Evidence map›Paper›PMID 36541454›Full record

SynthesisHealth technology assessment (Winchester, England)2022

Oral nutritional interventions in frail older people who are malnourished or at risk of malnutrition: a systematic review.

Katie Thomson, Stephen Rice, Oluwatomi Arisa, Eugenie Johnson, Louise Tanner, Christopher Marshall, Tumi Sotire, Catherine Richmond, Hannah O'Keefe, Wael Mohammed and 6 more

Open access · diamondAbstract readSystematic ReviewNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Health technology assessment (Winchester, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 1 pooled it
3.5field-weighted citation impact, top 6% 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

17 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.

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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

16 authors at 4 institutions in 1 country.

Katie ThomsonEvidence Synthesis Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.ORCID 0000-0002-9614-728X
Stephen RicePopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.ORCID 0000-0002-6767-0813
Oluwatomi ArisaEvidence Synthesis Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.ORCID 0000-0001-8581-6073
Eugenie JohnsonPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.ORCID 0000-0003-3324-7141
Louise TannerEvidence Synthesis Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.ORCID 0000-0003-2340-8677
Christopher MarshallEvidence Synthesis Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.ORCID 0000-0002-7970-681X
Tumi SotirePopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.ORCID 0000-0002-5330-9568
Catherine RichmondEvidence Synthesis Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.ORCID 0000-0002-2940-5197
Hannah O'KeefeEvidence Synthesis Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.ORCID 0000-0002-0107-711X
Wael MohammedPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.ORCID 0000-0003-0370-4903
Margot GosneyRoyal Berkshire NHS Foundation Trust, Reading, UK.ORCID 0000-0001-9004-7571
Anne RaffleElders Council of Newcastle upon Tyne, Newcastle upon Tyne, UK.ORCID 0000-0003-4684-2230
Barbara HanrattyPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.ORCID 0000-0002-3122-7190
Claire T McEvoyCentre for Public Health, Queen's University Belfast, Belfast, UK.ORCID 0000-0001-8512-3293
Dawn CraigEvidence Synthesis Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.ORCID 0000-0002-5808-0096
Sheena E RamsayPopulation Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.ORCID 0000-0002-0391-9704
Newcastle University · GBElders of Newscastle Upon Tyne · GBQueen's University Belfast · GBRoyal Berkshire NHS Foundation Trust · GB

Funding

Department of HealthMedical Research Council MR/K02325X/1
6 · The paper itself

Abstract

backgroundMalnutrition worsens the health of frail older adults. Current treatments for malnutrition may include prescribed oral nutritional supplements, which are multinutrient products containing macronutrients and micronutrients.

objectiveTo assess the effectiveness and cost-effectiveness of oral nutritional supplements (with or without other dietary interventions) in frail older people who are malnourished or at risk of malnutrition. DATA SOURCES: MEDLINE, EMBASE, Cochrane Library, Scopus, CINAHL (Cumulative Index to Nursing and Allied Health Literature) and grey literature were searched from inception to 13 September 2021. REVIEW

methodsA systematic review and meta-analysis was conducted to evaluate the effectiveness and cost-effectiveness of oral nutritional supplements in frail older people (aged ≥ 65 years) who are malnourished or at risk of malnutrition (defined as undernutrition as per National Institute for Health and Care Excellence guidelines). Meta-analysis and network meta-analysis were undertaken, where feasible, along with a narrative synthesis. A cost-effectiveness review was reported narratively. A de novo model was developed using effectiveness evidence identified in the systematic review to estimate the cost-effectiveness of oral nutritional supplements.

resultsEleven studies ( LIMITATIONS: The review scope was narrow in focus as few primary studies used frailty measures (or our proxy criteria). This resulted in only 11 included studies. The small evidence base and varied quality of evidence meant that it was not possible to determine accurate estimates of the effectiveness or cost-effectiveness of oral nutritional supplements. Furthermore, only English-language publications were considered.

conclusionsOverall, the review found little evidence of oral nutritional supplements having significant effects on reducing malnutrition or its adverse outcomes in frail older adults. FUTURE WORK: Future research should focus on independent, high-quality, adequately powered studies to investigate oral nutritional supplements alongside other nutritional interventions, with longer-term follow-up and detailed analysis of determinants, intervention components and cost-effectiveness. STUDY REGISTRATION: This study is registered as PROSPERO CRD42020170906.

fundingThis project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme and will be published in full in

Indexed as

Frail ElderlyMalnutritionAgedBody WeightCost-Benefit AnalysisHumansQuality of LifeAGEDDIETARY SUPPLEMENTSFRAILTYMALNUTRITION

Identifiers

PMID36541454
PMCPMC9791461
OpenAlexW4312043238

What OpenQuestion holds

Textmetadata
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.