Randomized clinical trial of comprehensive geriatric assessment and optimization in vascular surgery.
J S L Partridge, D Harari, F C Martin...
https://pubmed.ncbi.nlm.nih.gov/28198997/Actively Recruiting
Led by University of Wisconsin, Madison · Updated on 2026-03-19
42
Participants Needed
1
Research Sites
52 weeks
Total Duration
This research aims to test a new system-level implementation package designed to help more older adults prepare for major surgery by increasing access to a comprehensive geriatric assessment CGA. The study evaluates whether this package improves the number of older adults who receive a full CGA before surgery and whether medical and surgical providers use the CGA more often. The findings will be compared to historic baseline data and will inform a larger future trial. The implementation package includes streamlined referral processes and education for surgeons and staff about these new procedures. Participants include older adults planning major surgery and their healthcare providers. The intervention group will experience the new referral process, while the control group consists of historic patients who received routine care without the implementation package. Participants will be monitored by reviewing how many patients are referred and how many surgeons place referral orders at 6 and 12 months after implementation. Additional assessments include measuring the completion of CGA components within 30 days after visits and evaluating the feasibility, acceptability, and appropriateness of the intervention at 6 and 12 months. The total study duration extends until April 2029.
CONDITIONS
Implementation Pilot of Preoperative CGA Before Major Surgery
J
Julia R Berian, MD, MS
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University of Wisconsin, Madison
Lead Sponsor
National Institute on Aging (NIA)
Collaborating Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | Structured CGA Implementation Package | Usual Routine Clinical Care (no structured CGA package) |
|---|---|---|
| What it is | A structured implementation package introducing comprehensive geriatric assessment (CGA) before major elective surgery for older adults, including streamlined referral and education for surgical teams. | Typical preoperative approach where CGA may not be routinely performed; assessment of geriatric risks is inconsistent and may depend on individual provider practice. |
| Main use or purpose | To increase the adoption and reach of CGA before surgery, with the goal of optimizing outcomes and identifying geriatric risks in older adults. | Used as a comparator for assessing how preoperative care is commonly conducted, often without standardized identification of older adults' risks and needs. |
| How it is given or performed | A referral process triggers CGA after surgical scheduling; education is provided for surgeons and staff to integrate CGA steps before surgery. | CGA may be inconsistently performed, with assessment depending on provider awareness and local resources. There is no universal process for triggering or completing CGA before surgery. |
| Evidence status | Implementation pilot underway; direct patient outcome data not yet published. | Published studies report that lack of structured CGA may miss important risks and opportunities for optimization. CGA integration in standard practice improves perioperative outcomes, including function and complication risk, when implemented, though uptake is limited. |
| Important limitations | Single-center pilot; results may not generalize beyond the specific healthcare setting and team. Patient-level health outcomes are not the primary endpoint. | In routine clinical care, lack of systematic CGA can lead to missing important geriatric vulnerabilities and variations in preoperative assessment. Uptake depends on local policies and awareness. |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
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Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - Up to time of surgery
Participants undergo a streamlined referral process as part of an implementation package for comprehensive geriatric assessment (CGA) before surgery.
1 to 2 visits depending on referral and assessment scheduling
Duration - From referral until surgery
Participants who undergo routine clinical care are observed with or without the use of CGA depending on provider decisions.
Visits as part of usual clinical care
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
NA
Model
SINGLE_GROUP
Primary Purpose
HEALTH_SERVICES_RESEARCH
Number of Arms
1
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https://pubmed.ncbi.nlm.nih.gov/29299599/University of Wisconsin, Madison
Lead Sponsor
National Institute on Aging (NIA)
Collaborating Sponsor