New horizons in evidence-based care for older people: individual participant data meta-analysis

Clegg, A; Bandeen-Roche, K; Farrin, A; Forster, A; Gill, TM; Gladman, J; Kerse, N; Lindley, R; McManus, RJ; Melis, R; Mujica-Mota, R; Raina, P; Rockwood, K; Teh, R; Van Der Windt, D; Witham, M

doi:10.1093/ageing/afac090

New horizons in evidence-based care for older people: individual participant data meta-analysis

Clegg, A; Bandeen-Roche, K; Farrin, A; Forster, A; Gill, TM; Gladman, J; Kerse, N; Lindley, R; McManus, RJ; Melis, R; Mujica-Mota, R; Raina, P; Rockwood, K; Teh, R; Van Der Windt, D; Witham, M

Authors

A Clegg

K Bandeen-Roche

A Farrin

A Forster

TM Gill

J Gladman

N Kerse

R Lindley

RJ McManus

R Melis

R Mujica-Mota

P Raina

K Rockwood

R Teh

Danielle Van Der Windt d.van.der.windt@keele.ac.uk

M Witham

Abstract

Evidence-based decisions on clinical and cost-effectiveness of interventions are ideally informed by meta-analyses of intervention trial data. However, when undertaken, such meta-analyses in ageing research have typically been conducted using standard methods whereby summary (aggregate) data are extracted from published trial reports. Although meta-analysis of aggregate data can provide useful insights into the average effect of interventions within a selected trial population, it has limitations regarding robust conclusions on which subgroups of people stand to gain the greatest benefit from an intervention or are at risk of experiencing harm. Future evidence synthesis using individual participant data from ageing research trials for meta-analysis could transform understanding of the effectiveness of interventions for older people, supporting evidence-based and sustainable commissioning. A major advantage of individual participant data meta-analysis (IPDMA) is that it enables examination of characteristics that predict treatment effects, such as frailty, disability, cognitive impairment, ethnicity, gender and other wider determinants of health. Key challenges of IPDMA relate to the complexity and resources needed for obtaining, managing and preparing datasets, requiring a meticulous approach involving experienced researchers, frequently with expertise in designing and analysing clinical trials. In anticipation of future IPDMA work in ageing research, we are establishing an international Ageing Research Trialists collective, to bring together trialists with a common focus on transforming care for older people as a shared ambition across nations.

Journal Article Type	Article
Acceptance Date	Apr 1, 2022
Publication Date	Apr 22, 2022
Journal	Age and Ageing
Print ISSN	0002-0729
Publisher	Oxford University Press
Peer Reviewed	Peer Reviewed
Volume	51
Issue	4
DOI	https://doi.org/10.1093/ageing/afac090
Keywords	ageing, frailty, stratified care, individual participant data, meta-analysis, older people
Publisher URL	https://academic.oup.com/ageing/article/51/4/afac090/6572255#350261578