That was the year that was: An evidence-based clinical geriatrics update

BACKGROUND: Physicians are faced with an ever-growing information base in medical practice. Studies regularly show a disparity between science and patient care, with scientifically validated practices often taking 20 years and more to enter mainstream clinical practice. OBJECTIVES: To review the recent medical literature for high quality studies that practicing geriatricians should be aware of, either because they provide evidence that might lead to a change in clinical practice or because they provide insight into common geriatric syndromes. DESIGN: Overview DATA SOURCES: All articles abstracted or noted in ACP Journal Club, Evidence-Based Medicine, or The New York Times from July 1996 to June 1997. STUDY SELECTION: Studies that met the standards for inclusion in ACP Journal Club. STUDY DESIGN: Sampling plan (including eligibility criteria), sample size, response rate, data analysis plan, proportion available for follow-up, main outcomes and measures, main results. RESULTS: Review of the 98 articles that met criteria resulted in the identification of several themes of importance to geriatricians, including the hazards of hospitalization, the prevention of NSAID-induced peptic ulcers, and the treatment and prevention of Alzheimer's disease. The results of these studies expand the therapeutic armamentarium of practicing geriatricians, provide new insights into geriatric syndromes, and raise cautions about the use of certain therapies in older adults. CONCLUSIONS: Many methodologically rigorous studies relevant to the medical care of older people have recently been published. Evidence-based medicine and the use of journals of secondary publication are useful tools to enhance the efficiency of journal reading for geriatric practitioners whose interests span the journals of several disciplines and subspecialties.