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  • 2020-2024  (479)
  • 1
    Online Resource
    Online Resource
    Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition) 1
    Informa UK Limited ; 2021
    In:  Autophagy Vol. 17, No. 1 ( 2021-01-02), p. 1-382
    Details
    In: Autophagy, Informa UK Limited, Vol. 17, No. 1 ( 2021-01-02), p. 1-382
    Type of Medium: Online Resource
    ISSN: 1554-8627 , 1554-8635
    URL: Article
    DOI: 10.1080/15548627.2020.1797280
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2021
    detail.hit.zdb_id: 2262043-6
    SSG: 12
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  • 2
    Online Resource
    Online Resource
    Differences in End-of-Life Care between COVID-19 Inpatient Decedents with English Proficiency and Limited English Proficiency
    Mary Ann Liebert Inc ; 2022
    In:  Journal of Palliative Medicine Vol. 25, No. 11 ( 2022-11-01), p. 1629-1638
    Details
    In: Journal of Palliative Medicine, Mary Ann Liebert Inc, Vol. 25, No. 11 ( 2022-11-01), p. 1629-1638
    Type of Medium: Online Resource
    ISSN: 1096-6218 , 1557-7740
    URL: Article
    DOI: 10.1089/jpm.2021.0541
    Language: English
    Publisher: Mary Ann Liebert Inc
    Publication Date: 2022
    detail.hit.zdb_id: 2030890-5
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  • 3
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    Online Resource
    Place of Death and End-of-Life Care Utilization among COVID-19 Decedents in a Massachusetts Health Care System
    Mary Ann Liebert Inc ; 2021
    In:  Journal of Palliative Medicine Vol. 24, No. 3 ( 2021-03-01), p. 322-323
    Details
    In: Journal of Palliative Medicine, Mary Ann Liebert Inc, Vol. 24, No. 3 ( 2021-03-01), p. 322-323
    Type of Medium: Online Resource
    ISSN: 1096-6218 , 1557-7740
    URL: Article
    DOI: 10.1089/jpm.2020.0674
    Language: English
    Publisher: Mary Ann Liebert Inc
    Publication Date: 2021
    detail.hit.zdb_id: 2030890-5
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  • 4
    Online Resource
    Online Resource
    A crosswalk of commonly used frailty scales
    Wiley ; 2023
    In:  Journal of the American Geriatrics Society
    Details
    In: Journal of the American Geriatrics Society, Wiley
    Abstract: Several validated scales have been developed to measure frailty, yet the direct relationship between these measures and their scores remains unknown. To bridge this gap, we created a crosswalk of the most commonly used frailty scales. Methods We used data from 7070 community‐dwelling older adults who participated in National Health and Aging Trends Study (NHATS) Round 5 to construct a crosswalk among frailty scales. We operationalized the Study of Osteoporotic Fracture Index (SOF), FRAIL Scale, Frailty Phenotype, Clinical Frailty Scale (CFS), Vulnerable Elder Survey‐13 (VES‐13), Tilburg Frailty Indictor (TFI), Groningen Frailty Indicator (GFI), Edmonton Frailty Scale (EFS), and 40‐item Frailty Index (FI). A crosswalk between FI and the frailty scales was created using the equipercentile linking method, a statistical procedure that produces equivalent scoring between scales according to percentile distributions. To demonstrate its validity, we determined the 4‐year mortality risk across all scales for low‐risk (equivalent to FI 〈 0.20), moderate‐risk (FI 0.20 to 〈 0.40), and high‐risk (FI ≥0.40) categories. Results Using NHATS, the feasibility of calculating frailty scores was at least 90% for all nine scales, with the FI having the highest number of calculable scores. Participants considered frail on FI (cutpoint of 0.25) corresponded to the following scores on each frailty measure: SOF 1.3, FRAIL 1.7, Phenotype 1.7, CFS 5.3, VES‐13 5.5, TFI 4.4, GFI 4.8, and EFS 5.8. Conversely, individuals considered frail according to the cutpoint of each frailty measure corresponded to the following FI scores: 0.37 for SOF, 0.40 for FRAIL, 0.42 for Phenotype, 0.21 for CFS, 0.16 for VES‐13, 0.28 for TFI, 0.21 for GFI, and 0.37 for EFS. Across frailty scales, the 4‐year mortality risks between the same categories were similar in magnitude. Conclusion Our results provide clinicians and researchers with a useful tool to directly compare and interpret frailty scores across scales.
