National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (1)
- Ambulatory Care and Surgery (1)
- Arthritis (1)
- Back Health and Pain (1)
- Cancer (5)
- Cancer: Breast Cancer (6)
- Cancer: Lung Cancer (1)
- Cancer: Ovarian Cancer (1)
- Cancer: Skin Cancer (1)
- Cardiovascular Conditions (1)
- Children/Adolescents (1)
- Chronic Conditions (2)
- Comparative Effectiveness (12)
- Diabetes (1)
- Digestive Disease and Health (1)
- Disparities (1)
- Elderly (7)
- Evidence-Based Practice (2)
- Genetics (3)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Costs (4)
- Healthcare Utilization (1)
- Health Insurance (1)
- Home Healthcare (1)
- Hospitalization (1)
- Hospitals (1)
- Human Immunodeficiency Virus (HIV) (1)
- Injuries and Wounds (1)
- Kidney Disease and Health (1)
- Medicare (3)
- Medication (5)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (1)
- Opioids (1)
- Outcomes (2)
- Pain (1)
- Palliative Care (1)
- Patient-Centered Outcomes Research (7)
- Patient Experience (1)
- Patient Safety (1)
- Practice Patterns (1)
- Pregnancy (1)
- Racial and Ethnic Minorities (1)
- Registries (1)
- Shared Decision Making (2)
- Social Determinants of Health (2)
- Substance Abuse (1)
- Surgery (2)
- (-) Treatments (27)
- Women (3)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 27 Research Studies DisplayedLairson DR, Parikh RC, Cormier JN
Cost-effectiveness of chemotherapy for breast cancer and age effect in older women.
The researchers assessed the cost-effectiveness of chemotherapy regimens by age and disease stage under "real-world" conditions for patients with breast cancer. They found that anthracycline-based chemotherapy was found cost-effective for elderly patients with early stage (stage I, II, IIIa) breast cancer considering the US threshold of $100,000 per QALY.
AHRQ-funded; HS018956.
Citation: Lairson DR, Parikh RC, Cormier JN .
Cost-effectiveness of chemotherapy for breast cancer and age effect in older women.
Value Health 2015 Dec;18(8):1070-8. doi: 10.1016/j.jval.2015.08.008..
Keywords: Cancer: Breast Cancer, Treatments, Healthcare Costs, Elderly, Social Determinants of Health
Potosky AL, O'Neill SC, Isaacs C
Population-based study of the effect of gene expression profiling on adjuvant chemotherapy use in breast cancer patients under the age of 65 years.
The authors evaluated the relation between gene expression profiling (GEP) testing and the use of adjuvant chemotherapy by women treated in a general oncology practice. They found that adjuvant chemotherapy use after GEP testing is generally consistent with the recommended test interpretation for women with a high or low predicted risk of recurrence. Chemotherapy use in the intermediate-risk group increased with Recurrence Score values, and evidence from ongoing randomized trials may help to clarify whether this finding reflects optimal interpretation of GEP test results.
AHRQ-funded; HS022915.
Citation: Potosky AL, O'Neill SC, Isaacs C .
Population-based study of the effect of gene expression profiling on adjuvant chemotherapy use in breast cancer patients under the age of 65 years.
Cancer 2015 Nov 15;121(22):4062-70. doi: 10.1002/cncr.29621.
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Keywords: Cancer, Cancer: Breast Cancer, Treatments, Shared Decision Making, Genetics, Practice Patterns, Women
Dinan MA, Mi X, Reed SD
Association between use of the 21-gene recurrence score assay and receipt of chemotherapy among Medicare beneficiaries with early-stage breast cancer, 2005-2009.
The researchers examined whether adoption of the 21-Gene Recurrence Score (RS) assay in a nationally representative sample of patients with early-stage breast cancer was associated with use of chemotherapy. They found that the impact of the adoption of the RS assay on receipt of chemotherapy was strongly population dependent and was associated with relatively lower chemotherapy use in groups with high-risk disease and relatively higher chemotherapy use in patients with low-risk disease.
AHRQ-funded; HS022189.
