Reliability and Diagnostic Accuracy of Commonly Used Performance Tests Relative to Fall History in Older Persons: A Systematic Review

Simone Chantal Gafner,1,2 Lara Allet,3,4 Roger Hilfiker,4 Caroline Henrice Germaine Bastiaenen2 1Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland; 2Department of Epidemiology, Research Line Functioning, Participation and Rehabi...

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Autores principales:	Gafner SC, Allet L, Hilfiker R, Bastiaenen CHG
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	aged falls criterion validity post-test probability clinical application Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/4ff95a4de66543e1a12fac985696b866
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spelling	oai:doaj.org-article:4ff95a4de66543e1a12fac985696b8662021-12-02T15:09:50ZReliability and Diagnostic Accuracy of Commonly Used Performance Tests Relative to Fall History in Older Persons: A Systematic Review1178-1998https://doaj.org/article/4ff95a4de66543e1a12fac985696b8662021-08-01T00:00:00Zhttps://www.dovepress.com/reliability-and-diagnostic-accuracy-of-commonly-used-performance-tests-peer-reviewed-fulltext-article-CIAhttps://doaj.org/toc/1178-1998Simone Chantal Gafner,1,2 Lara Allet,3,4 Roger Hilfiker,4 Caroline Henrice Germaine Bastiaenen2 1Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland; 2Department of Epidemiology, Research Line Functioning, Participation and Rehabilitation, CAPHRI, Maastricht University, Maastricht, the Netherlands; 3Department of Community Medicine, University Hospitals and University of Geneva, Geneva, Switzerland; 4School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland, Valais, SwitzerlandCorrespondence: Simone Chantal GafnerGeneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, SwitzerlandEmail simone.gafner@hesge.chBackground/Objectives: Early detection of fall risk is crucial for targeted fall prevention and rehabilitation. This systematic review facilitates decision-making concerning the optimal choice for a suitable fall risk assessment test for older persons in four different settings. This systematic review provides an overview of reliability and diagnostic accuracy (sensitivity [SE], specificity, likelihood ratios, and post-test probabilities) of commonly used performance measures to assess older persons’ fall risk.Methods: Two reviewers independently screened titles, abstracts, and full texts of all articles identified through a systematic search on the PubMed, Embase, CINAHL, and Web of Science databases. The methodological quality was critically appraised using the Quality Assessment of Diagnostic Accuracy Studies-2 tool and the COSMIN risk of bias tool. Due to a setting-dependent fall risk, four relevant settings were selected for the analyses: 1) community dwelling, 2) nursing home, 3) hospital, and 4) the combined setting of hospitalized and community-dwelling persons.Results: Recommendations for diagnostic accuracy can be made for the specific settings: setting 1) mini-balance evaluation system test, timed up and go test with fast speed (TUG FAST), cognitive TUG FAST, functional reach test, and fast gait speed; 2) TUG at usual speed; 3) none of the included tests; and 4) some hip muscle strength and hand grip strength tests might be recommended.Conclusion: The review’s results are applicable for use in clinical practice, both on a population and on an individual level for patients and caregivers. Most measures’ reliability is sufficient. However, the included tests’ discriminative ability is not optimal for clinical use in relevant settings. The low sample sizes of most of the included studies and a limited amount of studies in all but the community-dwelling setting hinder us from making strong recommendations.Keywords: aged, falls, criterion validity, post-test probability, clinical applicationGafner SCAllet LHilfiker RBastiaenen CHGDove Medical Pressarticleagedfallscriterion validitypost-test probabilityclinical applicationGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 16, Pp 1591-1616 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	aged falls criterion validity post-test probability clinical application Geriatrics RC952-954.6
spellingShingle	aged falls criterion validity post-test probability clinical application Geriatrics RC952-954.6 Gafner SC Allet L Hilfiker R Bastiaenen CHG Reliability and Diagnostic Accuracy of Commonly Used Performance Tests Relative to Fall History in Older Persons: A Systematic Review
description	Simone Chantal Gafner,1,2 Lara Allet,3,4 Roger Hilfiker,4 Caroline Henrice Germaine Bastiaenen2 1Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland; 2Department of Epidemiology, Research Line Functioning, Participation and Rehabilitation, CAPHRI, Maastricht University, Maastricht, the Netherlands; 3Department of Community Medicine, University Hospitals and University of Geneva, Geneva, Switzerland; 4School of Health Sciences, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland, Valais, SwitzerlandCorrespondence: Simone Chantal GafnerGeneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, SwitzerlandEmail simone.gafner@hesge.chBackground/Objectives: Early detection of fall risk is crucial for targeted fall prevention and rehabilitation. This systematic review facilitates decision-making concerning the optimal choice for a suitable fall risk assessment test for older persons in four different settings. This systematic review provides an overview of reliability and diagnostic accuracy (sensitivity [SE], specificity, likelihood ratios, and post-test probabilities) of commonly used performance measures to assess older persons’ fall risk.Methods: Two reviewers independently screened titles, abstracts, and full texts of all articles identified through a systematic search on the PubMed, Embase, CINAHL, and Web of Science databases. The methodological quality was critically appraised using the Quality Assessment of Diagnostic Accuracy Studies-2 tool and the COSMIN risk of bias tool. Due to a setting-dependent fall risk, four relevant settings were selected for the analyses: 1) community dwelling, 2) nursing home, 3) hospital, and 4) the combined setting of hospitalized and community-dwelling persons.Results: Recommendations for diagnostic accuracy can be made for the specific settings: setting 1) mini-balance evaluation system test, timed up and go test with fast speed (TUG FAST), cognitive TUG FAST, functional reach test, and fast gait speed; 2) TUG at usual speed; 3) none of the included tests; and 4) some hip muscle strength and hand grip strength tests might be recommended.Conclusion: The review’s results are applicable for use in clinical practice, both on a population and on an individual level for patients and caregivers. Most measures’ reliability is sufficient. However, the included tests’ discriminative ability is not optimal for clinical use in relevant settings. The low sample sizes of most of the included studies and a limited amount of studies in all but the community-dwelling setting hinder us from making strong recommendations.Keywords: aged, falls, criterion validity, post-test probability, clinical application
format	article
author	Gafner SC Allet L Hilfiker R Bastiaenen CHG
author_facet	Gafner SC Allet L Hilfiker R Bastiaenen CHG
author_sort	Gafner SC
title	Reliability and Diagnostic Accuracy of Commonly Used Performance Tests Relative to Fall History in Older Persons: A Systematic Review
title_short	Reliability and Diagnostic Accuracy of Commonly Used Performance Tests Relative to Fall History in Older Persons: A Systematic Review
title_full	Reliability and Diagnostic Accuracy of Commonly Used Performance Tests Relative to Fall History in Older Persons: A Systematic Review
title_fullStr	Reliability and Diagnostic Accuracy of Commonly Used Performance Tests Relative to Fall History in Older Persons: A Systematic Review
title_full_unstemmed	Reliability and Diagnostic Accuracy of Commonly Used Performance Tests Relative to Fall History in Older Persons: A Systematic Review
title_sort	reliability and diagnostic accuracy of commonly used performance tests relative to fall history in older persons: a systematic review
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/4ff95a4de66543e1a12fac985696b866
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Reliability and Diagnostic Accuracy of Commonly Used Performance Tests Relative to Fall History in Older Persons: A Systematic Review

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