Validation and comparison of fall screening tools for predicting future falls among older adults.

BACKGROUND: Falls are the leading cause of injuries among older adults in the United States (US). Falls are preventable and clinicians are advised to screen for fall risk yearly. There are many falls screening tools and not all have been validated for their ability to predict future falls. METHODS: We enrolled 1905 community-dwelling older adults into a 13-month study using a probability-based representative panel of the US population recruited from NORC at the University of Chicago's National Frame. Respondents completed a baseline survey, 11 monthly fall calendars, and a final survey. The baseline survey included six falls screening tools (the Stay Independent, Three Key Questions (3KQ), a modified American Geriatric/British Geriatric tool, the short Falls Efficacy-1[FES-I]) and two single screening questions ("I have fallen in the past year" and "How many times did you fall in the past 12 months?"). The baseline and final survey collected demographic and health information, including falls. Sensitivity, specificity, positive and negative likelihood ratios, and corresponding 95% confidence intervals were calculated in SAS using weighted proportions. RESULTS: There were 1563 respondents who completed the final survey (completion rate 82%). Sensitivity estimates ranged from 22.5% for the short FES-I to 68.7% for the 3KQ. Specificity estimates ranged from 57.9% for the 3KQ to 89.4% for the short FES-I. CONCLUSIONS: Falls screening tools have varying sensitivity and specificity for predicting the occurrence of a fall in the following 12 months.

It's About Time: Examining the Effect of Interviewer-Quoted Survey Completion Time Estimates on Survey Efficiency.

Declining response rates may introduce bias into survey results and increase costs. Two national surveys, the National Immunization Survey (NIS) and the NIS-Teen, were used to study the impact of survey length, as stated by the interviewer, and inclusion of a topic of interest to respondents on response rates. The two studies included comparisons of the standard survey instruments to revised, condensed instruments. The NIS study also included variations of the standard survey with sections considered of interest for parental respondents, the Parental Concerns Module (PCM), which contained questions about parents' thoughts and beliefs about vaccinations. The outcomes of interest were differences in the response rates and resulting survey costs in each of the study conditions. The shortened instruments resulted in higher response rates compared to both the standard instruments and the instruments including the PCM and reduced the overall time needed to complete an interview. Based on these results, the NIS and NIS-Teen questionnaires were both shortened.

Statistical Methodology of the National Immunization Survey, 2005-2014.

The National Immunization Survey (NIS) family of surveys includes NIS-Child, which monitors vaccination coverage for the U.S. population of children aged 19-35 months; NIS- Teen, which monitors vaccination coverage for the U.S. population of adolescents aged 13-17; and NIS-Flu, which monitors influenza vaccination coverage for the U.S. population of children aged 6 months through 17 years. This report describes the methods used in this family of surveys during the 2005-2014 period.