Chapter 1: Effectiveness of each element of the comprehensive geriatric assessment (<scp>CGA</scp>): English translation of the Japanese <scp>CGA</scp>‐based healthcare guidelines 2024
Bibliographic record
Abstract
Clinical question (CQ) I-1 screeningIs screening with the comprehensive geriatric assessment (CGA) useful in older adults? StatementScreening with the CGA is recommended for older adults.Strength of evidence: B. Degree of recommendation: 1 (strong; agreement rate: 100%). ExplanationOf the literature included in the systematic review, six were randomized controlled trials (RCTs).The CGA is a multidimensional assessment of the medical and functioning of older adults, which identifies current life problems and the risk of developing problems.The CGA plays a screening role; however, simple screening tools such as the Kihon checklist, CGA7, and Dementia Assessment Sheet in Community-based Integrated Care System-21 items (DASC-21) are also used in clinical practice and are part of the CGA.In a systematic review, the usefulness of CGA in the outpatient, inpatient, and home settings was investigated, emphasizing on "reduced mortality," "reduced length of stay," "improved polypharmacy," and "increased costs."Six reports of RCTs assessed outcomes, randomly assigned with or without the CGA and CGA-based interventions.For the CGA of outpatients, a Swedish study comparing CGAbased care with usual care in outpatients aged ≥75 years was selected.In that study, the CGA contributed to longer survival (hazard ratio [HR], 1.49 [95% CI, 1.05-2.12])and shorter hospital stay (15.1 vs. 21.0 days; P = 0.01) 36 months after intervention, with no increase in costs. 1 Moreover, the CGA may improve outcomes after an emergency department visit.In an Australian study comparing the CGA with or without continuous care intervention in patients aged ≥75 years returning home from an emergency department visit, the CGA group had lower overall hospital admissions in the first 30 days (16.5% vs. 22.2%;P = 0.048) and emergency admissions over 18 months (44.4% vs. 54.3%;P = 0.007) than the usual care group (control group), whereas no difference in mortality was noted. 2 For inpatient CGA, a Swedish study compared acute care in a CGA care unit with that in a usual care unit for patients aged ≥75 years demonstrating frailty.The study found that patients receiving care in a CGA care unit had a slightly lower healthrelated quality of life (QOL) and a significantly lower mortality rate at 3 months (HR, 0.55 [95% CI, 0.32-0.96]),and the medical and
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.031 | 0.133 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.009 | 0.011 |
| Bibliometrics | 0.007 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.005 | 0.004 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.005 | 0.004 |
| Insufficient payload (model declined to judge) | 0.038 | 0.007 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".