Effectiveness of a web-based socio-geriatric pre-consultation tool for older adults in primary care: A randomized controlled trial (Preprint)
Notice bibliographique
Résumé
BACKGROUND Pre-consultation tools have been proposed as a solution to support primary care providers in effectively managing the growing number of older adults. Despite older adults making up 25% of primary care consultations, few tools are specifically adapted for them, and most only assess their physical health. The Evaluation SOcio-GERiatrique (ESOGER) tool, a short web-based pre-consultation questionnaire of older adults' physical, mental, cognitive, and social support needs, administered by phone, may provide an effective means of supporting providers in improving patient outcomes in the primary care setting. OBJECTIVE To evaluate the effectiveness of the ESOGER tool in improving health-related quality of life and unplanned health service use for older adults in the primary care context. METHODS A multi-center, individually-randomized parallel-group controlled trial was conducted at four university affiliated interprofessional primary care clinics in Quebec, Canada. Participants were randomized 1 to 1 to either the intervention or standard care group. The intervention group was administered the ESOGER tool by phone by clinic staff (total of 12 clinic staff across sites) at least one day prior to their consultation with their health provider. The ESOGER tool generated a report for the provider to view at the time of consultation. Although clinics were not blinded to group assignment, patients were blinded unless the tool was mentioned during consultation with the health provider. The primary outcome of interest was self-reported health-related quality of life (HRQoL) as measured by the EuroQol 5D (EQ-5D). Secondary outcomes were self-reported unplanned visits to their family doctor, visits to the emergency department (ED) and hospitalizations within the last three months. Data were collected at baseline and 3 months. An intention-to-treat (ITT) analysis was carried out for the study outcomes. The primary outcome was analysed using beta regression. Secondary outcomes were analysed using logistic regression. Inverse probability of censoring weighting was used to impute missing data due to censoring. RESULTS Of the 452 eligible to participate, 111 were lost to follow up, for a total sample size of 341 (75.4%) participants. No significant differences in the EQ-5D were observed between the intervention and the standard care group (OR = 1.0, 95%CI [0.5, 2.0]) or the secondary outcomes. CONCLUSIONS ESOGER, a pre-consultation tool in the primary care setting for older adults, did not have an effect on health-related quality of life or unplanned health service use when compared to standard care. The non-significant results of the ESOGER tool could be due to a ceiling effect, a limited follow-up duration, or lack of resources for the implementation of the ESOGER tool. Given the potential of pre-consultation tools to support the management of older adults, further research should explore the conditions under which these tools can lead to positive patient outcomes. CLINICALTRIAL ClinicalTrials.gov NCT05102890
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
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 | 0,007 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,004 | 0,004 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,002 | 0,002 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,003 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,010 | 0,001 |
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 ».