Advertisement

Aging Clinical and Experimental Research

, Volume 27, Issue 6, pp 767–774 | Cite as

Selection of the method to appraise and compare health systems using risk stratification: the ASSEHS approach

  • J. Mora
  • D. De Massari
  • S. Pauws
  • J. op den Buijs
  • M. David
  • L. Prieto
  • J. Contel
  • T. Martí
  • J. Bousquet
  • E. de Manuel
  • the ASSEHS Study Group
Review

Abstract

To face the challenge of active and healthy ageing, European Health Systems and services should move towards proactive, anticipatory and integrated care. The comparison of methods to combine results across studies and to determine an overall effect was undertaken by the EU project ASSEHS (Activation of Stratification Strategies and Results of the interventions on frail patients of Healthcare Services, EU project (No. 2013 12 04). The questions raised in ASSEHS are broad and involve a complex body of literature. Thus, systematic reviews are not appropriate. The most appropriate method appears to be scoping studies. In this paper, an updated method of scoping studies has been used to determine the questions needed to appraise the health systems and services for frailty in the ageing population. Three objectives were set (i) to detect a relevant number of risk stratification tools for frailty and identify the best-in-class, (ii) to understand the feasibility of introducing stratification tools and identify the difficulties of the process and (iii) to find evidence on the impact of risk stratification in Health Services. This novel approach may provide greater clarity about scoping study methodology and help enhance the methodological rigor with which authors undertake and report scoping studies.

Keywords

Scoping studies ASSEHS EIPonAHA Health system Frailty 

Abbreviations

ASSEHS

Activation of Stratification Strategies and Results of the interventions on frail patients of Healthcare Services

EIPonAHA

European innovation Partnership on Active and Healthy Ageing

EU

European union

PICO

Patient, problem or population, intervention, comparison, control or comparator, outcome

PRISMA

Preferred reporting items for systematic reviews and meta-analyses

RCT

Randomised controlled trial

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

This article does not contains any studies with human and participants or animals performed by any of the authors.

Informed consent

For this type of study informed consent is not required.

