{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T22:25:36Z","timestamp":1791066336370,"version":"4.1.0"},"reference-count":16,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,1,29]],"date-time":"2019-01-29T00:00:00Z","timestamp":1548720000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:p>\n                    In the United States, the population aged 65 and older is rapidly growing, and this group uses more healthcare resources and has unique healthcare needs that do not exist in younger populations. However, it was reported that older adults are excluded or underrepresented in clinical trials for several diseases. We examined phase III clinical trials funded by the National Institutes of Health found in\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">www.clinicaltrials.gov<\/jats:ext-link>\n                    from 1965 to 2015 that addressed top causes for hospitalization and\/or disability\u2010adjusted life years in older adults: congestive heart failure (n = 45), cardiac dysrhythmias (n = 24), coronary atherosclerosis (n = 106), heart attack (n = 76), stroke (n = 113), chronic obstructive pulmonary disease (n = 14), pneumonia (n = 48), lung cancer (n = 117), prostate cancer (n = 65), and osteoarthritis (n = 15). We then analyzed the representation of older adults in these studies. We found that 33% of studies had arbitrary upper age limits, and 67% of studies reported mean and\/or median ages that skewed younger than expected for the disease or condition of interest. Beyond explicit exclusion by age, older adults were often implicitly excluded based on various comorbid conditions such as polypharmacy\/concomitant medication (37%) or cardiac issues (30%). We conclude that outcomes of these trials may not be fully generalizable to the general population of older adults.\n                    <jats:bold>J Am Geriatr Soc 67:218\u2013222, 2019.<\/jats:bold>\n                  <\/jats:p>","DOI":"10.1111\/jgs.15786","type":"journal-article","created":{"date-parts":[[2019,1,29]],"date-time":"2019-01-29T13:30:45Z","timestamp":1548768645000},"page":"218-222","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":79,"title":["Adequacy of Inclusion of Older Adults in NIH\u2010Funded Phase III Clinical Trials"],"prefix":"10.1111","volume":"67","author":[{"given":"Jaron","family":"Lockett","sequence":"first","affiliation":[{"name":"National Institute on Aging National Institutes of Health  Bethesda Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir","family":"Sauma","sequence":"additional","affiliation":[{"name":"National Institute on Aging National Institutes of Health  Bethesda Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Radziszewska","sequence":"additional","affiliation":[{"name":"National Institute on Aging National Institutes of Health  Bethesda Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie A.","family":"Bernard","sequence":"additional","affiliation":[{"name":"National Institute on Aging National Institutes of Health  Bethesda Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,1,29]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"Agency for Healthcare Research and Quality.Statistical Brief #497: Concentration of Health Expenditures in the U.S. Civilian Noninstitutionalized Population 2014. Published November 2016.https:\/\/meps.ahrq.gov\/data_files\/publications\/st497\/stat497.shtml. Accessed January 8 2019."},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1992.03490110055029"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.321.7267.992"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2008.12.009"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.12215"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0b013e31827e2145"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.14833"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0041601"},{"key":"e_1_2_6_10_1","unstructured":"Healthcare Cost and Utilization Project (HCUP) Fast Stats2017.Agency for Healthcare Research and Quality.www.hcup\u2010us.ahrq.gov\/faststats\/national\/inpatientcommondiagnoses.jsp?year1=2014&characteristic1=24&included1=0&year2=&characteristic2=0&included2=1&expansionInfoState=hide&dataTablesState=hide&definitionsState=hide&exportState=hide. Accessed September 15 2018."},{"key":"e_1_2_6_11_1","unstructured":"World Health Organization.The global burden of disease: 2004 update.https:\/\/www.who.int\/healthinfo\/global_burden_disease\/2004_report_update\/en\/. Accessed January 8 2019."},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.5888\/pcd10.120137"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1300237"},{"key":"e_1_2_6_14_1","unstructured":"21st Century Cures.https:\/\/www.nih.gov\/research-training\/medical-research-initiatives\/cures. Accessed August 22 2018."},{"key":"e_1_2_6_15_1","unstructured":"NIH Report: Inclusion Across the Lifespan.https:\/\/report.nih.gov\/UploadDocs\/NIH%20Inclusion%20Across%20the%20Lifespan%20Workshop%20Summary%20Report.pdf. Accessed August 22 2018."},{"key":"e_1_2_6_16_1","unstructured":"NIH Policy and Guidelines on the Inclusion of Individuals Across the Lifespan as Participants in Research Involving Human Subjects.https:\/\/grants.nih.gov\/grants\/guide\/notice-files\/NOT-OD-18-116.html. Accessed August 22 2018."},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.12368"}],"container-title":["Journal of the American Geriatrics Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjgs.15786","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.15786","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T18:02:04Z","timestamp":1762192924000},"score":1,"resource":{"primary":{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/10.1111\/jgs.15786"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1,29]]},"references-count":16,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2019,2]]}},"alternative-id":["10.1111\/jgs.15786"],"URL":"https:\/\/doi.org\/10.1111\/jgs.15786","archive":["Portico"],"relation":{},"ISSN":["0002-8614","1532-5415"],"issn-type":[{"value":"0002-8614","type":"print"},{"value":"1532-5415","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1,29]]},"assertion":[{"value":"2018-12-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-12-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-01-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}