During follow-up, information about treatment complications, hospitalisations, functional decline, quality of life and mortality is collected. The primary outcome is the composite endpoint of functional decline or mortality at 1 year. DISCUSSION: Implementation of a routine clinical care pathway for older patients in need of intensive treatment provides the opportunity to study associations between determinants of frailty and outcomes of treatment. Results of the TENT study will support individualised treatment for future patients.

trial registrationThe study is retrospectively registered at the Netherlands Trial Register (NTR), trial number NL8107 . Date of registration: 22-10-2019.

Indexed as

FrailtyQuality of LifeAgedGeriatric AssessmentHumansNetherlandsProspective StudiesAortic valve replacementColon cancerComprehensive geriatric assessmentFrailtyGeriatric oncologyHead and neck cancerOesophageal cancerOlder patientsStudy protocol

Identifiers

PMID33413165
PMCPMC7791733
OpenAlexW3118358076

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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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.