SynthesisBMC geriatrics2022
The effectiveness of interventions to reduce adverse outcomes among older adults following Emergency Department discharge: umbrella review.
Synthesis in BMC geriatrics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 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
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 53 citations in OpenAlex.
- Patient flow in emergency departments: a comprehensive umbrella review of solutions and challenges across the health system.BMC health services research · 2024Pooled it
- Nursing Sensitive Outcomes evaluation in the Emergency Department: An Umbrella Review.Investigacion y educacion en enfermeria · 2023Pooled it
- Geriatric team support in the emergency department-a randomised trial investigating the effects on hospital admission and community care in older adults (GerED-21).Age and ageing · 2026Trial
- A Physiotherapy-Led Transition to Home Intervention for Older Adults Following Emergency Department Discharge: A Pilot Feasibility Randomised Controlled Trial (ED PLUS).Clinical interventions in aging · 2023Trial
- Addressing Frailty in the Emergency Department: Early Outcomes of a Geriatric Rapid Access Clinic.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Article
- Early Warning Scores in Emergency Department Patients Aged 80 Years or Older.JAMA network open · 2026Article
- Development of a Triage-Level Predictive Model for Hospitalization in the Emergency Department.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
- Article
- Frailty Alerts Reduce Waiting Time and Length of Stay in the Emergency Department.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Observational
- A Model for Developing Subspecialty Clinical Practice Guidelines: The Geriatric Emergency Department Guidelines 2.0.Journal of the American College of Emergency Physicians open · 2025Article
- Scoping Review of Adult Emergency Department Discharge Interventions.The western journal of emergency medicine · 2025Article
- Validation of The Umbrella Collaboration for Tertiary Evidence Synthesis in Geriatrics: Mixed Methods Study.JMIR formative research · 2025Article
- Emergency department interventions and their effect on subsequent healthcare resource use after discharge: an overview of systematic reviews.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Review
- Frailty in older adults with systemic lupus erythematosus and emergency department utilization: an administrative claims data analysis of Medicare beneficiaries.Clinical rheumatology · 2025Article
- The Experiences and Expectations of Older Adults and Close Family in Nursing Home and Emergency Department Transitions: A Qualitative Study.Journal of aging research · 2025Article
- A Multi-Stakeholder Qualitative Evaluation of ED PLUS: A Physiotherapy-Led Transition to Home Intervention for Older Adults Following Emergency Department Discharge.Clinical interventions in aging · 2025Article
- Older adults experience of transition to the community from the emergency department: a qualitative evidence synthesis.BMC geriatrics · 2024Article
- Strategies for improving ED-related outcomes of older adults who seek care in emergency departments: a systematic review.International journal of emergency medicine · 2024Review
- Developing a novel transitional care model for older emergency department patients and exploring the target population in Taiwan.Frontiers in medicine · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPopulation ageing is increasing rapidly worldwide. Older adults are frequent users of health care services including the Emergency Department (ED) and experience a number of adverse outcomes following an ED visit. Adverse outcomes include functional decline, unplanned hospital admission and an ED revisit. Given these adverse outcomes a number of interventions have been examined to improve the outcomes of older adults following presentation to the ED. The aim of this umbrella review was to evaluate the effectiveness of ED interventions in reducing adverse outcomes in older adults discharged from the ED.
methodsSystematic reviews of randomised controlled trials investigating ED interventions for older adults presenting to the ED exploring clinical, patient experience and healthcare utilisation outcomes were included. A comprehensive search strategy was employed in eleven databases and the PROSPERO register up until June 2020. Grey literature was also searched. Quality was assessed using the A MeaSurement Tool to Assess Systematic Reviews 2 tool. Overlap between systematic reviews was assessed using a matrix of evidence table. An algorithm to assign the Grading of Recommendations Assessment, Development and Evaluation to assess the strength of evidence was applied for all outcomes.
resultsNine systematic reviews including 29 randomised controlled trials were included. Interventions comprised of solely ED-based or transitional interventions. The specific interventions delivered were highly variable. There was high overlap and low methodological quality of the trials informing the systematic reviews. There is low quality evidence to support ED interventions in reducing functional decline, improving patient experience and improving quality of life. The quality of evidence of the effectiveness of ED interventions to reduce mortality and ED revisits varied from very low to moderate. Results were presented narratively and summary of evidence tables created.
conclusionOlder adults are the most important emerging group in healthcare for several economic, social and political reasons. The existing evidence for the effectiveness of ED interventions for older adults is limited. This umbrella review highlights the challenge of synthesising evidence due to significant heterogeneity in methods, intervention content and reporting of outcomes. Higher quality intervention studies in line with current geriatric medicine research guidelines are recommended, rather than the publication of further systematic reviews.
trial registrationUMBRELLA REVIEW REGISTRATION: PROSPERO ( CRD42020145315 ).
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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.