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Cohen 2002 GEMC (Continued)<br />

Baseline characteristics similar Low risk Similar baseline characteristics<br />

Study protected against contamination Low risk Care conducted on different units with different<br />

groups of staff<br />

Cohen 2002 UCOP<br />

Methods This is the subgroup of the trial that evaluated Usual Care Outpatient (UCOP) follow<br />

up following discharge from inpatient care. This splitting of the data has been done <strong>to</strong><br />

enable meta-analysis <strong>for</strong> the outpatient follow up subgroup.<br />

Participants Numbers (<strong>to</strong>tal): 1388<br />

Mean age: 74<br />

Male:female ratio: 98% male<br />

Inclusion criteria: age at least 65, hospitalised on a medical ward, expected length of stay<br />

> 2 days, frailty (presence of stroke, his<strong>to</strong>ry of falls, inability <strong>to</strong> per<strong>for</strong>m ADLs, prolonged<br />

bed rests, incontinence)<br />

Exclusion criteria: admissions from nursing home, terminal illness<br />

Patient selection criteria: selected<br />

Patient selection criteria details: as above<br />

Interventions Team members: senior <strong>geriatric</strong>ian, specialist nurse, social workers, physiotherapists,<br />

occupational therapists, dieticians, pharmacists<br />

Team organisation: comprehensive <strong>assessment</strong>, at least weekly MDT meeting<br />

Outcomes Outcomes: death, perceived health status, basic and extended ADL, costs<br />

Trial conclusions: no overall effects on survival. Improved physical function with inpatient<br />

care, improved cognitive function with outpatient care<br />

Notes See above<br />

Risk of bias<br />

Bias Authors’ judgement Support <strong>for</strong> judgement<br />

Random sequence generation (selection<br />

bias)<br />

Low risk Computerised random numbers in two-bytwo<br />

fac<strong>to</strong>rial design with stratification according<br />

<strong>to</strong> functional status<br />

Allocation concealment (selection bias) Low risk Randomisation remote at co-ordinating<br />

centre<br />

Blinding (per<strong>for</strong>mance bias and detection<br />

bias)<br />

All outcomes<br />

Incomplete outcome data (attrition bias)<br />

All outcomes<br />

<strong>Comprehensive</strong> <strong>geriatric</strong> <strong>assessment</strong> <strong>for</strong> <strong>older</strong> <strong>adults</strong> <strong>admitted</strong> <strong>to</strong> hospital (Review)<br />

Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.<br />

Low risk Blinding of outcome assessor only<br />

Low risk Intention-<strong>to</strong>-treat analysis<br />

26

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