Predictive accuracy of falls risk screening tools
It was pleasing to see the careful review of the accuracy of in-hospital falls risk screening tools in your June edition however we believe the conclusion that the "STRATIFY may still be useful in particular settings"(1) is misleading. We are currently conducting a prospective cohort study which includes all patients 65 years and over who are admitted to a large acute care facility. Patients are initially screened for their falls risk by research personnel using the STRATIFY falls risk tool. The nurse caring for the patient, who is blinded to the STRATIFY score, is then asked if s/he believes the patient is at risk of falling. We currently have follow-up data for 389 patients. Using the standard cut off score off two, the sensitivity of the STRATIFY is 58.8% and the specificity 82.9%. However, the positive predictive value is only 23.8%. This means that 76.2% of those who are predicted as being at high risk of falling did not fall. When nurses' clinical judgement is assessed the sensitivity is higher (94.1%) but the specificity is low, 36.6%. The false positive rate for nurses is 87.5%. We currently do not routinely screen for falls risk but, if we did, considerable resources may be wasted on further assessment and interventions for patients who will not fall. Additionally, classifying patients as low risk could lead to a false sense of security; over 40% of patients scoring less than two in our study did indeed sustain a fall.
Impact and interest:
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|Item Type:||Journal Article|
|Additional Information:||Self-archiving of the author-version is not yet supported by this publisher. For more information, please refer to the journal's website (see hypertext link) or contact the author.|
|Subjects:||Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000)|
|Divisions:||Current > QUT Faculties and Divisions > Faculty of Health|
|Copyright Owner:||Copyright 2008 The Gerontological Society of America|
|Deposited On:||22 Sep 2008|
|Last Modified:||09 Jun 2010 13:04|
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