    Type of Medium: Online Resource
    ISSN: 0002-8614 , 1532-5415
    URL: Article
    DOI: 10.1111/jgs.18453
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2040494-3
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  • 5
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    Online Resource
    Post–Acute Care Rehabilitation Services and Outcomes in Skilled Nursing Facilities Before and During the COVID-19 Pandemic
    American Medical Association (AMA) ; 2023
    In:  JAMA Health Forum Vol. 4, No. 3 ( 2023-03-03), p. e230019-
    Details
    In: JAMA Health Forum, American Medical Association (AMA), Vol. 4, No. 3 ( 2023-03-03), p. e230019-
    Abstract: This cohort study evaluates changes in rehabilitation services provided by skilled nursing facilities during the COVID-19 pandemic.
    Type of Medium: Online Resource
    ISSN: 2689-0186
    URL: Article
    DOI: 10.1001/jamahealthforum.2023.0019
    Language: English
    Publisher: American Medical Association (AMA)
    Publication Date: 2023
    detail.hit.zdb_id: 3064651-0
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  • 6
    Online Resource
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    Risk Factors, Presentation, and Course of Coronavirus Disease 2019 in a Large, Academic Long-Term Care Facility
    Elsevier BV ; 2020
    In:  Journal of the American Medical Directors Association Vol. 21, No. 10 ( 2020-10), p. 1378-1383.e1
    Details
    In: Journal of the American Medical Directors Association, Elsevier BV, Vol. 21, No. 10 ( 2020-10), p. 1378-1383.e1
    Type of Medium: Online Resource
    ISSN: 1525-8610
    URL: Article
    DOI: 10.1016/j.jamda.2020.08.027
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
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  • 7
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    Restricted mean survival time versus conventional measures for treatment decision‐making
    Wiley ; 2021
    In:  Journal of the American Geriatrics Society Vol. 69, No. 8 ( 2021-08), p. 2282-2289
    Details
    In: Journal of the American Geriatrics Society, Wiley, Vol. 69, No. 8 ( 2021-08), p. 2282-2289
    Abstract: Restricted mean survival time (RMST) summarizes treatment effect in terms of a gain or loss in the event‐free days. It remains uncertain whether communicating treatment benefit and harm using RMST‐based summary is more effective than conventional summary based on absolute and relative risk reduction. We compared the effect of RMST‐based approach and conventional approach on decisional conflict using an example of intensive versus standard blood pressure‐lowering strategies. Design On‐line survey. Setting A convenience sample of patients in the United States. Participants Two hundred adults aged 65 and older with hypertension requiring anti‐hypertensive treatment (response rate 85.5%). Interventions Participants were randomly assigned to either RMST‐based summary or conventional summary about the benefit and harm of blood pressure‐lowering strategies. Measurements Decisional Conflict Scale (DCS), ranging from 0 (no conflict) to 100 (high conflict), and preference for intensive blood pressure‐lowering strategy. Results Participants assigned to RMST‐based approach ( n  = 100) and conventional approach ( n  = 100) had similar age (mean [standard deviation, SD]: 72.3 [5.6] vs 72.8 [5.5] years) and proportions of female (50 [50.0%] vs 61 [61.0%]) and white race (92 [92.0%] vs 92 [92.0%]). The mean (SD) DCS score was 25.2 (15.0) for RMST‐based approach and 25.6 (14.1) for conventional approach ( p  = 0.84). The number (%) of participants who preferred intensive strategy was 10 (10.0%) for RMST‐based approach and 14 (14.0%) for conventional approach ( p  = 0.52). The results were consistent in subgroups defined by age, sex, education level, cardiovascular disease status, and predicted mortality risk categories. Conclusion In a sample of relatively healthy older adults with hypertension, RMST‐based approach was as effective as conventional approach on decisional conflict about choosing a blood pressure‐lowering strategy. This study provides proof‐of‐concept evidence that RMST‐based approach can be used in conjunction with absolute and relative risk reduction for communicating treatment benefit and harm in a decision aid.
