dc.contributor.author | MCCABE, DOMINICK | |
dc.contributor.author | BOLAND, FRANCIS | |
dc.contributor.author | HARBISON, JOSEPH | |
dc.contributor.author | Walsh, Mary E. | |
dc.contributor.author | Galvin, Rose | |
dc.contributor.author | Williams, David | |
dc.contributor.author | Murphy, Sean | |
dc.contributor.author | Collins, Ronan | |
dc.contributor.author | Crowe, Morgan | |
dc.contributor.author | Horgan, Frances | |
dc.date.accessioned | 2020-04-06T15:21:25Z | |
dc.date.available | 2020-04-06T15:21:25Z | |
dc.date.issued | 2017 | |
dc.date.submitted | 2017 | en |
dc.identifier.citation | Walsh, M.E., Galvin, R., Boland, F., Williams, D., Harbison, J.A., Murphy, S., Collins, D.R., McCabe, D.J.H., Crowe, M. & Horgan, N.F., Validation of two risk prediction models for recurrent falls in the first year after stroke: A prospective cohort study, Age and Ageing, 2017, 1-6 | en |
dc.identifier.other | Y | |
dc.identifier.uri | https://academic.oup.com/ageing/article/46/4/642/2926040 | |
dc.identifier.uri | http://hdl.handle.net/2262/92194 | |
dc.description | IN_PRESS | en |
dc.description.abstract | Background:
several multivariable models have been derived to predict post-stroke falls. These require validation before integration into clinical practice. The aim of this study was to externally validate two prediction models for recurrent falls in the first year post-stroke using an Irish prospective cohort study.
Methodology:
stroke patients with planned home-discharges from five hospitals were recruited. Falls were recorded with monthly diaries and interviews 6 and 12 months post-discharge. Predictors for falls included in two risk-prediction models were assessed at discharge. Participants were classified into risk groups using these models. Model 1, incorporating inpatient falls history and balance, had a 6-month outcome. Model 2, incorporating inpatient near-falls history and upper limb function, had a 12-month outcome. Measures of calibration, discrimination (area under the curve (AUC)) and clinical utility (sensitivity/specificity) were calculated.
Results:
128 participants (mean age = 68.6 years, SD = 13.3) were recruited. The fall status of 117 and 110 participants was available at 6 and 12 months, respectively. Seventeen and 28 participants experienced recurrent falls by these respective time points. Model 1 achieved an AUC = 0.56 (95% CI 0.46–0.67), sensitivity = 18.8% and specificity = 93.6%. Model 2 achieved AUC = 0.55 (95% CI 0.44–0.66), sensitivity = 51.9% and specificity = 58.7%. Model 1 showed no significant difference between predicted and observed events (risk ratio (RR) = 0.87, 95% CI 0.16–4.62). In contrast, model 2 significantly over-predicted fall events in the validation cohort (RR = 1.61, 95% CI 1.04–2.48).
Conclusions:
both models showed poor discrimination for predicting recurrent falls. A further large prospective cohort study would be required to derive a clinically useful falls-risk prediction model for a similar population. | en |
dc.description.sponsorship | This work was supported by the Irish Research Council (Government of Ireland Postgraduate Scholarship Scheme 2013). | en |
dc.format.extent | 1-6 | en |
dc.language.iso | en | en |
dc.relation.ispartofseries | Age and Ageing; | |
dc.rights | Y | en |
dc.subject | Risk prediction | en |
dc.subject | Accidental falls | en |
dc.subject | Stroke | en |
dc.subject | Older people | en |
dc.title | Validation of two risk prediction models for recurrent falls in the first year after stroke: A prospective cohort study | en |
dc.type | Journal Article | en |
dc.type.supercollection | scholarly_publications | en |
dc.type.supercollection | refereed_publications | en |
dc.identifier.peoplefinderurl | http://people.tcd.ie/mccabedo | |
dc.identifier.peoplefinderurl | http://people.tcd.ie/jharbiso | |
dc.identifier.peoplefinderurl | http://people.tcd.ie/fboland | |
dc.identifier.rssinternalid | 149793 | |
dc.identifier.doi | http://dx.doi.org/10.1093/ageing/afw255 | |
dc.rights.ecaccessrights | openAccess | |