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Department of Veterans Affairs
Health Services Research & Development Service Evidence-based Synthesis Program
Life Expectancy Calculators
June 2016
Prepared for: Investigators:
Department of Veterans Affairs Principal Investigator:
Veterans Health Administration Thomas Rector, PhD, PharmD
Quality Enhancement Research Initiative
Health Services Research & Development Service Co-investigators:
Washington, DC 20420 Brent Taylor, PhD
Shahnaz Sultan, MD, MHSc
Prepared by: Aasma Shaukat, MD, MPH
Evidence-based Synthesis Program (ESP) Center
Selcuk Adabag, MD, MS
David Nelson, PhD
Minneapolis VA Medical Center Timothy Capecchi, MD
Minneapolis, MN
Tim Wilt, MD, MPH, Director Research Associate:
Nancy Greer, PhD, Program Manager Roderick MacDonald, MS
NOTE: This publication is for internal use of the Department of
Veterans Affairs and should not be distributed outside the agency.
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Life Expectancy Calculators Evidence-based Synthesis Program
PREFACE
The VA Evidence-based Synthesis Program (ESP) was established in 2007 to provide timely and
accurate syntheses of targeted healthcare topics of particular importance to clinicians, managers, and
policymakers as they work to improve the health and healthcare of Veterans. QUERI provides funding
for four ESP Centers, and each Center has an active University affiliation. Center Directors are
recognized leaders in the field of evidence synthesis with close ties to the AHRQ Evidence-based
Practice Centers. The ESP is governed by a Steering Committee comprised of participants from VHA
Policy, Program, and Operations Offices, VISN leadership, field-based investigators, and others as
designated appropriate by QUERI/HSR&D.
The ESP Centers generate evidence syntheses on important clinical practice topics. These reports help:
? Develop clinical policies informed by evidence;
? Implement effective services to improve patient outcomes and to support VA clinical practice
guidelines and performance measures; and
? Set the direction for future research to address gaps in clinical knowledge.
The ESP disseminates these reports throughout VA and in the published literature; some evidence
syntheses have informed the clinical guidelines of large professional organizations.
The ESP Coordinating Center (ESP CC), located in Portland, Oregon, was created in 2009 to expand the
capacity of QUERI/HSR&D and is charged with oversight of national ESP program operations, program
development and evaluation, and dissemination efforts. The ESP CC establishes standard operating
procedures for the production of evidence synthesis reports; facilitates a national topic nomination,
prioritization, and selection process; manages the research portfolio of each Center; facilitates editorial
review processes; ensures methodological consistency and quality of products; produces "rapid response
evidence briefs" at the request of VHA senior leadership; collaborates with HSR&D Center for
Information Dissemination and Education Resources (CIDER) to develop a national dissemination
strategy for all ESP products; and interfaces with stakeholders to effectively engage the program.
Comments on this evidence report are welcome and can be sent to Nicole Floyd, ESP CC Program
Manager, at Nicole.Floyd@va.gov.
Recommended citation: Rector T, Taylor BC, Sultan S, Shaukat A, Adabag S, Nelson D, Capecchi T,
MacDonald R, Greer, N, Wilt TJ. Life Expectancy Calculators, VA ESP Project #09-009; 2016.
This report is based on research conducted by the Evidence-based Synthesis Program (ESP) Center located at
the Minneapolis VA Medical Center, Minneapolis, MN, funded by the Department of Veterans Affairs, Veterans
Health Administration, Office of Research and Development, Quality Enhancement Research Initiative. The
findings and conclusions in this document are those of the author(s) who are responsible for its contents; the
findings and conclusions do not necessarily represent the views of the Department of Veterans Affairs or the
United States government. Therefore, no statement in this article should be construed as an official position of the
Department of Veterans Affairs. No investigators have any affiliations or financial involvement (eg, employment,
consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or
royalties) that conflict with material presented in the report.
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Life Expectancy Calculators Evidence-based Synthesis Program
TABLE OF CONTENTS
Definitions...................................................................................................................................... 1
Executive Summary ...................................................................................................................... 2
Introduction................................................................................................................................. 2
Methods ...................................................................................................................................... 2
Data Sources and Searches ..................................................................................................... 2
Study Selection ....................................................................................................................... 3
Data Abstraction, Quality Assessment, Synthesis, and Strength of Evidence........................ 3
Results .........................................................................................................................................3
Key Question 1 ....................................................................................................................... 3
Key Question 2 ....................................................................................................................... 4
Key Question 3 ....................................................................................................................... 4
Discussion ................................................................................................................................... 4
Key Findings ........................................................................................................................... 4
Applicability ........................................................................................................................... 5
Research Gaps/Future Research ............................................................................................. 5
Conclusions............................................................................................................................. 5
Introduction................................................................................................................................... 6
Methods........................................................................................................................................ 10
Topic Development................................................................................................................... 10
Search Strategy ......................................................................................................................... 10
Study Selection ......................................................................................................................... 10
Data Abstraction ....................................................................................................................... 11
Quality Assessment................................................................................................................... 11
Data Synthesis........................................................................................................................... 11
Rating the Strength of Evidence ............................................................................................... 11
Peer Review .............................................................................................................................. 12
Results .......................................................................................................................................... 13
Literature Flow ......................................................................................................................... 13
Reviewed Studies.................................................................................................................. 14
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