Dedicated orthogeriatric comprehensive care,
does it really help with Improved four-month mobility after hip fracture in previously ambulatory older adults?
research showsThe grade is C with 50 points. This publicly funded single-center trial randomized 397 patients, 198 versus 199, and assessed 174 versus 170 at four months. The prespecified primary SPPB score was 5.12 versus 4.38, adjusted difference 0.74 points (95% CI 0.18 to 1.30). The between-group difference was statistically significant, but its standardized magnitude was small (d≈0.28) and fell below the clinical-magnitude criterion. This was a small but real difference.
ads claimThe tested intervention was not a ward label. It integrated geriatric medicine, nursing, physiotherapy, occupational therapy, nutrition, medication review, and discharge planning. Evidence from general hospitalized older adults cannot be relabeled as this hip-fracture pathway.
Useful facts when choosing a product
- Participants were at least 70, community dwelling, and able to walk 10 meters before fracture.
- The pathway admitted patients directly from the emergency department to a dedicated geriatric ward while retaining orthopedic surgical care.
- The 0-to-12 SPPB combines balance, four-meter gait speed, and repeated chair rise.
What the research actually shows
Prestmo and colleagues used web-based computer block randomization in the emergency department to assign 397 patients to immediate geriatric-ward or usual orthopedic-ward care. NCT00667914 and the prospective protocol specified four-month SPPB as primary, matching the paper, and the main analysis followed intention to treat. Patients and clinicians could not be masked to a ward-level intervention, and assessors were only partly masked; partial assessor unmasking was retained as one avoidable limitation. Funding came from Norwegian public, regional health, hospital, university, research-institute, and municipal sources.
Why this is classified as C (50)
The prospectively registered patient-centered primary endpoint differed significantly between groups, but no validated between-group minimum clinically important difference was available and statistical convention classified the standardized magnitude as small (d≈0.28), giving C with 50 points.
Counterpoint. Verdict 2308 is C with 56 points and pools ward and consultation-team comprehensive geriatric assessment across general hospitalized older adults. This verdict instead tests four-month mobility after hip fracture in previously ambulatory patients.
Rejudgment record. Cross-check applied — Cross-checked randomized and four-month assessment counts, registered primary endpoint, adjusted difference, masking, and funding against the Lancet article, prospective protocol, and NCT00667914
| Endpoint | P | Patient-reported treatment goal - the symptom is the goal |
| Replication | R1 | Single confirmatory trial |
| Independence | I2 | Decisive evidence is publicly or non-profit funded |
| Effect size | E~ | Statistically positive but below the threshold |
The scoring table and the verdict agree (C).
Sub-claim grades by effect
This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.
| Effect (sub-claim) | Grade | Basis |
|---|---|---|
| Improved mobility at four months | C | The adjusted SPPB difference was 0.74 points (95% CI 0.18 to 1.30), with a small standardized magnitude (d≈0.28). |
| The same effect in every older adult with hip fracture | ? | The trial was limited to community-dwelling patients able to walk 10 meters before fracture. |
Cross-check — Codex and Claude
Evidence Table
| Study | Design | Sample | Funding | Endpoint | Result | Weight |
|---|---|---|---|---|---|---|
| Prestmo A, Hagen G, Sletvold O, Helbostad JL, Thingstad P, Taraldsen K, Lydersen S, Halsteinli V, Saltnes T, Lamb SE, Johnsen LG, Saltvedt I. 2015 | Single-center parallel-group randomized controlled trial | 170 | Public and academic sources including the Norwegian Research Council, regional health authority, hospital, NTNU, SINTEF, and Trondheim municipality | SPPB mobility score four months after surgery | Mean 5.12 (SE 0.20) versus 4.38 (SE 0.20), adjusted difference 0.74 points (95% CI 0.18 to 1.30), P=0.010 | Single confirmatory trial of a registered patient-centered functional primary endpoint |
Receipt — 1 References
All 1 cited sources were verified for existence at the original page (as of 2026-08-15).
Reviewed and approved: Chamgap Editorial Team · Approval date: 2026-08-15 · Corrections: none
Cite this verdict
[Chamgap] Dedicated orthogeriatric comprehensive care x mobility after hip fracture — Evidence Grade C·50. 1 cited sources checked. Source: https://chamgap.com/en/verdicts/joint-bone/orthogeriatric-comprehensive-care-hip-fracture-mobility/ · CC BY 4.0CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.
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