Fall risk-assessment tools compared with clinical judgment: An evaluation in a rehabilitation ward

This source preferred by Stephen Allen

Authors: Vassallo, M., Poynter, L., Sharma, J.C., Kwan, J.W. and Allen, S.C.

http://ageing.oxfordjournals.org/cgi/content/abstract/37/3/277

Journal: Age and Ageing

Volume: 37

Pages: 277-281

ISSN: 0002-0729

DOI: 10.1093/ageing/afn062

Objectives: to compare the use of two falls risk-identification tools (Downton and STRATIFY) with clinical judgment (based upon the observation of wandering behaviour) in predicting falls of medically stable patients in a rehabilitation ward for older people.

Methods: in a prospective observational study, with blinded end-point evaluation, 200 patients admitted to a geriatric rehabilitation hospital had a STRATIFY and Downton Fall Risk assessment and were observed for wandering behaviour.

Results: wandering had a predictive accuracy of 78%. A total of 157/200 were identified correctly compared to 100/200 using the Downton score (P < 0.0001 95%, CI 0.18–0.42), or 93/200 using STRATIFY (P < 0.0001; 95% CI 0.15–0.37). The Downton and STRATIFY tools demonstrated predictive accuracies of 50% and 46.5%, respectively, with no statistical significance between the two (P = 0.55; 95% CI 0.77–1.71). Sensitivity for predicting falls using wandering was 43.1% (22/51). This was significantly worse than Downton 92.2% (47/51: P < 0.001) and STRATIFY 82.3% (42/51: P < 0.001).

Conclusions: this study showed that clinical observation had a higher accuracy than two used falls risk-assessment tools. However it was significantly less sensitive implying that fewer patients who fell were correctly identified as being at risk.

This data was imported from PubMed:

Authors: Vassallo, M., Poynter, L., Sharma, J.C., Kwan, J. and Allen, S.C.

Journal: Age Ageing

Volume: 37

Issue: 3

Pages: 277-281

eISSN: 1468-2834

DOI: 10.1093/ageing/afn062

OBJECTIVES: to compare the use of two falls risk-identification tools (Downton and STRATIFY) with clinical judgment (based upon the observation of wandering behaviour) in predicting falls of medically stable patients in a rehabilitation ward for older people. METHODS: in a prospective observational study, with blinded end-point evaluation, 200 patients admitted to a geriatric rehabilitation hospital had a STRATIFY and Downton Fall Risk assessment and were observed for wandering behaviour. RESULTS: wandering had a predictive accuracy of 78%. A total of 157/200 were identified correctly compared to 100/200 using the Downton score (P < 0.0001 95%, CI 0.18-0.42), or 93/200 using STRATIFY (P < 0.0001; 95% CI 0.15-0.37). The Downton and STRATIFY tools demonstrated predictive accuracies of 50% and 46.5%, respectively, with no statistical significance between the two (P = 0.55; 95% CI 0.77-1.71). Sensitivity for predicting falls using wandering was 43.1% (22/51). This was significantly worse than Downton 92.2% (47/51: P < 0.001) and STRATIFY 82.3% (42/51: P < 0.001). CONCLUSIONS: this study showed that clinical observation had a higher accuracy than two used falls risk-assessment tools. However it was significantly less sensitive implying that fewer patients who fell were correctly identified as being at risk.

This data was imported from Scopus:

Authors: Vassallo, M., Poynter, L., Sharma, J.C., Kwan, J. and Allen, S.C.

Journal: Age and Ageing

Volume: 37

Issue: 3

Pages: 277-281

eISSN: 1468-2834

ISSN: 0002-0729

DOI: 10.1093/ageing/afn062

Objectives: To compare the use of two falls risk-identification tools (Downton and STRATIFY) with clinical judgment (based upon the observation of wandering behaviour) in predicting falls of medically stable patients in a rehabilitation ward for older people. Methods: in a prospective observational study, with blinded end-point evaluation, 200 patients admitted to a geriatric rehabilitation hospital had a STRATIFY and Downton Fall Risk assessment and were observed for wandering behaviour. Results: wandering had a predictive accuracy of 78%. A total of 157/200 were identified correctly compared to 100/200 using the Downton score (P < 0.0001 95%, CI 0.18-0.42), or 93/200 using STRATIFY (P < 0.0001; 95% CI 0.15-0.37). The Downton and STRATIFY tools demonstrated predictive accuracies of 50% and 46.5%, respectively, with no statistical significance between the two (P = 0.55; 95% CI 0.77-1.71). Sensitivity for predicting falls using wandering was 43.1% (22/51). This was significantly worse than Downton 92.2% (47/51: P <0.001) and STRATIFY 82.3% (42/51: P < 0.001). Conclusions: this study showed that clinical observation had a higher accuracy than two used falls risk-assessment tools. However it was significantly less sensitive implying that fewer patients who fell were correctly identified as being at risk. © The Author 2008. Published by Oxford University Press on behalf of the British Geriatrics Society.

This data was imported from Web of Science (Lite):

Authors: Vassallo, M., Poynter, L., Sharma, J.C., Kwan, J. and Allen, S.C.

Journal: AGE AND AGEING

Volume: 37

Issue: 3

Pages: 277-281

ISSN: 0002-0729

DOI: 10.1093/ageing/afn062

This data was imported from Europe PubMed Central:

Authors: Vassallo, M., Poynter, L., Sharma, J.C., Kwan, J. and Allen, S.C.

Journal: Age and ageing

Volume: 37

Issue: 3

Pages: 277-281

eISSN: 1468-2834

ISSN: 0002-0729

OBJECTIVES: to compare the use of two falls risk-identification tools (Downton and STRATIFY) with clinical judgment (based upon the observation of wandering behaviour) in predicting falls of medically stable patients in a rehabilitation ward for older people. METHODS: in a prospective observational study, with blinded end-point evaluation, 200 patients admitted to a geriatric rehabilitation hospital had a STRATIFY and Downton Fall Risk assessment and were observed for wandering behaviour. RESULTS: wandering had a predictive accuracy of 78%. A total of 157/200 were identified correctly compared to 100/200 using the Downton score (P < 0.0001 95%, CI 0.18-0.42), or 93/200 using STRATIFY (P < 0.0001; 95% CI 0.15-0.37). The Downton and STRATIFY tools demonstrated predictive accuracies of 50% and 46.5%, respectively, with no statistical significance between the two (P = 0.55; 95% CI 0.77-1.71). Sensitivity for predicting falls using wandering was 43.1% (22/51). This was significantly worse than Downton 92.2% (47/51: P < 0.001) and STRATIFY 82.3% (42/51: P < 0.001). CONCLUSIONS: this study showed that clinical observation had a higher accuracy than two used falls risk-assessment tools. However it was significantly less sensitive implying that fewer patients who fell were correctly identified as being at risk.

The data on this page was last updated at 05:14 on July 22, 2019.