Survey on Fall Detection and Fall Prevention Using Wearable and External Sensors <s> STRATIFY <s> The Barthel Index is a valid measure of disability. In this study we investigated the reliability of four different methods of obtaining the score in 25 patients: self-report, asking a trained nurse who had worked with the patient for at least one shift, and separate testing by two skilled observers within 72 hours of admission. Analysis of total (summed) scores revealed a close correlation between all four methods: a difference of 4/20 points was likely to reflect a genuine difference. In individual items, most disagreement was minor and involved the definition of middle grades. Asking an informed nurse or relative was as reliable as testing, and is quicker. <s> BIB001 </s> Survey on Fall Detection and Fall Prevention Using Wearable and External Sensors <s> STRATIFY <s> OBJECTIVES ::: To identify clinical characteristics of elderly inpatients that predict their chance of falling (phase 1) and to use these characteristics to derive a risk assessment tool and to evaluate its power in predicting falls (phases 2 and 3). ::: ::: ::: DESIGN ::: Phase 1: a prospective case-control study. Phases 2 and 3: prospective evaluations of the derived risk assessment tool in predicting falls in two cohorts. ::: ::: ::: SETTING ::: Elderly care units of St Thomas's Hospital (phase 1 and 2) and Kent and Canterbury Hospital (phase 3). ::: ::: ::: SUBJECTS ::: Elderly hospital inpatients (aged > or = 65 years): 116 cases and 116 controls in phase 1,217 patients in phase 2, and 331 in phase 3. ::: ::: ::: MAIN OUTCOME MEASURES ::: 21 separate clinical characteristics were assessed in phase 1, including the abbreviated mental test score, modified Barthel index, a transfer and mobility score obtained by combining the transfer and mobility sections of the Barthel index, and several nursing judgements. ::: ::: ::: RESULTS ::: In phase 1 five factors were independently associated with a higher risk of falls: fall as a presenting complaint (odds ratio 4.64 (95% confidence interval 2.59 to 8.33); a transfer and mobility score of 3 or 4 (2.10 (1.22 to 3.61)); and primary nurses' judgment that a patient was agitated (20.9 (9.62 to 45.62)), needed frequent toileting (2.48 (1.08 to 5.70)), and was visually impaired (3.56 (1.26 to 10.05)). A risk assessment score (range 0-5) was derived by scoring one point for each of these five factors. In phases 2 and 3 a risk assessment score > 2 was used to define high risk: the sensitivity and specificity of the score to predict falls during the following week was 93% and 88% respectively in phase 2 and 92% and 68% respectively in phase 3. ::: ::: ::: CONCLUSION ::: This simple risk assessment tool predicted with clinically useful sensitivity and specificity a high percentage of falls among elderly hospital inpatients. <s> BIB002
St Thomass' risk assessment tool in falling elderly inpatients (STRATIFY) is a risk assessment tool developed to predict elderly patient falls in hospitals BIB002 . It uses a 0-5 (low risk-high risk) score system to rank patients' likelihood of experiencing a fall. Patients of elderly units from St Thomas, Kent and Canterbury Hospital in the UK were monitored in order to identify the risk factors of a fall. After a fall occurs a series of falling characteristics (risk factors) are recorded in a log and used to compute the probability of a future fall. Five factors were found to have a direct impact in falls and were used to build the risk assessment tool. These factors were agitation, patient was admitted with a fall or patient fell inside the ward, visual impairment, need of toileting, and a transfer and mobility score (0-6) based on the transfer and mobility section of the barthel index BIB001 . The recall and specificity of the score for fall prediction were 92% and 68% respectively.