TY - JOUR
T1 - Expanded review criteria
T2 - The case of nonpharmacological interventions in Dementia
AU - Cohen-Mansfield, Jiska
AU - Buckwalter, Kathleen
AU - Beattie, Elizabeth
AU - Rose, Karen
AU - Neville, Christine
AU - Kolanowski, Ann
PY - 2014
Y1 - 2014
N2 - This paper challenges the assumptions underlying many reviews and offers alternative criteria for examining evidence for nonpharmacological interventions. We evaluated 27 reviews examining interventions for persons with dementia as they relate to the issues of selection based on randomized controlled trial (RCT) design. Reviews were described by type of intervention, level of cognitive function, and criteria for inclusion. Of the 27 reviews, 46% required RCTs for inclusion and most had stringent inclusion criteria. This resulted in poor utilization of the literature and low ecological validity. Eliminating most of the available data poses a critical problem to clinical and research development. Studies meeting strict methodological criteria may not generalize to the greater population or may exclude sub-populations and interventions. Limitations of double-blind RCTs and potential design solutions are set forth based on appropriate populations, problems, interventions, and settings characteristics.
AB - This paper challenges the assumptions underlying many reviews and offers alternative criteria for examining evidence for nonpharmacological interventions. We evaluated 27 reviews examining interventions for persons with dementia as they relate to the issues of selection based on randomized controlled trial (RCT) design. Reviews were described by type of intervention, level of cognitive function, and criteria for inclusion. Of the 27 reviews, 46% required RCTs for inclusion and most had stringent inclusion criteria. This resulted in poor utilization of the literature and low ecological validity. Eliminating most of the available data poses a critical problem to clinical and research development. Studies meeting strict methodological criteria may not generalize to the greater population or may exclude sub-populations and interventions. Limitations of double-blind RCTs and potential design solutions are set forth based on appropriate populations, problems, interventions, and settings characteristics.
KW - dementia
KW - interventions
KW - older persons
KW - randomized controlled trials
KW - research designs
KW - review
UR - http://www.scopus.com/inward/record.url?scp=84902271483&partnerID=8YFLogxK
U2 - 10.3233/JAD-132357
DO - 10.3233/JAD-132357
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AN - SCOPUS:84902271483
SN - 1387-2877
VL - 41
SP - 15
EP - 28
JO - Journal of Alzheimer's Disease
JF - Journal of Alzheimer's Disease
IS - 1
ER -