References

  1. 1.
    Rechel B, Grundy E, Robine JM et al (2013) Ageing in the European Union. Lancet 381:1312–1322CrossRefPubMedGoogle Scholar
  2. 2.
    Bousquet J, Michel J, Standberg T et al (2014) The European Innovation Partnership on Active and Healthy Ageing: the European Geriatric Medicine introduces the EIP on AHA Column. Eur Geriatr Med. 5:361–362CrossRefGoogle Scholar
  3. 3.
    Watt G, O’Donnell C, Sridharan S (2011) Building on Julian Tudor Hart’s example of anticipatory care. Prim Health Care Res Dev 12:3–10CrossRefPubMedGoogle Scholar
  4. 4.
    Dorfman R, Khayat Z, Sieminowski T et al (2013) Application of personalized medicine to chronic disease: a feasibility assessment. Clin Transl Med 2:16PubMedCentralCrossRefPubMedGoogle Scholar
  5. 5.
    Kansagara D, Englander H, Salanitro A et al (2011) Risk prediction models for hospital readmission: a systematic review. JAMA 306:1688–1698PubMedCentralCrossRefPubMedGoogle Scholar
  6. 6.
    Wennberg D, Siegel M, Darin B et al (2006) Combined predictive model: final report and technical documentation. Health Dialog/King’s Fund/New York University, London. http://www.kingsfund.org.uk/research/projects
  7. 7.
    Ilinca S, Calciolari S (2015) The patterns of health care utilization by elderly Europeans: frailty and its implications for health systems. Health Serv Res 50:305–320CrossRefPubMedGoogle Scholar
  8. 8.
    Pialoux T, Goyard J, Lesourd B (2012) Screening tools for frailty in primary health care: a systematic review. Geriatr Gerontol Int 12:189–197CrossRefPubMedGoogle Scholar
  9. 9.
    Fox KA, Fitzgerald G, Puymirat E et al (2014) Should patients with acute coronary disease be stratified for management according to their risk? Derivation, external validation and outcomes using the updated GRACE risk score. BMJ open 4:e004425PubMedCentralCrossRefPubMedGoogle Scholar
  10. 10.
    Wu RR, Orlando LA, Himmel TL et al (2013) Patient and primary care provider experience using a family health history collection, risk stratification, and clinical decision support tool: a type 2 hybrid controlled implementation-effectiveness trial. BMC Fam Pract 14:111PubMedCentralCrossRefPubMedGoogle Scholar
  11. 11.
    de-Manuel-Keenoy E, David M, Mora J et al (2014) Activation of stratification strategies and results of the interventions on frail patients of healthcare services (ASSEHS) DG Sanco Project No. 2013 12 04. Eur Geriatr Med 5:342-346CrossRefGoogle Scholar
  12. 12.
    NHS National Services Scotland (2011) Scottish Patients at Risk of Readmission (SPARRA). Version 3. Available at http://www.isdscotland.org/Health-Topics/Healthand-Social-Community-Care/SPARRA/SPARRA_Version_3_October 2011.pdf. 2011
  13. 13.
    Billings J, Blunt I, Steventon A et al (2012) Development of a predictive model to identify inpatients at risk of re-admission within 30 days of discharge (PARR-30). BMJ Open 2:e001667. doi: 10.1136/bmjopen-2012-001667 PubMedCentralCrossRefPubMedGoogle Scholar
  14. 14.
    Chenore T, Pereira Gray DJ, Forrer J et al (2013) Emergency hospital admissions for the elderly: insights from the Devon predictive model. J Public Health 35:616–623Google Scholar
  15. 15.
    Health Dialog UK (2008) Wales predictive model final report and technical documentation. Prepared for NHS Wales, Informing Healthcare. http://www.nliah.com/portal/microsites/Uploads/Resources/k5cma8PPy.pdf. Accessed Nov 2014
  16. 16.
    Falasca P, Berardo A, Di Tommaso F (2011) Development and validation of predictive MoSaiCo (Modello Statistico Combinato) on emergency admissions: can it also identify patients at high risk of frailty? Annali dell’Istituto Superiore di Sanità 47:220–228PubMedGoogle Scholar
  17. 17.
    Lemke KW, Weiner JP, Clark JM (2012) Development and validation of a model for predicting inpatient hospitalization. Med Care 50:131–139CrossRefPubMedGoogle Scholar
  18. 18.
    Lewis G, Curry N, Bardsley M (2011) Admissions planning. Guess who. Health Serv J 121:23–25PubMedGoogle Scholar
  19. 19.
    Liberati A, Altman DG, Tetzlaff J et al (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol 62:e1–e34CrossRefPubMedGoogle Scholar
  20. 20.
    Dixon-Woods M, Cavers D, Agarwal S et al (2006) Conducting a critical interpretive synthesis of the literature on access to healthcare by vulnerable groups. BMC Med Res Methodol 6:35PubMedCentralCrossRefPubMedGoogle Scholar
