Background The involvement of older adults in research on digital health is uneven with respect to e.g. age, gender, health status, and digital skills. However, little is known regarding the impact of the uneven involvement of older adults in digital health research on researched outcomes. This study helps to fill this knowledge gap and identifies the effects of uneven involvement of older adults in digital health research on researched outcomes, and also develops a correction for this. Methods Data are retrieved from a digital health intervention for postoperative monitoring of people who underwent day surgery in Sweden. Based on field information on the recruitment process and researched outcomes for the intervention, this study (1) tested intervention effects by using two standard unweighted procedures in a sample of 281 individuals aged 50 years or older, and then (2) used the information on participants, non-participants and their respective probabilities to be involved in the intervention study to perform a weighting of the intervention effects for each step of selection and for the study group membership. Results The intervention effects were found to be overestimated due to overrepresentation of groups which gained from receiving the intervention. No intervention effects were found after adjustment for participation bias. Conclusions Selective participation of older adults in digital health research biases research outcomes and can lead to overestimation of intervention effects. Weighting allows researchers to correct and describe the impact of selective participation on researched outcomes.

中文翻译：

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不参与老年人数字健康干预研究：参与不均衡、偏倚结果和加权效应


背景 老年人在年龄、性别、健康状况和数字技能等方面参与数字健康研究的程度参差不齐。然而，关于老年人参与数字健康研究的不均衡对研究结果的影响，人们知之甚少。这项研究有助于填补这一知识空白，并确定老年人参与数字健康研究不均衡对研究结果的影响，并为此进行了纠正。方法 从数字健康干预中检索数据，用于对瑞典接受日间手术的患者进行术后监测。根据招募过程的现场信息和干预的研究结果，本研究 （1） 在 281 名 50 岁或以上的个体样本中使用两个标准未加权程序测试干预效果，然后 （2） 使用有关参与者、非参与者及其各自参与干预研究的概率的信息对每个选择步骤和研究组的干预效果进行加权会员。结果 由于从接受干预中获得的群体比例过高，发现干预效果被高估。调整参与偏倚后未发现干预效果。结论 老年人选择性参与数字健康研究会使研究结果产生偏差，并可能导致对干预效果的高估。加权使研究人员能够纠正和描述选择性参与对研究结果的影响。