Abstract
BackgroundComprehensive geriatric assessment has been shown to improve patient outcomes, but the geriatricians who deliver it are in short-supply. A web-based method of comprehensive geriatric assessment has been developed with the potential to improve access to specialist geriatric expertise. The current study aims to test the reliability and safety of comprehensive geriatric assessment performed "online" in making geriatric triage decisions. It will also explore the accuracy of the procedure in identifying common geriatric syndromes, and its cost relative to conventional "live" consultations.Methods/DesignThe study population will consist of 270 acutely hospitalized patients referred for geriatric consultation at three sites. Paired assessments (live and online) will be conducted by independent, blinded geriatricians and the level of agreement examined. This will be compared with the level of agreement between two independent, blinded geriatricians each consulting with the patient in person (i.e. "live"). Agreement between the triage decision from live-live assessments and between the triage decision from live-online assessments will be calculated using kappa statistics. Agreement between the online and live detection of common geriatric syndromes will also be assessed using kappa statistics. Resource use data will be collected for online and live-live assessments to allow comparison between the two procedures.DiscussionIf the online approach is found to be less precise than live assessment, further analysis will seek to identify patient subgroups where disagreement is more likely. This may enable a protocol to be developed that avoids unsafe clinical decisions at a distance.Trial registrationTrial registration number: ACTRN12611000936921
Highlights
Comprehensive geriatric assessment has been shown to improve patient outcomes, but the geriatricians who deliver it are in short-supply
If the online approach is found to be less precise than live assessment, further analysis will seek to identify patient subgroups where disagreement is more likely
Research aims This study aims to determine whether appropriate and reliable geriatric triage decisions can be made using Comprehensive geriatric assessment (CGA) performed “online”, by establishing whether agreement between “online” and “live” triage decisions is comparable to inter-rater agreement for conventional “live” geriatrician assessment
Summary
Comprehensive geriatric assessment has been shown to improve patient outcomes, but the geriatricians who deliver it are in short-supply. The current study aims to test the reliability and safety of comprehensive geriatric assessment performed “online” in making geriatric triage decisions. It will explore the accuracy of the procedure in identifying common geriatric syndromes, and its cost relative to conventional “live” consultations. Geriatric consultation is delivered by geriatricians, gerontic nurses - alone or in partnership - sometimes with support from other allied health specialists. The availability of these aged care specialists, and the specialist services within which they work, is currently inadequate. The undersupply is mal-distributed, with access considerably worse in provincial cities and rural communities [2]
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call