Background
Methods
Search strategy
Study selection and data extraction
Quality assessment
Statistical methods
Results
Study identification
Study characteristics
Study | Participants: n, sex, mean age (range) | Time frame patients followed up | Population type | Person who administered tool | Person who recorded the fall | Number of falls | Number of individuals who fell* |
---|---|---|---|---|---|---|---|
Oliver et al. 1997[8] United Kingdom (Local validation) | n = 217 79.5 years | 8 weeks | Geriatric unit, rehabilitation unit | Nurse | NR - recorded in ward incident book | 71 | Unreported |
Oliver et al. 1997[8] United Kingdom (Remote validation) | n = 331 83 years | 8 weeks | Geriatric unit, rehabilitation unit | Nurse | NR - recorded in ward incident book | 79 | Unreported |
Walsh et al. 2011[2] Australia | n = 130 51 men; 79 women 75 years (29-97) | Until discharge | Medical/surgical inpatients | Research team | Principal investigator | 14 | 7 (5.4%) |
Marschollek et al. 2011[25] Germany | n = 46 81.3 years | One year | Geriatric inpatients | Interdisciplinary geriatric team | Interdisciplinary Geriatric care team | Unreported | 19 (41.3%) |
Barker et al. 2010[14] United Kingdom | n = 263 137 men; 126 women 61.32 years | Until discharge | Medical/surgical inpatients | Research nurse | Nurse | 44 | 23 (8.7%)* |
Webster et al. 2010[20] Australia | n = 788 77.7 years | Until discharge | Hospital inpatients ≥65 years | Research team | Staff member recorded into Incident Report Database | Unreported | 72 (9.1%) |
Vassallo et al 2008[16] United Kingdom | n = 200 77 men; 123 women 80.9 years | 3 weeks | Rehabilitation unit | Clinician | Nurse | Unreported | 51 (25.5%) |
Milisen et al. 2007[6] Belgium | n = 1602† 627 men; 975 women 79.3 years | Until discharge | Hospital inpatients ≥65 years | Bedside nurses | Nurse | 1968 | 123 (7.7%) |
Kim et al. 2007[21] Australia | n = 5489 2842 men; 2647 women 55 years | Until first fall, discharge or death | Hospital inpatients ≥ 18 years | Research nurse | Nurse | Unreported | 60 (1.1%) |
Wijnia et al. 2006[26] The Netherlands | n = 120 75 men; 45 women 74.5 years | 13 weeks | Nursing home | Nurse | Nurse | Unreported | 36 (30%) |
Smith et al. 2005[17] United Kingdom (Inpatient study) | n = 225 | 28 days | Stroke rehabilitation units | Nurse | Staff member using incident report form | Unreported | 53 (23.6%) |
Haines et al. 2006[19] Australia (Phase 1) | n = 122 38 men; 84 women 79 years | Until discharge | Hospital inpatients | Project researcher | Staff member (using incident report form) | 59 | 26 (21.3%) |
Vassallo et al. 2005[15] United Kingdom | n = 135 49 men; 86 women 83.8 years (56-100) | Until discharge | Hospital inpatients | Clinician | Nurse | 29 | 22 (18%) |
Jester et al. 2005[18] United Kingdom | n = 90 20 men; 70 women (60-81 years) | Unreported | Hospital inpatients | Unreported | NR – information was obtained from medical/nursing/therapy notes,Incident report forms | Unreported | 5 (5.6%) |
Hill et al. 2004[22] Australia | n = 44 26 men; 18 women 79.8 years (64-101) | Unreported | Geriatric rehabilitation unit | Clinician | Ward staff | Unreported | 7 (15.9%) |
Papaioannou et al. 2004[24] Canada | n = 620 282 men; 338 women 78 years | Unreported | Hospital inpatients ≥65 years | Nurse | Nurse | 77 | 34 (5.5%) |
Coker et al. 2003[23] Canada | n = 432 | Until discharge | Geriatric rehabilitation unit | Nurse | Nurse | Unreported | 111 (25.7%) |
Chiari et al. 2002[28] Italy | n = 1,181 507 men; 604 women (65-104 years) | 2 months | Hospital inpatients | Project researcher | Staff member | Unreported | 51 (4.3%) |
Bailleux, 2006[27] France | n = 155 55 men; 100 women 80.3 years | Until discharge | Geriatric rehabilitation unit | Project researcher | Staff member (using incident report form) | Unreported | 36 (23.2%) |
Study quality
Diagnostic test accuracy of all included studies
Application of STRATIFY rule | No. of studies (patients) | Sensitivity (95% CI) | Variance Logit Sensitivity (95% CI) | Specificity (95% CI) | Variance Logit Specificity (95% CI) |
---|---|---|---|---|---|
All studies
| 17 (n = 11,378) | 0.67 (0.52-0.80) | 1.49 (0.63-3.53) | 0.57 (0.45-0.69) | 1.04 (0.49-2.21) |
Studies with spectrum bias excluded
| 14 (n = 11,063) | 0.66 (0.54-0.76) | 0.69 (0.28-1.72) | 0.61 (0.51-0.69) | 0.49 (0.22-1.09) |
Studies with no definition ‘fall’ excluded
| 10 (n = 4,193) | 0.61 (0.42-0.78) | 1.26 (0.43-3.68) | 0.65 (0.55-0.74) | 0.42 (0.15-1.16) |
Studies with a high prevalence of falls (>10%)
| 9 (n = 1479) | 0.58 (0.41-0.73) | 0.94 (0.32-2.77) | 0.58 (0.43-0 .71) | 0.76 (0.28-2.08) |
Studies with a low prevalence of falls (<10%)
| 8 (n = 9899) | 0.75 (0.42-0.93) | 1.12 (-0.31-2.55) | 0.63 (0.43-0.79) | 0.53 (-0.28-1.33) |
Sensitivity analysis
Bayesian analysis
Application of STRATIFY rule | Pre test probability (%) | + LR (95% CI) | Post test probability (%) + LR | -LR (95% CI) | Post test probability (%) -LR |
---|---|---|---|---|---|
All studies
| 6.27% (5.84%-6.74%) | 1.58 (1.34-1.86) | 9.58% (8.26%-11.09%) | 0.57 (0.43-0.75) | 3.67% (2.8%-5.03%) |
Studies with spectrum bias excluded
| 5.93% (5.51%-6.39%) | 1.67 (1.43-1.95) | 9.53% (8.29%-10.93%) | 0.56 (0.45-0.71) | 3.44% (2.75%-4.29%) |
Studies with no definition ‘fall’ excluded
| 11.9% (10.96%-12.92%) | 1.76 (1.48-2.12) | 19.27% (16.62%-22.24%) | 0.59 (0.41-0.85) | 7.4% 5.25%-10.32% |
Studies with a high prevalence of falls (>10%)
| 24.41% (22.24%-26.68%) | 1.39 (1.21-1.60) | 30.98% (28.08%-34.03%) | 0.72 (0.59-0.87) | 18.82% (15.99%-22.03%) |
Studies with a low prevalence of falls (<10%)
| 3.57% (3.22%-3.95%) | 2.03 (1.69-2.44) | 6.99% (5.89%-8.28%) | 0.39 (0.18-0.86) | 1.42% (0.65%-3.08%) |