A proposed methodology for assessing the effectiveness of geriatric services

Article type
Authors
Cole MG, McCusker J
Abstract
Discussion: Given limited resources, there is increasing concern about the effectiveness of geriatric services. This paper presents a new methodology for assessing evidence of effectiveness of these services. This methodology, adapted from the analytic practices of the Canadian Task Force on the Periodic Health Examination, has five steps. The first step identifies a target illness or disability in the elderly. The second step involves development of a condition-specific service model that maps out relationships between service procedures, clinical events, and the target condition. The third step calls for establishment of criteria (e.g. benefits, adverse effects) that must be satisfied for each service model to be considered effective. The fourth step entails reviewing evidence from published clinical research to determine if the service model meets established criteria. This review process includes comprehensive information retrieval, evaluation of the quality of study designs and methodologies and synthesis of results. The fifth and final step classifies services based on evidence of effectiveness. This methodology can enhance scientific standards for assessing the effectiveness of geriatric services by encouraging evaluation of evidence.