Citation: Dinan MA, Mi X, Reed SD .
Association between use of the 21-gene recurrence score assay and receipt of chemotherapy among Medicare beneficiaries with early-stage breast cancer, 2005-2009.
JAMA Oncol 2015 Nov 1;1(8):1098-109. doi: 10.1001/jamaoncol.2015.2722..
Keywords: Cancer, Cancer: Breast Cancer, Treatments, Genetics, Medicare, Women
Poonawalla IB, Parikh RC, Du XL
Cost effectiveness of chemotherapeutic agents and targeted biologics in ovarian cancer: a systematic review.
The authors evaluated the cost-effectiveness of various chemotherapeutic and targeted therapy alternatives for ovarian cancer. They found that standard platinum-taxane combination chemotherapy for first-line treatment was most cost-effective.
AHRQ-funded; HS018956.
Citation: Poonawalla IB, Parikh RC, Du XL .
Cost effectiveness of chemotherapeutic agents and targeted biologics in ovarian cancer: a systematic review.
Pharmacoeconomics 2015 Nov;33(11):1155-85. doi: 10.1007/s40273-015-0304-9.
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Keywords: Treatments, Healthcare Costs, Medication, Cancer: Ovarian Cancer
Du XL, Zhang Y, Parikh RC
Comparative effectiveness of chemotherapy regimens in prolonging survival for two large population-based cohorts of elderly adults with breast and colon cancer in 1992-2009.
The purpose of this study was to compare the effectiveness of chemotherapy in prolonging survival according to age in breast and colon cancer. It found that the effectiveness of chemotherapy decreased with age in participants with breast cancer, in whom chemotherapy appears to be effective until age 79 except for the doxorubicin-cyclophosphamide combination, which was effective in participants aged 80 to 84.
AHRQ-funded; HS018956.
Citation: Du XL, Zhang Y, Parikh RC .
Comparative effectiveness of chemotherapy regimens in prolonging survival for two large population-based cohorts of elderly adults with breast and colon cancer in 1992-2009.
J Am Geriatr Soc 2015 Aug;63(8):1570-82. doi: 10.1111/jgs.13523..
Keywords: Cancer, Cancer: Breast Cancer, Treatments, Comparative Effectiveness, Patient-Centered Outcomes Research
Roberts MC, Weinberger M, Dusetzina SB
Racial variation in adjuvant chemotherapy initiation among breast cancer patients receiving oncotype DX testing.
The researchers examined whether adjuvant chemotherapy initiation varied by race. No racial differences were found in adjuvant chemotherapy initiation among women receiving ODX testing. As treatment decision-making becomes increasingly targeted with the use of genetic technologies, these results provide evidence that test results may drive treatment in a similar way across racial subgroups.
AHRQ-funded; HS022189.
Citation: Roberts MC, Weinberger M, Dusetzina SB .
Racial variation in adjuvant chemotherapy initiation among breast cancer patients receiving oncotype DX testing.
Breast Cancer Res Treat 2015 Aug;153(1):191-200. doi: 10.1007/s10549-015-3518-9..
Keywords: Cancer: Breast Cancer, Treatments, Shared Decision Making, Genetics, Racial and Ethnic Minorities
Rhee SM, Valle MF, Wilson LM
Negative pressure wound therapy technologies for chronic wound care in the home setting: a systematic review.
The researchers conducted a systematic review on the efficacy and safety of negative pressure wound therapy (NPWT) for the treatment of chronic wounds in the home setting. Data were limited by variability in the types of comparator groups, methodological limitations, and poor reporting of outcomes. The researchers were unable to draw conclusions about the efficacy or safety of NPWT for the treatment of chronic wounds in the home setting due to the insufficient evidence.
AHRQ-funded; 290201200007I.
Citation: Rhee SM, Valle MF, Wilson LM .
Negative pressure wound therapy technologies for chronic wound care in the home setting: a systematic review.
Wound Repair Regen 2015 Jul-Aug;23(4):506-17. doi: 10.1111/wrr.12295..
