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| ID | Type | Description | Link |
|---|---|---|---|
| Trim no. P0901 074 | Other Identifier | Institute for Clinical Evaluative Sciences |
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| Name | Class |
|---|---|
| Institute for Clinical Evaluative Sciences | OTHER |
| Canadian Institutes of Health Research (CIHR) | OTHER_GOV |
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To develop a mortality risk prediction model that can be applied to the wide spectrum of risks that are seen in the home care setting.
ABSTRACT
Introduction: Older adults living in the community often have multiple, chronic conditions and functional impairments. A challenge for healthcare providers working in the community is the lack of a predictive tool that can be applied to the broad spectrum of mortality risks observed and may be used to inform care planning.
Objective: To develop a mortality risk prediction model for older adults in the home care setting. The final algorithm will be implemented as a web-based calculator that can be used by older adults needing care, as well as their informal and formal caregivers.
Design: Open cohort study using the Resident Assessment Instrument for Home Care (RAI-HC) data in Ontario, Canada, from January 1, 2007, to December 31, 2013.
Participants: The derivation cohort will consist of approximately 437 000 home care recipients from January 1, 2007, to December 31, 2012. A split sample validation cohort will include approximately 122 000 recipients from January 1 to December 31, 2013.
Main outcome measures: Predicted survival from the time of an RAI-HC assessment. All deaths (N ≈ 245 000) will be ascertained through linkage to the provincial vital statistics records.
Statistical analysis: Proportional hazards regression will be estimated after assessment of assumptions. Predictors will include sociodemographic characteristics, social support, health conditions, functional status, cognition, symptoms of decline, and prior healthcare use. Model performance will be evaluated for 6- and 12-month predicted risks, including measures of calibration (e.g., calibration plots) and discrimination (e.g., c-statistics). The final algorithm will be generated by combining development and validation data.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Development Cohort | 437,000 home care recipients who received services from January 1, 2007 to December 31, 2012. |
| |
| Validation Cohort | 122,000 home care recipients who received services from January 1, 2013 to December 31, 2013. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Home Care/RAI-HC Assessment | Procedure | Home care recipients who have received a comprehensive health assessment using the Resident Assessment Instrument for Home Care (RAI-HC). |
|
| Measure | Description | Time Frame |
|---|---|---|
| 6-month Mortality | Mortality status at 6 months after receiving a structured Resident Assessment Instrument for Home Care (RAI-HC) Assessment. | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| 12-month Mortality | Mortality status at 12 months after receiving a structured Resident Assessment Instrument for Home Care (RAI-HC) Assessment. | 12 months |
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Inclusion Criteria:
Exclusion Criteria:
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Older adults receiving home care in Ontario, Canada, who have received a structured Resident Assessment Instrument for Home Care (RAI-HC) assessment between January 1, 2007 and December 31, 2013.
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27909039 | Derived | Hsu AT, Manuel DG, Taljaard M, Chalifoux M, Bennett C, Costa AP, Bronskill S, Kobewka D, Tanuseputro P. Algorithm for predicting death among older adults in the home care setting: study protocol for the Risk Evaluation for Support: Predictions for Elder-life in the Community Tool (RESPECT). BMJ Open. 2016 Dec 1;6(12):e013666. doi: 10.1136/bmjopen-2016-013666. |
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| ID | Term |
|---|---|
| D003643 | Death |
| ID | Term |
|---|---|
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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