Design-related bias in hospital fall risk screening tool predictive accuracy evaluations: systematic review and meta-analysis. Haines, Terry, Hill, Keith, Walsh, Willeke and Osborne, Richard 2007, Design-related bias in hospital fall risk screening tool predictive accuracy evaluations: systematic review and meta-analysis., The journals of gerontology. Series A, Biological sciences and medical sciences, vol. 62, no. 6, pp. 664-672. Attached Files Name Description MIMEType Size Downloads Title Design-related bias in hospital fall risk screening tool predictive accuracy evaluations: systematic review and meta-analysis. Author(s) Haines, Terry Hill, Keith Walsh, Willeke Osborne, Richard Journal name The journals of gerontology. Series A, Biological sciences and medical sciences Volume number 62 Issue number 6 Start page 664 End page 672 Publisher Gerontological Society of America Place of publication Washington, D.C. Publication date 2007-06 ISSN 1079-5006 1758-535X Summary Introduction: Fall risk screening tools are frequently used as a part of falls prevention programs in hospitals. Design-related bias in evaluations of tool predictive accuracy could lead to overoptimistic results, which would then contribute to program failure in practice. Methods: A systematic review was undertaken. Two blind reviewers assessed the methodology of relevant publications into a four-point classification system adapted from multiple sources. The association between study design classification and reported results was examined using linear regression with clustering based on screening tool and robust variance estimates with point estimates of Youden Index (= sensitivity + specificity - 1) as the dependent variable. Meta-analysis was then performed pooling data from prospective studies. Results: Thirty-five publications met inclusion criteria, containing 51 evaluations of fall risk screening tools. Twenty evaluations were classified as retrospective validation evaluations, 11 as prospective (temporal) validation evaluations, and 20 as prospective (external) validation evaluations. Retrospective evaluations had significantly higher Youden Indices (point estimate [95% confidence interval]: 0.22 [0.11, 0.33]). Pooled Youden Indices from prospective evaluations demonstrated the STRATIFY, Morse Falls Scale, and nursing staff clinical judgment to have comparable accuracy. Discussion: Practitioners should exercise caution in comparing validity of fall risk assessment tools where the evaluation has been limited to retrospective classifications of methodology. Heterogeneity between studies indicates that the Morse Falls Scale and STRATIFY may still be useful in particular settings, but that widespread adoption of either is unlikely to generate benefits significantly greater than that of nursing staff clinical judgment. Language eng Field of Research 110399 Clinical Sciences not elsewhere classified Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences HERDC Research category C1.1 Refereed article in a scholarly journal Copyright notice ©2007, Gerontological Society of America Persistent URL http://hdl.handle.net/10536/DRO/DU:30019390 Document type: Journal Article Collection: School of Health and Social Development Related Links Link Description Connect to published version (restricted access) Go to link with your DU access privileges     Unless expressly stated otherwise, the copyright for items in DRO is owned by the author, with all rights reserved. Versions Version Filter Type Fri, 11 Sep 2009, 16:09:35 EST Fri, 11 Sep 2009, 16:12:12 EST Fri, 11 Sep 2009, 16:14:33 EST Mon, 14 Sep 2009, 13:59:27 EST Mon, 14 Sep 2009, 14:00:09 EST Fri, 27 Nov 2009, 13:33:57 EST Wed, 02 Dec 2009, 10:57:27 EST Thu, 25 Feb 2010, 10:46:47 EST Thu, 18 Oct 2012, 12:20:26 EST Filtered Full Citation counts:   Cited 0 times in TR Web of Science Cited 77 times in Scopus Search Google Scholar Access Statistics: 808 Abstract Views, 1 File Downloads  -  Detailed Statistics Created: Fri, 11 Sep 2009, 16:09:33 EST by Lorraine Driscoll

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