Ryan-Wenger Nancy A, Kimchi-Woods Judy, Erbaugh Melanie A, LaFollette Lauren, Lathrop Janet
Nationwide Children's Hospital, Columbus, OH, USA.
Pediatr Nurs. 2012 May-Jun;38(3):159-67.
The 10-item Pediatric Fall Risk Assessment (PFRA) was developed to evaluate patients at low- or high-risk for falling. To avoid the unnecessary use of resources for children not likely to fall, children evaluated as high-risk are targeted for more intensive fall prevention interventions. In a retrospective, case-control design, the precision, accuracy, and error rate of the PFRA with patients ages 1 month to 24 years were evaluated. Cases included children who fell (n = 326), and controls (n = 326) were children from the same cohort who did not fall. Inter-rater agreement (precision) on PFRA cut-off scores was 95.1%, but accuracy was unacceptably low due to 60% false-positive and 58.5% false-negative risk ratings. Neither the PFRA nor three other widely used pediatric fall risk scales have sufficient precision or accuracy to justify implementing or withholding a high-risk fall prevention protocol. Several logistic and methodological challenges must be addressed before further development of these tools.
10项儿科跌倒风险评估（PFRA）旨在评估患者跌倒的低风险或高风险。为避免将资源不必要地用于不太可能跌倒的儿童，被评估为高风险的儿童将成为更强化跌倒预防干预措施的目标对象。在一项回顾性病例对照设计中，对年龄在1个月至24岁的患者使用PFRA的精确性、准确性和错误率进行了评估。病例包括跌倒的儿童（n = 326），对照（n = 326）为来自同一队列未跌倒的儿童。评估者间关于PFRA临界值分数的一致性（精确性）为95.1%，但由于60%的假阳性和58.5%的假阴性风险评级，准确性低得令人无法接受。PFRA以及其他三种广泛使用的儿科跌倒风险量表都没有足够的精确性或准确性来证明实施或不实施高风险跌倒预防方案的合理性。在进一步开发这些工具之前，必须解决一些逻辑和方法上的挑战。
