McVey 1989

Methods	Year: 1989 Location: Durham, North Caroina, USA (VA Centre) Team/ward?: team Timing: acute (within 48 hours) Trial method: randomised trial
Participants	Number (total): 178 Mean age: 81 years Male:female proportion: 96% male Inclusion criteria: patients ≥ 75 years of age Exclusion criteria: admitted to ICU; had previously received geriatric care; expected length of stay < 48 hours
Interventions	Team members: senior geriatrician, trainee geriatrician, specialist nurse, social worker Team organisation: comprehensive assessment and recommendations made, at least weekly multi‐disciplinary meetings, standardised assessment tools Control: usual care.
Outcomes	Activities of daily living/dependence Institutionalisation Death Trial conclusions: no significant effect on functional decline
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Computerised randomisation scheme
Allocation concealment (selection bias)	Unclear risk	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 measures (e.g. living at home) unlikely to be influenced by lack of blinding
Blinding of outcome assessment (detection bias) for subjective outcome measures	Low risk	Outcome assessors blinded to the allocation.
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Insufficient reporting of attritions/exclusions
Selective reporting (reporting bias)	Unclear risk	No a priori documentation found to judge this item
Other bias	Low risk	No clear evidence of contamination of control group