Individualized interventions and precision health: Lessons learned from a systematic review and implications for analytics‐driven geriatric research

Older adults are characterized by profound clinical heterogeneity. When designing and delivering interventions, there exist multiple approaches to account for heterogeneity. We present the results of a systematic review of data‐driven, personalized interventions in older adults, which serves as a us...

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Bibliographic Details
Published inJournal of the American Geriatrics Society (JAGS) Vol. 71; no. 2; pp. 383 - 393
Main Authors Kahkoska, Anna R., Freeman, Nikki L. B., Jones, Emily P., Shirazi, Daniela, Browder, Sydney, Page, Annie, Sperger, John, Zikry, Tarek M., Yu, Fei, Busby‐Whitehead, Jan, Kosorok, Michael R., Batsis, John A.
Format Journal Article
LanguageEnglish
Published Hoboken, USA John Wiley & Sons, Inc 01.02.2023
Wiley Subscription Services, Inc
Subjects
Aged
Elder care
Geriatrics
Humans
individualized interventions
Intervention
Medical research
older adults
Older people
precision health
Precision Medicine
randomized trials
Systematic review
older adults
randomized trials
precision health
individualized interventions
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Summary:Older adults are characterized by profound clinical heterogeneity. When designing and delivering interventions, there exist multiple approaches to account for heterogeneity. We present the results of a systematic review of data‐driven, personalized interventions in older adults, which serves as a use case to distinguish the conceptual and methodologic differences between individualized intervention delivery and precision health‐derived interventions. We define individualized interventions as those where all participants received the same parent intervention, modified on a case‐by‐case basis and using an evidence‐based protocol, supplemented by clinical judgment as appropriate, while precision health‐derived interventions are those that tailor care to individuals whereby the strategy for how to tailor care was determined through data‐driven, precision health analytics. We discuss how their integration may offer new opportunities for analytics‐based geriatric medicine that accommodates individual heterogeneity but allows for more flexible and resource‐efficient population‐level scaling.
Bibliography:Funding information
National Institutes of Health, Grant/Award Numbers: K23 AG051681, KL2TR002490; School of Medicine, University of North Carolina at Chapel Hill, Grant/Award Number: ACTP1R1001
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AUTHOR CONTRIBUTIONS
Anna R. Kahkoska: conception, design, acquisition of data, analysis and interpretation; drafting the article; final approval of the version to be published. Nikki L. B. Free-man: conception, design, acquisition of data, analysis and interpretation; drafting the article; final approval of the version to be published. Emily Jones: design, acquisition of data, analysis and interpretation; drafting the article; final approval of the version to be published. Daniela Shirazi: acquisition of data, analysis and interpretation; revising article critically for important intellectual content; final approval of the version to be published. Sydney Browder: acquisition of data, analysis and interpretation; revising article critically for important intellectual content; final approval of the version to be published. Annie Page: acquisition of data, analysis and interpretation; revising article critically for important intellectual content; final approval of the version to be published. John Sperger: acquisition of data, analysis and interpretation; revising article critically for important intellectual content; final approval of the version to be published. Tarek M. Zikry: acquisition of data, analysis and interpretation; revising article critically for important intellectual content; final approval of the version to be published. Yu Fei: design, revising article critically for important intellectual content; final approval of the version to be published. Jan Busby-Whitehead: design, revising article critically for important intellectual content; final approval of the version to be published. Michael R. Kosorok: design, revising article critically for important intellectual content; final approval of the version to be published. John A. Batsis: conception, design, acquisition of data, analysis and interpretation; revising article critically for important intellectual content; final approval of the version to be published.
ISSN:0002-8614
1532-5415
1532-5415
DOI:10.1111/jgs.18141