title: Expanded review criteria: the case of nonpharmacological interventions in dementia.
abstract: This paper challenges the assumptions underlying many reviews and offers alternative criteria for examining evidence for nonpharmacological interventions. We evaluated 27 reviews examining interventions for persons with dementia as they relate to the issues of selection based on randomized controlled trial (RCT) design. Reviews were described by type of intervention, level of cognitive function, and criteria for inclusion. Of the 27 reviews, 46% required RCTs for inclusion and most had stringent inclusion criteria. This resulted in poor utilization of the literature and low ecological validity. Eliminating most of the available data poses a critical problem to clinical and research development. Studies meeting strict methodological criteria may not generalize to the greater population or may exclude sub-populations and interventions. Limitations of double-blind RCTs and potential design solutions are set forth based on appropriate populations, problems, interventions, and settings characteristics.
authors.affiliation: Tel-Aviv University, Tel-Aviv, Israel George Washington University, Washington, DC, USA.
authors.forename: Jiska
authors.initials: J
authors.lastname: Cohen-Mansfield
authors.affiliation: The University of Iowa, Iowa City, IA, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Buckwalter
authors.affiliation: Queensland University of Technology, Kelvin Grove QLD, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Beattie
authors.affiliation: University of Virginia, Charlottesville, VA, USA.
authors.forename: Karen
authors.initials: K
authors.lastname: Rose
authors.affiliation: The University of Queensland, Brisbane, St Lucia QLD, Australia.
authors.forename: Christine
authors.initials: C
authors.lastname: Neville
authors.affiliation: Penn State University, State College, PA, USA.
authors.forename: Ann
authors.initials: A
authors.lastname: Kolanowski
mesh_terms: D003704:Dementia / Q000628:therapy*; D019317:Evidence-Based Medicine; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012196:Review Literature as Topic
keywords: dementia; interventions; older persons; randomized controlled trials; research designs; review