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The Value of Routinely Collected Data in Evaluating Home Assessment and Modification Interventions to Prevent Falls in Older People: Systematic Literature Review
JMIR Aging, Volume: 4, Issue: 2, Start page: e24728
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Background: Falls in older people commonly occur at home. Home assessment and modification (HAM) interventions can be effective in reducing falls; however, there are some concerns over the validity of evaluation findings. Routinely collected data could improve the quality of HAM evaluations and stre...
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Background: Falls in older people commonly occur at home. Home assessment and modification (HAM) interventions can be effective in reducing falls; however, there are some concerns over the validity of evaluation findings. Routinely collected data could improve the quality of HAM evaluations and strengthen their evidence base.Objective: The aim of this study is to conduct a systematic review of the evidence of the use of routinely collected data in the evaluations of HAM interventions.Methods: We searched the following databases from inception until January 31, 2020: PubMed, Ovid, CINAHL, OpenGrey, CENTRAL, LILACS, and Web of Knowledge. Eligible studies were those evaluating HAMs designed to reduce falls involving participants aged 60 years or more. We included study protocols and full reports. Bias was assessed using the Risk Of Bias In Non-Randomized Studies of Interventions (ROBINS-I) tool.Results: A total of 7 eligible studies were identified in 8 papers. Government organizations provided the majority of data across studies, with health care providers and third-sector organizations also providing data. Studies used a range of demographic, clinical and health, and administrative data. The purpose of using routinely collected data spanned recruiting and creating a sample, stratification, generating independent variables or covariates, and measuring key study-related outcomes. Nonhome-based modification interventions (eg, in nursing homes) using routinely collected data were not included in this study. We included two protocols, which meant that the results of those studies were not available. MeSH headings were excluded from the PubMed search because of a reduction in specificity. This means that some studies that met the inclusion criteria may not have been identified.Conclusions: Routine data can be used successfully in many aspects of HAM evaluations and can reduce biases and improve other important design considerations. However, the use of these data in these studies is currently not widespread. There are a number of governance barriers to be overcome to allow these types of linkage and to ensure that the use of routinely collected data in evaluations of HAM interventions is exploited to its full potential.
falls; aged; routinely collected data; evaluation research; systematic review
Swansea University Medical School
SR was supported in part by the National Institute for Health Research Applied Research (NIHR) Collaboration North West Coast. AC was supported in part by the NIHR Collaboration Yorkshire and Humber and Health Data Research UK, an initiative funded by the UK Research and Innovation Councils, National Institute for Health Research and the UK devolved administrations, and leading medical research charities. The views expressed here are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care. The funder has no input in the study. This work was supported by Health and Care Research Wales (Project SCF-18-1504), the Dunhill Medical Trust (Project BEHA\41), and Health Data Research UK (HDR-9006), which received funding from HDR UK Ltd funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation, and the Wellcome Trust. This research was also supported by the Administrative Data Research (ADR) Wales program of work. The ADR Wales program of work is aligned with the priority themes identified in the Welsh Government’s national strategy: Prosperity for All. ADR Wales brings together data science experts at Swansea University Medical School; staff from the Wales Institute of Social and Economic Research, Data and Methods at Cardiff University; and specialist teams within the Welsh Government to develop new evidence that supports Prosperity for All by using the SAIL Databank at Swansea University, to link and analyze anonymized data. ADR Wales is part of the Economic and Social Research Council (part of the UK Research and Innovation) funded by ADR UK (Grant ES/S007393/1). This work was also supported by the Wales School for Social Care Research, which was funded by Health and Care Research. The data used in this study are available from the SAIL Databank at Swansea University, Swansea, United Kingdom. All proposals to use SAIL data are subject to review by an independent IGRP. Before any data can be accessed, approval must be provided by the IGRP. The IGRP gives careful consideration to each project to ensure the proper and appropriate use of SAIL data. When access has been approved, it is gained through a privacy-protecting safe haven and remote access system, referred to as the SAIL Gateway. SAIL has established an application process to be followed by anyone who would like to access data via SAIL