    Type of Medium: Online Resource
    ISSN: 0002-8614 , 1532-5415
    URL: Issue
    URL: Article
    DOI: 10.1111/jgs.v69.8
    DOI: 10.1111/jgs.17195
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2040494-3
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  • 8
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    Restricted mean survival time versus conventional effect summary for treatment decision‐making: A mixed‐methods study
    Wiley ; 2023
    In:  Journal of the American Geriatrics Society Vol. 71, No. 2 ( 2023-02), p. 528-537
    Details
    In: Journal of the American Geriatrics Society, Wiley, Vol. 71, No. 2 ( 2023-02), p. 528-537
    Abstract: Treatment effect is typically summarized in terms of relative risk reduction or number needed to treat (“conventional effect summary”). Restricted mean survival time (RMST) summarizes treatment effect in terms of a gain or loss in event‐free days. Older adults' preference between the two effect summary measures has not been studied. Methods We conducted a mixed methods study using a quantitative survey and qualitative semi‐structured interviews. For the survey, we enrolled 102 residents with hypertension at five senior housing facilities (mean age 81.3 years, 82 female, 95 white race). We randomly assigned respondents to either RMST‐based ( n  = 49) or conventional decision aid ( n  = 53) about the benefits and harms of intensive versus standard blood pressure‐lowering strategies and compared decision conflict scale (DCS) responses (range: 0 [no conflict] to 100 [maximum conflict] ; 〈 25 is associated with implementing decisions). We used a purposive sample of 23 survey respondents stratified by both their random assignment and DCS from the survey. Inductive qualitative thematic analysis explored complementary perspectives on preferred ways of summarizing treatment effects. Results The mean (standard deviation) total DCS was 22.0 (14.3) for the conventional decision aid group and 16.7 (14.1) for the RMST‐based decision aid group ( p  = 0.06), but the proportion of participants with a DCS 〈 25 was higher in the RMST‐based group (26 [49.1%] vs 34 [69.4%] ; p  = 0.04). Qualitative interviews suggested that, regardless of effect summary measure, older individuals' preference depended on their ability to clearly comprehend quantitative information, clarity of presentation in the visual aid, and inclusion of desired information. Conclusions When choosing a blood pressure‐lowering strategy, older adults' perceived uncertainty may be reduced with a time‐based effect summary, although our study was underpowered to detect a statistically significant difference. Given highly variable individual preferences, it may be useful to present both conventional and RMST‐based information in decision aids.
    Type of Medium: Online Resource
    ISSN: 0002-8614 , 1532-5415
    URL: Issue
    URL: Article
    DOI: 10.1111/jgs.v71.2
    DOI: 10.1111/jgs.18107
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2040494-3
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  • 9
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    Online Resource
    Accuracy of diagnosis and health service codes in identifying frailty in Medicare data
    Springer Science and Business Media LLC ; 2020
    In:  BMC Geriatrics Vol. 20, No. 1 ( 2020-12)
    Details
    In: BMC Geriatrics, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2020-12)
    Abstract: Capturing frailty within administrative claims data may help to identify high-risk patients and inform population health management strategies. Although it is common to ascertain frailty status utilizing claims-based surrogates (e.g. diagnosis and health service codes) selected according to clinical knowledge, the accuracy of this approach has not yet been examined. We evaluated the accuracy of claims-based surrogates against two clinical definitions of frailty. Methods This cross-sectional study was conducted in a Health and Retirement Study subsample of 3097 participants, aged 65 years or older and with at least 12-months of continuous fee-for-service Medicare enrollment. We defined 18 previously utilized claims-based surrogates of frailty from Medicare data and evaluated each against clinical reference standards, ascertained from a direct examination: a