SHORTS: Determining Risk of Falls in Community Dwelling Older Adults: A Systematic Review and Meta-Analysis Using Posttest Probability #23YearsofDataInOneTable #GameChanger

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Lusardi M, Fritz S, Middleton A, et al. Determining Risk of Falls in Community Dwelling Older Adults: A Systematic Review and Meta-Analysis Using Posttest Probability. Journal of Geriatric Physical Therapy. 2010;40(1), 1-36.

"Falls and their consequences are significant concerns for older adults, caregivers, and health care providers. Identification of fall risk is crucial for appropriate referral to preventive interventions. Falls are multi-factorial; no single measure is an accurate diagnostic tool. There is limited information on which history question, self-report measure, or performance-based measure, or combination of measures, best predicts future falls."

"Purpose: First, to evaluate the predictive ability of history questions, self-report measures, and performance-based measures for assessing fall risk of community-dwelling older adults by calculating and comparing posttest probability (PoTP) values for individual test/measures. Second, to evaluate usefulness of cumulative PoTP for measures in combination."

Use the link below to calculate cumulative PoTP by inserting the highest PoTP value gathered (use table 5) into the Pre-test probability box. Then use the +LR of your follow-up question/outcome measure/self-report (also from the table) in the likelihood ratio box below it. Hit re-calculate for a new cumulative PoTP.

Don't forget to take into account negatively answered questions, or outcome measures/self-report tools outside of the cut-off scores by using the -LR to go in the opposite direction for a cumulative "decreased fall risk" score. I suggest doing this first, then going back up using +LR responses.

http://www.sample-size.net/post-probability-calculator-test-new/

Questions or comments? Find me here:

Twitter: @jdaniels_SPT

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Email: jd2012@nova.edu

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