The development of a validated falls risk assessment for use in clinical practice

Abstract

Falls risk factor assessment is the first step in the development of appropriate intervention strategies for the prevention of falls. However, few multifactorial, validated falls risk assessments exist which are suitable for use in busy clinical settings. This project aimed to develop a reliable and valid falls risk assessment that was feasible for use in various clinical settings. The QuickScreen Clinical Falls Risk Assessment was developed and evaluated via four methods; a) the test-retest reliability of the measures was assessed with 30 community-dwelling older people, b) the concurrent validity of the measures was assessed by comparison with performance in the Physiological Profile Assessment, c) the predictive validity of the measures was assessed by comparison of performance with prospective falls in two studies involving large samples of community dwelling older people and d) the feasibility of the assessment was evaluated with 40 clinicians who trialled the assessment with their patients. The QuickScreen clinical falls risk assessment consists of eight measures, including previous falls, total medications, psychoactive medications, visual acuity, touch sensation, the sit to stand test, the near tandem stand test and the alternate step test. The test-retest reliability of the assessment measures was acceptable (intraclass correlation coefficients ranged from 0.56 to 0.89) and the assessment measures discriminated between multiple fallers and non-multiple fallers with relative risk values ranging from 1.4 to 2.5. The clinicians that trialled the assessment reported that it was quick and easy to administer and that it assisted in the management of their elderly patients. These results show that the QuickScreen Clinical Falls Risk Assessment has proven validity, test-retest reliability and is practical for use in a variety of clinical settings.