Keywords: Injuries and Wounds, Home Healthcare, Comparative Effectiveness, Treatments, Chronic Conditions
Suskind AM, Clemens JQ, Zhang Y
Physician use of sacral neuromodulation among Medicare beneficiaries with overactive bladder and urinary retention.
This study identified physician-level factors associated with high rates of sacral neuromodulation testing. It found that, over time, physicians are testing more patients but are not implanting more devices. Additionally, there is an inverse relationship between rates of device testing and implantation, suggesting opportunities to improve efficiency and resource utilization.
AHRQ-funded; HS018726.
Citation: Suskind AM, Clemens JQ, Zhang Y .
Physician use of sacral neuromodulation among Medicare beneficiaries with overactive bladder and urinary retention.
Urology 2015 Jul;86(1):30-4. doi: 10.1016/j.urology.2015.04.003..
Keywords: Elderly, Medicare, Treatments, Women
Smith ME, Haney E, McDonagh M
Treatment of myalgic encephalomyelitis/chronic fatigue syndrome: a systematic review for a National Institutes of Health Pathways to Prevention Workshop.
This review evaluates and summarizes research on the benefits and harms of medical and nonmedical treatments for myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS) based on trials enrolling patients meeting criteria for ME, CFS, or both. It concluded that trials of rintatolimod, counseling therapies, and graded exercise therapy suggest benefit for some patients meeting case definitions for CFS, whereas evidence for other treatments and harms is insufficient.
AHRQ-funded; 290201200014I.
Citation: Smith ME, Haney E, McDonagh M .
Treatment of myalgic encephalomyelitis/chronic fatigue syndrome: a systematic review for a National Institutes of Health Pathways to Prevention Workshop.
Ann Intern Med 2015 Jun 16;162(12):841-50. doi: 10.7326/m15-0114..
Keywords: Comparative Effectiveness, Evidence-Based Practice, Treatments
Poonawalla IB, Lairson DR, Chan W
Cost-effectiveness of neoadjuvant chemotherapy versus primary surgery in elderly patients with advanced ovarian cancer.
This study investigated the cost-effectiveness of neoadjuvant chemotherapy (NAC) compared with that of standard primary debulking surgery. It concluded that NAC use before surgery has a favorable cost-effectiveness profile in the high-risk group alone at classic willingness-to-pay thresholds. Its use as a general first-line treatment in all patients is not supported.
AHRQ-funded; HS018956.
Citation: Poonawalla IB, Lairson DR, Chan W .
Cost-effectiveness of neoadjuvant chemotherapy versus primary surgery in elderly patients with advanced ovarian cancer.
Value Health 2015 Jun;18(4):387-95. doi: 10.1016/j.jval.2015.01.005..
Keywords: Treatments, Comparative Effectiveness, Patient-Centered Outcomes Research, Surgery
Huo J, Du XL, Lairson DR
Utilization of surgery, chemotherapy, radiation therapy, and hospice at the end of life for patients diagnosed with metastatic melanoma.
The authors examined the patterns of utilization of radiation therapy, chemotherapy, surgery, and hospice at the end-of-life care for patients diagnosed with metastatic melanoma. They found that surgery and hospice care use increased over the 8 years of this study, whereas the use of chemotherapy and radiation therapy remained consistent for patients diagnosed with metastatic melanoma.
AHRQ-funded; HS018956.
Citation: Huo J, Du XL, Lairson DR .
Utilization of surgery, chemotherapy, radiation therapy, and hospice at the end of life for patients diagnosed with metastatic melanoma.
Am J Clin Oncol 2015 Jun;38(3):235-41. doi: 10.1097/COC.0b013e31829378f9.
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Keywords: Cancer, Cancer: Skin Cancer, Treatments, Elderly, Healthcare Utilization, Palliative Care, Patient-Centered Outcomes Research, Surgery
Krell RW, Regenbogen SE, Wong SL
Variation in hospital treatment patterns for metastatic colorectal cancer.
