Evidence map›Paper›PMID 38919511›Full record

SynthesisCritical care explorations2024

Critically Ill Older Adults' Representation in Intervention Trials: A Systematic Review.

Marie-France Forget, Han Ting Wang, Raphaelle Carignan, Alexandre Dessureault, Mathieu Gravel, Jeanne Bienvenue, Maude Bouchard, Camille Durivage, Richard Coveney, Laveena Munshi

Abstract readSystematic Review
In one paragraph

Synthesis in Critical care explorations, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
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

10 authors.

Marie-France ForgetDepartment of Medicine, Division of Geriatric Medicine, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada.ORCID 0000-0002-1102-1750
Han Ting WangDepartment of Medicine, Division of Critical Care Medicine, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada.
Raphaelle CarignanDepartment of Medicine, Division of Internal Medicine, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada.
Alexandre DessureaultDepartment of Medicine, Division of Internal Medicine, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada.
Mathieu GravelDepartment of Medicine, Faculty of Medicine, Université de Laval, Québec, QC, Canada.
Jeanne BienvenueDepartment of Medicine, Division of Internal Medicine, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada.
Maude BouchardDepartment of Medicine, Division of Internal Medicine, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada.
Camille DurivageDepartment of Medicine, Division of Internal Medicine, Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada.
Richard CoveneyTeaching Division/Library, Hôpital Maisonneuve-Rosemont, CIUSSS de l'Est-de-l'île-de-Montréal, Montréal, QC, Canada.
Laveena MunshiInterdepartmental Division of Critical Care, Sinai Health System, University of Toronto, Toronto, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesOlder adults may be under-represented in critical care research, and results may not apply to this specific population. Our primary objective was to evaluate the prevalence of inclusion of older adults across critical care trials focused on common ICU conditions or interventions. Our secondary objective was to evaluate whether older age was used as a stratification variable for randomization or outcome analysis. DESIGN SETTING AND SUBJECTS: We performed a systematic review of previously published systematic reviews of randomized controlled trials (RCTs) in critical care. We searched PubMed, Ovid, CENTRAL, and Cochrane from 2009 to 2022. Systematic reviews of any interventions across five topics: acute respiratory distress syndrome (ARDS), sepsis/shock, nutrition, sedation, and mobilization were eligible. MAIN

resultsWe identified 216 systematic reviews and included a total of 253 RCTs and 113,090 patients. We extracted baseline characteristics and the reported proportion of older adults. We assessed whether any upper age limit was an exclusion criterion for trials, whether age was used for stratification during randomization or data analysis, and if age-specific subgroup analysis was present. The most prevalent topic was sepsis (78 trials, 31%), followed by nutrition (62 trials, 25%), ARDS (39 trials, 15%), mobilization (38 trials, 15%), and sedation (36 trials, 14%). Eighteen trials (7%) had exclusion criteria based on older age. Age distribution with information on older adults prevalence was given in six trials (2%). Age was considered in the analysis of ten trials (5%) using analytic methods to evaluate the outcome stratified by age. Conclusions: In this systematic review, the proportion of older critically ill patients is undetermined, and it is unclear how age is or is not an effect modifier or to what extent the results are valid for older adult groups. Reporting age is important to guide clinicians in personalizing care. These results highlight the importance of incorporating older critically ill patients in future trials to ensure the results are generalizable to this growing population.

Indexed as

Critical CareCritical IllnessRandomized Controlled Trials as TopicAgedAged, 80 and overAge FactorsHumansIntensive Care UnitsPatient SelectionRespiratory Distress SyndromeSepsiscritical illnesshumansolder adultssystematic review

Identifiers

PMID38919511
PMCPMC11196082

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.