DETERMINING RISK OF FALLS IN COMMUNITY DWELLING OLDER ADULTS: A SYTEMATIC REVIEW AND META-ANALYSIS USING POSTTEST PROBABILITY

Review written by Dr Mariana Wingood info

BACKGROUND & OBJECTIVE

Falls affect a significant number of older adults and can cause multiple fall-related consequences and/or injuries. However, if valid reliable outcome measures are used, a clinician can determine increased risk for falling and provide appropriate interventions. A clinician can select their outcome measures based on psychometric properties, including Sensitivity (Sn), Specificity (Sp), Likelihood Ratios (LR), and post-test probability(PoTP) identified in a systematic review. The authors of this systematic review did this by completing two objectives:(1) evaluating the predictive ability of fall risk assessment tools for community-dwelling older adults by using PoTP, and (2) exploring the usefulness of cumulative PoTP using test results from multiple measures.

METHODS

The Institute of Medicine Guidelines were used to complete the sytematic review. With the assistance from a librarian, MEDLINE and CINAHL were searched for literature. To increase the rigor of the article search, data mining of references was performed. Studies that met inclusion/exclusion criteria were assessed for quality using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) Critical Appraisal Tool. This was followed by data extraction and analysis.

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RESULTS

A total of 59 articles were selected for analysis. See Table 1 for Results. Table 1: Summary of Clinically Useful Tools.

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