This study used national clinical registry data to assess treatment patterns for patients with metastatic colorectal cancer (CRC). The goal was to determine the degree to which different treatment modalities such as metastatic site surgery or multiagent chemotherapy can characterize a hospital’s overall “aggressiveness” in treatment. It found that hospitals with high volumes of service consistently using more metastatic site resection and multiagent chemotherapy than hospitals with low volumes of service.
AHRQ-funded; HS020937.
Citation: Krell RW, Regenbogen SE, Wong SL .
Variation in hospital treatment patterns for metastatic colorectal cancer.
Cancer 2015 Jun 1;121(11):1755-61. doi: 10.1002/cncr.29253..
Keywords: Treatments, Registries, Hospitals, Patient Safety
Duong VH, Baer MR, Hendrick F
AHRQ Author: Davidoff AJ
Variations in erythropoiesis-stimulating agent administration in transfusion-dependent myelodysplastic syndromes impact response.
The researchers studied the association of timing of erythropoiesis-stimulating agents (ESA) initiation, agent, and number of weeks of ESA use with response in myelodysplastic syndrome (MDS) patients in routine practice. They found that variations in ESA administration impacted response in transfusion-dependent MDS patients, with higher response rates with early administration and use of darbepoetin, and low response likelihood in non-responders beyond 16 weeks of therapy.
AHRQ-authored.
Citation: Duong VH, Baer MR, Hendrick F .
Variations in erythropoiesis-stimulating agent administration in transfusion-dependent myelodysplastic syndromes impact response.
Leuk Res 2015 Jun;39(6):586-91. doi: 10.1016/j.leukres.2015.03.013.
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Keywords: Comparative Effectiveness, Elderly, Treatments
Singh JA, Akhras KS, Shiozawa A
Comparative effectiveness of urate lowering with febuxostat versus allopurinol in gout: analyses from large U.S. managed care cohort.
The researchers sought to assess the comparative effectiveness of febuxostat and allopurinol in reducing serum urate (sUA) levels in a real-world U.S. managed care setting. It concluded that febuxostat was more effective than allopurinol at the currently used doses in lowering sUA in gout patients as demonstrated by post-index mean sUA level, the likelihood of and the time to achieving sUA goals.
AHRQ-funded; HS021110.
Citation: Singh JA, Akhras KS, Shiozawa A .
Comparative effectiveness of urate lowering with febuxostat versus allopurinol in gout: analyses from large U.S. managed care cohort.
Arthritis Res Ther 2015 May 12;17(1):120. doi: 10.1186/s13075-015-0624-3..
Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Evidence-Based Practice, Medication, Treatments
McCoy RG, Zhang Y, Herrin J
Changing trends in type 2 diabetes mellitus treatment intensification, 2002-2010.
This paper examined trends in hyperglycemia treatment intensification between 2002 and 2010. The investigators found a significant increase in diabetes treatment intensification during this time period. They concluded that the choice of secondline agents changed, with decreasing prevalence of thiazolidinedione and sulfonylurea use and rising prevalence of incretin use.
AHRQ-funded; HS018339; HS017628.
Citation: McCoy RG, Zhang Y, Herrin J .
Changing trends in type 2 diabetes mellitus treatment intensification, 2002-2010.
Am J Manag Care 2015 May;21(5):e288-96.
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Keywords: Diabetes, Medication, Treatments
Finnell SM, Rosenman MB, Christenson JC
Decolonization of children after incision and drainage for MRSA abscess: a retrospective cohort study.
The researchers sought to determine whether decolonization following incision and drainage (I&D) for methicillin-resistant Staphylococcus aureus (MRSA) abscess decreases repeat I&D and MRSA-positive cultures in children. They found that no statistically significant association between referral to the Pediatric Infectious Disease Service for decolonization and the outcomes.
AHRQ-funded; HS020014.
Citation: Finnell SM, Rosenman MB, Christenson JC .
Decolonization of children after incision and drainage for MRSA abscess: a retrospective cohort study.
Clin Pediatr 2015 May;54(5):445-50. doi: 10.1177/0009922814556059..
