Fretwell 1990

Methods	Year: 1990 Location: Providence, Rhode Island, USA (Teaching Hospital) Team/ward?: ward Timing: direct Trial method: randomised trial
Participants	Number (total): 436 Mean age: 83 years Male:female proportion: 28% male Inclusion criteria: > 75 years of age; physician given consent; did not require CCU or ICU Exclusion criteria: none given
Interventions	Team members: specialist nurses, ward nurses, senior geriatrician, pharmacist, physiotherapist, dietician, social worker Team organisation: at least weekly multi‐disciplinary meetings, goal setting, standardised assessment tools Control: usual hospital care
Outcomes	Death Cognition Dependence Mood Costs Institutionalisation Trial conclusions: no significant differences between groups observed
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Insufficient information on the sequence generation process
Allocation concealment (selection bias)	Unclear risk	Method of allocation concealment not described
Blinding of participants and personnel (performance bias)	High risk	Blinding of participants and personnel not possible
Blinding of outcome assessment (detection bias) for objective outcome measures	Low risk	Objective outcome measures (e.g. living at home) unlikely to be influenced by lack of blinding
Blinding of outcome assessment (detection bias) for subjective outcome measures	Unclear risk	Few details of outcome assessors given
Incomplete outcome data (attrition bias) All outcomes	Low risk	Attrition rates after entry clearly described and balanced and apparently negligible
Selective reporting (reporting bias)	Unclear risk	No a priori documentation found to judge this item
Other bias	Low risk	Little evidence of contamination of control group