New horizons in evidence-based care for older people: individual participant data meta-analysis


Evidence-based decisions on clinical and cost-effectiveness of interventions are ideally informed by meta-analyses of intervention trial data. However, when undertaken, such meta-analyses in ageing research have typically been conducted using standard methods whereby summary (aggregate) data are extracted from published trial reports. Although meta-analysis of aggregate data can provide useful insights into the average effect of interventions within a selected trial population, it has limitations regarding robust conclusions on which subgroups of people stand to gain the greatest benefit from an intervention or are at risk of experiencing harm. Future evidence synthesis using individual participant data from ageing research trials for meta-analysis could transform understanding of the effectiveness of interventions for older people, supporting evidence-based and sustainable commissioning. A major advantage of individual participant data meta-analysis (IPDMA) is that it enables examination of characteristics that predict treatment effects, such as frailty, disability, cognitive impairment, ethnicity, gender and other wider determinants of health. Key challenges of IPDMA relate to the complexity and resources needed for obtaining, managing and preparing datasets, requiring a meticulous approach involving experienced researchers, frequently with expertise in designing and analysing clinical trials. In anticipation of future IPDMA work in ageing research, we are establishing an international Ageing Research Trialists collective, to bring together trialists with a common focus on transforming care for older people as a shared ambition across nations.

References: Clegg A, Bandeen-Roche K, Farrin A, Forster A, Gill TM, Gladman J, et al. New horizons in evidence-based care for older people: individual participant data meta-analysis. Age and Ageing. 2022;51(4)




Andrew Clegg, Karen Bandeen-Roche, Amanda Farrin, Anne Forster, Thomas M Gill, John Gladman, Ngaire Kerse, Richard Lindley, Richard J McManus, Rene Melis, Ruben Mujica-Mota, Parminder Raina, Kenneth Rockwood, Ruth Teh, Danielle van der Windt, Miles Witham

Theme Lead

Related Publications

The effect of ageing on skeletal muscle as assessed by quantitative MR imaging: an association with frailty and muscle strength

The DynAIRx Project Protocol: Artificial Intelligence for dynamic prescribing optimisation and care integration in multimorbidity.

The Community Ageing Research 75+ (CARE75+) REMOTE Study: a remote model of recruitment and assessment of the health, wellbeing and social circumstances of older people.