Mackenzie Lynette, Byles Julie, D'Este Catherine
Discipline of Occupational Therapy, School of Health Sciences, Faculty of Health, The University of Newcastle, NSW 2308, Australia.
Clin Rehabil. 2006 Apr;20(4):331-9. doi: 10.1191/0269215506cr947oa.
To determine if self-reported data recalling at least one fall over a six-month recall period could be used as a reliable measure of falls by comparing retrospective self-report with a 'gold standard' method of reporting these events using a prospective calendar-reported method.
Prospective study.
Community-dwelling older people living in New South Wales (NSW) and Queensland in Australia.
A stratified sample of 264 randomly selected participants from a concurrent randomized controlled trial (RCT) of preventive health assessment for people over the age of 70 years.
Intervention and control group participants in the RCT kept a calendar of fall events for a six-month validation substudy. At the end of six months, participants were asked to retrospectively report their falls over the six-month period.
Results indicated that percentage agreement between retrospective self-report and the calendar report of falls was 84%, however, sensitivity was 56% (95% confidence interval (CI) 44.1-67.5). Ten participants (4%) gave false positive self-reports of falls, and 33 (13%) participants gave false negative self-reports of falls. Therefore, retrospective self-reported fall rates were likely to involve under-reporting of falls. Significant differences were found in the sensitivity of retrospectively self-reported falls reported by the intervention group participants (sensitivity = 71%; 95% CI 56.6-85.5) compared with the control group (sensitivity = 40.5%; 95% CI 24.7-56.4, P = 0.008). Validity of self-reported injuries as a result of a fall was less accurate (71% agreement; sensitivity 24% (95% CI 16.0-33.6).
As recall of falls was more accurate in the intervention group than in the control group, it could appear that the intervention had the effect of increasing falls compared to the control group. Using these results, a method was devised to weight self-reported retrospective data to compensate for the poorer recall demonstrated in the control group, so that a more accurate estimate of falls could be derived from the self-reported data.
通过将回顾性自我报告与使用前瞻性日历报告法报告这些事件的“金标准”方法进行比较，确定在六个月回顾期内回忆起至少一次跌倒的自我报告数据是否可作为跌倒的可靠衡量指标。
前瞻性研究。
居住在澳大利亚新南威尔士州（NSW）和昆士兰州的社区老年人。
从一项针对70岁以上人群的预防性健康评估的同期随机对照试验（RCT）中随机选取的264名参与者组成的分层样本。
RCT中的干预组和对照组参与者为一项为期六个月的验证性子研究记录跌倒事件日历。在六个月结束时，要求参与者回顾性报告他们在六个月期间的跌倒情况。
结果表明，回顾性自我报告与跌倒日历报告之间的百分比一致性为84%，然而，敏感性为56%（95%置信区间（CI）44.1 - 67.5）。10名参与者（4%）给出了跌倒的假阳性自我报告，33名（13%）参与者给出了跌倒的假阴性自我报告。因此，回顾性自我报告的跌倒率可能存在跌倒报告不足的情况。与对照组（敏感性 = 40.5%；95% CI 24.7 - 56.4，P = 0.008）相比，干预组参与者回顾性自我报告跌倒的敏感性存在显著差异（敏感性 = 71%；95% CI 56.6 - 85.5）。因跌倒导致的自我报告损伤的有效性较低（一致性为71%；敏感性为24%（95% CI 16.0 - 33.6））。
由于干预组对跌倒情况的回忆比对照组更准确，与对照组相比，似乎干预有增加跌倒的效果。利用这些结果，设计了一种方法来权衡自我报告的回顾性数据，以补偿对照组中表现较差的回忆情况，从而可以从自我报告数据中得出更准确的跌倒估计值。