Keywords: Children/Adolescents, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Healthcare-Associated Infections (HAIs), Treatments
Zhang J, Xie F, Delzell E
Impact of biologic agents with and without concomitant methotrexate and at reduced doses in older rheumatoid arthritis patients.
The purpose of this study was to examine whether concomitant methotrexate (MTX) use is associated with better biologic persistence and whether self-administered anti–tumor necrosis factor (anti-TNF) therapies are used at reduced doses in real world clinical care settings, not just clinical trials. It found that use of concomitant MTX is associated with greater persistence to biologic therapy.
AHRQ-funded; HS018517.
Citation: Zhang J, Xie F, Delzell E .
Impact of biologic agents with and without concomitant methotrexate and at reduced doses in older rheumatoid arthritis patients.
Arthritis Care Res 2015 May;67(5):624-32. doi: 10.1002/acr.22510..
Keywords: Arthritis, Comparative Effectiveness, Patient-Centered Outcomes Research, Treatments
Malhotra J, Mhango G, Gomez JE
Adjuvant chemotherapy for elderly patients with stage I non-small-cell lung cancer >/=4 cm in size: an SEER-Medicare analysis.
The researchers compared overall survival and rates of serious adverse events (defined as those requiring admission to hospital) between patients treated with resection alone, platinum-based adjuvant chemotherapy, or postoperative radiation (PORT) with or without adjuvant chemotherapy. Platinum-based adjuvant chemotherapy is associated with reduced mortality and increased serious adverse events in elderly patients with stage I non-small-cell lung cancer ≥4 cm in size.
AHRQ-funded; HS019670.
Citation: Malhotra J, Mhango G, Gomez JE .
Adjuvant chemotherapy for elderly patients with stage I non-small-cell lung cancer >/=4 cm in size: an SEER-Medicare analysis.
Ann Oncol 2015 Apr;26(4):768-73. doi: 10.1093/annonc/mdv008..
Keywords: Cancer: Lung Cancer, Elderly, Treatments, Adverse Events, Comparative Effectiveness
Kadakia A, Rajan SS, Abughosh S
CMF-regimen preferred as first-course chemotherapy for older and sicker women with breast cancer: findings from a SEER-Medicare-based population study.
This study aimed to determine the utilization of Cyclophosphamide, Methotrexate, and 5-Fluorouracil (CMF) as first-course chemotherapy in recent years, and identify the sociodemographic and clinical characteristics associated with its prescription. It found that older and sicker women, living in census tracts with lower average education, and diagnosed with advanced stage, hormone receptor-negative tumors have a higher probability of CMF administration.
AHRQ-funded; HS018956.
Citation: Kadakia A, Rajan SS, Abughosh S .
CMF-regimen preferred as first-course chemotherapy for older and sicker women with breast cancer: findings from a SEER-Medicare-based population study.
Am J Clin Oncol 2015 Apr;38(2):165-73. doi: 10.1097/COC.0b013e31828f5b01..
Keywords: Cancer: Breast Cancer, Treatments, Elderly, Social Determinants of Health
Tangri N, Miskulin DC, Zhou J
Effect of intravenous iron use on hospitalizations in patients undergoing hemodialysis: a comparative effectiveness analysis from the DEcIDE-ESRD study.
The researchers studied the association of receipt of intravenous iron with hospitalizations in an incident cohort of hemodialysis patients. They concluded that a higher cumulative dose of intravenous iron may not be associated with increased risk of hospitalizations in hemodialysis patients. While clinical trials are needed, employing higher iron doses to reduce erythropoiesis-stimulating agents does not appear to increase morbidity in routine clinical care.
AHRQ-funded; 290200500341I.
Citation: Tangri N, Miskulin DC, Zhou J .
Effect of intravenous iron use on hospitalizations in patients undergoing hemodialysis: a comparative effectiveness analysis from the DEcIDE-ESRD study.
Nephrol Dial Transplant 2015 Apr;30(4):667-75. doi: 10.1093/ndt/gfu349.
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Keywords: Comparative Effectiveness, Hospitalization, Kidney Disease and Health, Cardiovascular Conditions, Treatments
Memtsoudis SG, Yoo D, Stundner O
Subsartorial adductor canal vs femoral nerve block for analgesia after total knee replacement.
