Jahnigen D W, Applegate W B, Cohen H J, Epstein A, Granger C, Hogan D, Kennedy R, Lazaroff A
Cleveland Clinic Foundation, OH 44195-5001.
J Am Geriatr Soc. 1991 Sep;39(9 Pt 2):42S-44S. doi: 10.1111/j.1532-5415.1991.tb05933.x.
Methods of conducting comprehensive geriatric evaluation and management (GEM) are proliferating in a variety of clinical settings. However, rigorous evaluations of efficacy for this new approach to care of older patients have demonstrated a favorable impact on patient outcome in only a few studies. All of these have been controlled single site studies, and replication is needed. If replication studies show similar results, further studies should be undertaken to define the minimum necessary intervention to achieve the desired outcome. Controlled trials are needed to determine if consultative geriatric evaluation and/or primary patient management is effective. Further innovative work is needed in model development for geriatric assessment and management in outpatient settings. Finally, studies of geriatric evaluation and management in other environments, such as home care or the nursing home, are recommended.
开展综合老年医学评估与管理（GEM）的方法正在各种临床环境中不断涌现。然而，对这种老年患者护理新方法的疗效进行的严格评估仅在少数研究中显示出对患者预后有积极影响。所有这些都是对照单中心研究，需要进行重复研究。如果重复研究显示出相似的结果，则应开展进一步研究以确定实现预期结果所需的最低必要干预措施。需要进行对照试验来确定老年医学咨询评估和/或患者初级管理是否有效。在门诊环境中开展老年医学评估与管理的模型开发方面，还需要进一步的创新性工作。最后，建议开展在其他环境（如家庭护理或养老院）中的老年医学评估与管理研究。
