Review: evidence from single studies shows that very few fall risk assessment tools can predict falls in elderly people.

摘要

Prevention of falls in older people is of interest to both clinicians and researchers. The rationale of a fall risk assessment toof is to predict which patients may have specific risk factors for falling, identifying older adults who are at risk of falling is complex. The systematic review by Scott ef a/examines the test characteristics of various fall assessment tools and will be of interest to those who work with older people in long-term care, community, and acute-care settings. The review is comprehensive in scope, although the qualify of some of the included studies seems low when judged against the gold standard criteria identified by the authors. The authors state that many fools have acceptable evidence of sensitivity and specificity, but of 38 .different fools assessed, only 6 had values 3;70% for both sensitivity and specificity, and even fewer had adequate likelihood ratios. A lack of repeat testing of fools means that performance in settings other than the original settings cannot be assumed.Choosing a fall risk assessment tool for nursing practice will depend on several factors, such as available time and skills of nurses. Evidence of good sensitivity and specificity and predictive values is important, but translating such data into everyday use may be problematic because determining the utility of a test in practice from this information alone is difficult.1 However, no'matter which tool is chosen, its predictive ability will be quite limited. There is an urgent need for accurate fall risk assessment tools and a research programme to provide such tools across a spectrum of practice areas.