Geriatric rehabilitation following fractures in older people: a systematic review.

Abstract

et al. Geriatric rehabilitation following fractures in older people: a systematic review. Health Technol Assess 2000;4(2). Health Technology Assessment is indexed in Index Medicus/MEDLINE and Excerpta Medica/ EMBASE. Copies of the Executive Summaries are available from the NCCHTA web site (see overleaf). NHS R&D HTA Programme T he overall aim of the NHS R&D Health Technology Assessment (HTA) programme is to ensure that high-quality research information on the costs, effectiveness and broader impact of health technologies is produced in the most efficient way for those who use, manage and work in the NHS. Research is undertaken in those areas where the evidence will lead to the greatest benefits to patients, either through improved patient outcomes or the most efficient use of NHS resources. The Standing Group on Health Technology advises on national priorities for health technology assessment. Six advisory panels assist the Standing Group in identifying and prioritising projects. These priorities are then considered by the HTA Commissioning Board supported by the National Coordinating Centre for HTA (NCCHTA). This report is one of a series covering acute care, diagnostics and imaging, methodology, pharmaceuticals, population screening, and primary and community care. It was identified as a priority by the Acute Sector Panel and funded as project number 95/36/02. The views expressed in this publication are those of the authors and not necessarily those of the Standing Group, the Commissioning Board, the Panel members or the Department of Health. The editors wish to emphasise that funding and publication of this research by the NHS should not be taken as implicit support for the recommendations for policy contained herein. In particular, policy options in the area of screening will be considered by the National Screening Committee. This Committee, chaired by the Chief Medical Officer, will take into account the views expressed here, further available evidence and other relevant considerations. Reviews in Health Technology Assessment are termed 'systematic' when the account of the search, appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. Criteria for inclusion in the HTA monograph series Reports are published in the HTA monograph series if (1) they have resulted from work either prioritised by the Standing Group on Health Technology, or otherwise commissioned for the HTA Programme, and (2) they are of a sufficiently high scientific quality as assessed by the referees and editors.

A systematic review of tools used to assess the quality of observational studies that examine incidence or prevalence and risk factors for diseases

“…Formulation of the questions, however, resulted in different degrees of subjectivity. For example, a section to assess external validity would have one question that required an additional judgment of ''representativeness'' of the study population to the target population and another question that can have a definitive answer, such as the length of the follow up greater than or less than 1 year [70].…”

An audit of hip fracture services in the Mater Hospital Dublin 2001 compared with 2006

“…A trend towards earlier functional independence, reduced length of stay, improved management of medical conditions and decreased future need for institutional care, including nursing home care has been demonstrated in the literature [3][4][5]. In 2007 the British Orthopaedic Association published a collaborative paper summarising the evidence base regarding the care of patients with fragility fracture [6].…”

Musculoskeletal rehabilitation after hip fracture: a review

“…Medical care and rehabilitation are supervised by a geriatrician, often with the help of a specialized general practitioner. There is no evidence, however, that length of stay is reduced in a GORU compared to a conventional unit [27].…”

“…Factors such as complexity of case mix, service context, details of service organisation and multi-disciplinary inputs, and even healthcare reimbursement systems, can add greatly to the problems normally associated with the organisation of large scale clinical trials involving older patients [20,27].…”