Effect of Case Management after Functional Evaluation in the Annual Elderly Health Examination
Notice bibliographique
Résumé
Objectives: The items of annual elderly health examination from Taipei city government are mainly disease oriented at present. However, screening for frail elderly and preventing their functional decline are also very important. We tried to increase function evaluation in the elderly annual health examination and use case management method to improve the function of examinees thereafter. Methods: This is a quasi-experimental controlled trial. Four hundred and four adults aged 70 and older who joined in the 2013 annual elderly health examination at Taipei city hospital Yangming branch and Canadian Study of Health and Aging Clinical Frailty Scale (CSHA- CFS) Chinese In-Person Interview Version scored 3-6 were enrolled. One hundred and thirty two participants who agreed to receive functional examination joined in the experimental group. Interventions: Experiment group received CSHA- CFS, Fried Frailty Index(FFI), timed up and go test(TUG), Short-form Physical Performance Battery (SPPB) examination, exercise instruction and nutrition education at 0, 3rd and 12th month and routine annual elderly health examination at 0 and 12th month. Case manager reminded the experimental group to keep exercise and nutrition supplement by telephone interview at 6th and 9th month. Control group receive CSHA- CFS and routine annual elderly health examination at 0 and 12th month. Both groups received telephone interview to collect adverse event data at 3rd, 6th, 9th and 12th month. Results: The baseline characteristics including gender, age, CSHACFA, difficult in walking 800 meters, difficult in climbing 10 stairs, number of comorbidity... were similar for the two groups.112 (84.5%) persons of experimental group and 267 (98.2%) persons of control group completed the study. CSHA- CFS of the experimental group were more likely to improve (OR=9.50, 95% CI=4.62-19.56) and less likely to deteriorate (OR=0.04, 95% CI=0.01-0.31), one year after intervention respectively. Within experimental group, FFI improvement percentage was greater than deterioration percentage (46.4% vs. 2.4%, p＜0.0001), five meters walk speed increased from 1.0±0.2 m/sec to 1.2±0.2 m/ sec (p＜0.0001), grip strength increased from 22.3±7.1kg to 24.8±6.7 kg (p＜0.0001), SPPB increased from 10.0±1.6 to 11.0±1.2 (p＜0.0001), TUG decreased from 10.9±2.9 second to 9.5±2.1 second (p＜0.0001). However, there was no statistical difference of composite endpoint including hospitalization, emergency department visit and falls between two groups though the incidence of composite endpoint was higher in the control group. Conclusions: Case management after functional evaluation in the annual elderly health examination may improve function for adults above 70 years old. We suggests to add FFI and TUG in the annual elderly examination.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,015 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,002 | 0,002 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».