Baylor Health Care System, Dallas, USA.
J Nurs Adm. 2010 Nov;40(11):483-8. doi: 10.1097/NNA.0b013e3181f88fbd.
The aim of the study was to identify which fall-risk tool is most accurate for assessing adults in the hospital setting.
Falls can have physical, emotional, social, and financial consequences. Risk assessment affords the first opportunity in prevention.
To standardize the use of a fall-risk tool across the Baylor Health Care System, nurse executives undertook a meta-analysis of published research on fall-risk assessment tools used with adult inpatients.
Both random-effects and fixed-effects models showed that Morse Fall Scale had significantly higher sensitivity than St Thomas's Risk Assessment Tool (STRATIFY). Specificity of Morse Fall Scale was significantly lower than that of STRATIFY with the fixed-effects model, but the random-effects model showed the opposite. Morse Fall Scale had a significantly higher Youden index than STRATIFY with the fixed-effects model (P = .001), but the result from random-effects model indicated no significant difference (P = .117). The sensitivity, specificity, and Youden index fell within the 95% confidence intervals.
Meta-analysis is a useful methodology for evaluating current evidence when variation exists in the literature.
本研究旨在确定哪种跌倒风险评估工具最适合评估医院环境中的成年人。
跌倒可能会对个人造成身体、情绪、社交和经济方面的后果。风险评估是预防跌倒的首要机会。
为了在贝勒医疗保健系统内标准化使用跌倒风险评估工具，护理管理人员对用于成年住院患者的跌倒风险评估工具的已发表研究进行了荟萃分析。
随机效应和固定效应模型均显示 Morse 跌倒量表的敏感性显著高于 St Thomas 风险评估工具（STRATIFY）。Morse 跌倒量表的特异性在固定效应模型下显著低于 STRATIFY，但随机效应模型显示相反的结果。Morse 跌倒量表的 Youden 指数在固定效应模型下显著高于 STRATIFY（P =.001），但随机效应模型的结果表明没有显著差异（P =.117）。敏感性、特异性和 Youden 指数均在 95%置信区间内。
荟萃分析是一种有用的方法学，可用于评估文献中存在差异时的现有证据。