deficit accumulation frailty index (FI) (range: 0–1) and frailty phenotype. We also compared the accuracy of the total count of 18 claims-based surrogates with that of a validated claims-based FI model, comprised of 93 claims-based variables. Results 19% of participants met clinical criteria for the clinical frailty phenotype. The mean clinical FI for our sample was 0.20 (standard deviation 0.13). Hospital Beds and associated supplies was the claims-based surrogate associated with the highest clinical FI (mean FI 0.49). Claims-based surrogates had low sensitivity ranging from 0.01 ( cachexia, adult failure to thrive, anorexia ) to 0.38 ( malaise and fatigue ) and high specificity ranging from 0.79 ( malaise and fatigue ) to 0.99 ( cachexia, adult failure to thrive, anorexia ) in discriminating the clinical frailty phenotype. Compared with a validated claims-based FI, the total count of claims-based surrogates demonstrated lower Spearman correlation with the clinical FI (0.41 [95% CI 0.38–0.44] versus 0.59 [95% CI, 0.56–0.61] ) and poorer discrimination of the frailty phenotype (C-statistics 0.68 [95% CI, 0.66–0.70] versus 0.75 [95% CI, 0.73–0.77] ). Conclusions Claims-based surrogates, selected according to clinical knowledge, do not accurately capture frailty in Medicare claims data. A simple count of claims-based surrogates improves accuracy but remains inferior to a claims-based FI model.
    Type of Medium: Online Resource
    ISSN: 1471-2318
    URL: Article
    DOI: 10.1186/s12877-020-01739-w
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2059865-8
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  • 10
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    Online Resource
    Changes in Predictive Performance of a Frailty Index with Availability of Clinical Domains
    Wiley ; 2020
    In:  Journal of the American Geriatrics Society Vol. 68, No. 8 ( 2020-08), p. 1771-1777
    Details
    In: Journal of the American Geriatrics Society, Wiley, Vol. 68, No. 8 ( 2020-08), p. 1771-1777
    Abstract: Determine the effects of missing data in frailty identification and risk prediction. DESIGN Analysis of the National Health in Aging Trends Study. SETTING Community. PARTICIPANTS About 6206 older adults. MEASUREMENTS A 41‐variable frailty index (FI) was constructed with the following domains: comorbidities, activities of daily living (ADLs), instrumental activities of daily living, self‐reported physical limitations, physical performance, and neuropsychiatric tests. We evaluated discrimination after removing single and multiple domains, comparing C‐statistics for predicting 5‐year risk of mortality and 1‐year risks of disability and falls. RESULTS The full FI yielded a mean of .18 and C‐statistics of .72 (95% confidence interval, .70‐.74) for mortality, .80 (.77‐.82) for disability, and .66 (.64‐.68) for falls. Removal of any single domain shifted the FI distribution, resulting in a mean FI ranging from .13 (removing comorbidities) to .20 (removing ADLs) and frailty prevalence (FI ≥ .25) from 16.0% to 28.7%. Among robust participants models missing ADLs misclassified most often, (19% as pre‐frail). Among pre‐frail and frail participants missing comorbidities misclassified most often(69.2% from pre‐frail to robust, 24% from frail to pre‐frail, and 4.9% from frail to robust). Removal of any single domain minimally changed C‐statistics: mortality, .71‐.73; disability, .79‐.80; and falls, .64‐.66. Removing neuropsychiatric testing and physical performance yielded comparable C‐statistics of .70, .78, and .66 for mortality, ADLs, and falls, respectively. However, removal of three or four domains based on likely availability decreased C‐statistics for mortality (.69, .66),disability (.75, .70), and falls (.64, .63), respectively. CONCLUSION While FI discrimination is robust to missing information in any single domain, risk prediction is affected by absence of multiple domains. This work informs the application of FI as a clinical and research tool. J Am Geriatr Soc 68:1771‐1777, 2020.
    Type of Medium: Online Resource
    ISSN: 0002-8614 , 1532-5415
    URL: Issue
    URL: Article
    DOI: 10.1111/jgs.v68.8
    DOI: 10.1111/jgs.16436
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2040494-3
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