This study compares both single-shot femoral nerve block (FNB) and adductor canal block (ACB), side to side, in the same patients undergoing bilateral TKA. It found that the use of ACBs vs FNBs in knee arthroplasty patients yielded similar results in absolute pain scores, motor strength and patient satisfaction.
AHRQ-funded; HS021734.
Citation: Memtsoudis SG, Yoo D, Stundner O .
Subsartorial adductor canal vs femoral nerve block for analgesia after total knee replacement.
Int Orthop 2015 Apr;39(4):673-80. doi: 10.1007/s00264-014-2527-3..
Keywords: Comparative Effectiveness, Treatments, Outcomes, Patient Experience, Pain
Dalton VK, Liang A, Hutton DW
Beyond usual care: the economic consequences of expanding treatment options in early pregnancy loss.
The objective of this study was to estimate the economic consequences of expanding options for early pregnancy loss treatment beyond expectant management and operating room surgical evacuation (usual care). It found that the cost per case was $241.29 lower for women undergoing treatment in the expanded care model as compared with the usual care model.
AHRQ-funded; HS015491.
Citation: Dalton VK, Liang A, Hutton DW .
Beyond usual care: the economic consequences of expanding treatment options in early pregnancy loss.
Am J Obstet Gynecol 2015 Feb;212(2):177.e1-6. doi: 10.1016/j.ajog.2014.08.031..
Keywords: Healthcare Costs, Pregnancy, Treatments, Ambulatory Care and Surgery
Hazelwood GS, Rezaie A, Borman M
Comparative effectiveness of immunosuppressants and biologics for inducing and maintaining remission in Crohn's disease: a network meta-analysis.
The authors compared therapies for induction and maintenance of remission in patients with Crohn's disease. They found that adalimumab and infliximab + azathioprine are the most effective therapies for induction and maintenance of remission of Crohn's disease.
AHRQ-funded; HS021747.
Citation: Hazelwood GS, Rezaie A, Borman M .
Comparative effectiveness of immunosuppressants and biologics for inducing and maintaining remission in Crohn's disease: a network meta-analysis.
Gastroenterology 2015 Feb;148(2):344-54.e5; quiz e14-5. doi: 10.1053/j.gastro.2014.10.011.
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Keywords: Comparative Effectiveness, Digestive Disease and Health, Medication, Patient-Centered Outcomes Research, Treatments
Koroukian SM
Dual-eligibility status: a marker of vulnerability and cancer-related disparities.
This editorial discusses a study by Warren et al that highlights important differences in receipt of chemotherapy across subgroups of the Medicare population according to type of supplemental insurance. It explores the important questions raised by the findings, especially the individual factors that may have contributed to the observed disparities.
AHRQ-funded; HS023113.
Citation: Koroukian SM .
Dual-eligibility status: a marker of vulnerability and cancer-related disparities.
J Clin Oncol 2015 Feb 1;33(4):297-8. doi: 10.1200/jco.2014.59.1933..
Keywords: Medicare, Cancer, Health Insurance, Treatments, Disparities
Rundell SD, Sherman KJ, Heagerty PJ
Patient-reported outcomes associated with use of physical therapist services by older adults with a new visit for back pain.
The researchers conducted an observational comparative effectiveness research study to investigate the association between types or amounts of physical therapist services and outcomes, such as disability and pain intensity, among older adults. Higher amounts of active physical therapy were associated with decreased back and leg pain and increased odds of clinically meaningful improvements in back and leg pain relative to results obtained with no active physical therapy.
AHRQ-funded; HS019222.
Citation: Rundell SD, Sherman KJ, Heagerty PJ .
Patient-reported outcomes associated with use of physical therapist services by older adults with a new visit for back pain.
Phys Ther 2015 Feb;95(2):190-201. doi: 10.2522/ptj.20140132..
Keywords: Back Health and Pain, Patient-Centered Outcomes Research, Comparative Effectiveness, Treatments, Elderly