  21. 21.
    Davis J, Mengersen K, Bennett S et al (2014) Viewing systematic reviews and meta-analysis in social research through different lenses. Springerplus 3:511PubMedCentralCrossRefPubMedGoogle Scholar
  22. 22.
    Thomas J, Harden A (2008) Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol 8:45PubMedCentralCrossRefPubMedGoogle Scholar
  23. 23.
    Ioannidis JP, Patsopoulos NA, Rothstein HR (2008) Reasons or excuses for avoiding meta-analysis in forest plots. BMJ 336:1413–1415PubMedCentralCrossRefPubMedGoogle Scholar
  24. 24.
    Slavin RE (1995) Best evidence synthesis: an intelligent alternative to meta-analysis. J Clin Epidemiol 48:9–18CrossRefPubMedGoogle Scholar
  25. 25.
    Arksey H, O’Malley L (2005) Scoping studies: towards a methodological framework. Int J Soc res Meth. 8:19–32CrossRefGoogle Scholar
  26. 26.
    Colquhoun HL, Levac D, O’Brien KK et al (2014) Scoping reviews: time for clarity in definition, methods, and reporting. J Clin Epidemiol 67:1291–1294CrossRefPubMedGoogle Scholar
  27. 27.
    Levac D, Colquhoun H, O’Brien KK (2010) Scoping studies: advancing the methodology. Implement Sci. 5:69PubMedCentralCrossRefPubMedGoogle Scholar
  28. 28.
    Sarrami-Foroushani P, Travaglia J, Debono D et al (2015) Scoping meta-review: introducing a new methodology. Clin Transl Sci 8:77–81CrossRefPubMedGoogle Scholar
  29. 29.
    Brien SE, Lorenzetti DL, Lewis S et al (2010) Overview of a formal scoping review on health system report cards. Implement Sci 5:2PubMedCentralCrossRefPubMedGoogle Scholar
  30. 30.
    Brien S, Gheihman G, Tse YK et al (2014) A scoping review of appropriateness of care research activity in Canada from a health system-level perspective. Health Policy 9:48–61Google Scholar
  31. 31.
    Bassi J, Lau F (2013) Measuring value for money: a scoping review on economic evaluation of health information systems. J Am Med Inform Assoc 20:792–801PubMedCentralCrossRefPubMedGoogle Scholar
  32. 32.
    Bigdeli M, Javadi D, Hoebert J et al (2013) Health policy and systems research in access to medicines: a prioritized agenda for low- and middle-income countries. Health Res Policy Syst 11:37Google Scholar
  33. 33.
    Brandt B, Lutfiyya MN, King JA et al (2014) A scoping review of interprofessional collaborative practice and education using the lens of the Triple Aim. J Interprof Care 28:393–399PubMedCentralCrossRefPubMedGoogle Scholar
  34. 34.
    Dennis SM, Harris M, Lloyd J et al (2013) Do people with existing chronic conditions benefit from telephone coaching? A rapid review. Aust Health Rev 37:381–388Google Scholar
  35. 35.
    Howell D, Fitch M, Bakker D et al (2013) Core domains for a person-focused outcome measurement system in cancer (PROMS-Cancer Core) for routine care: a scoping review and Canadian Delphi Consensus. Value Health 16:76–87CrossRefPubMedGoogle Scholar
  36. 36.
    Ehrlich K, Freeman G, Richards S et al (2002) How to do a scoping exercise: continuity of care. Res Pol Plan 20:25–29Google Scholar
  37. 37.
    Anderson S, Allen P, Peckham S et al (2008) Asking the right questions: scoping studies in the commissioning of research on the organisation and delivery of health services. Health Res Policy Syst 6:7PubMedCentralCrossRefPubMedGoogle Scholar
  38. 38.
    Grant MJ, Booth A (2009) A typology of reviews: an analysis of 14 review types and associated methodologies. Health Info Libr J 26:91–108CrossRefPubMedGoogle Scholar
  39. 39.
    Davis K, Drey N, Gould D (2009) What are scoping studies? A review of the nursing literature. Int J Nurs Stud 46:1386–1400CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • J. Mora
    • 1
  • D. De Massari
    • 2
  • S. Pauws
    • 2
  • J. op den Buijs
    • 2
  • M. David
    • 1
  • L. Prieto
    • 1
  • J. Contel
    • 3
  • T. Martí
    • 4
  • J. Bousquet
    • 5
  • E. de Manuel
    • 1
  • the ASSEHS Study Group
  1. 1.International Center for Research in Chronicity, KronikguneBiscaySpain
  2. 2.Philips Electronics Nederland B.V.EindhovenThe Netherlands
  3. 3.Generalitat de CatalunyaBarcelonaSpain
  4. 4.Fundació TicsalutMataróSpain
  5. 5.Centre Hospitalier Régional Universitaire MontpellierMontpellierFrance

Personalised recommendations