Jahantabi-Nejad Seifollah, Azad Akram
Musculoskeletal Rehabilitation Research Center, Ahvaz University of Medical Sciences, Ahvaz, Iran, & University of Medical Sciences, Tehran, Iran.
Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
Med J Islam Repub Iran. 2019 May 1;33:38. doi: 10.34171/mjiri.33.38. eCollection 2019.
Performance Oriented Mobility Assessment (POMA) is a commonly used screening tool for identifying patients at risk of falling. The purpose of this systematic review was to determine the overall predictive accuracy of POMA for falls in community-dwelling older adults. This review could provide useful information to use POMA in both research and clinical settings. In this study, PubMed, EMBASE, CINHAL, Cochrane Library, EBSCO, and SCOPUS were searched to identify studies published from 1987 to 2017 that aimed at validating POMA and reporting predictive value with sufficient data to calculate sensitivity and specificity. The methodological quality of the selected studies was assessed using the Quality Assessment of Diagnostic Accuracy studies (QUADAS-2). Of the 121 identified studies, 12 met the inclusion criteria and were entered in the final analysis. Fall rate ranged from 5% to 61% in the included studies. The POMA cutoff point for discriminating fallers from non-fallers varied from 15 to 26. Sensitivity and specificity of the POMA ranged from 24-91 to 37-97, respectively. Due to heterogeneity of the type of studies, participants, the definition of fall, and use of different versions of POMA, it was not possible to determine a specific cutoff point for POMA. In addition, using the same version and scoring method of POMA and controlling the significant potential confounders (eg, age, gender, and comorbidities) would provide better information about the predictive accuracy of POMA for falls in older adults.
以性能为导向的移动性评估（POMA）是一种常用的筛查工具，用于识别有跌倒风险的患者。本系统评价的目的是确定POMA对社区居住老年人跌倒的总体预测准确性。该评价可为在研究和临床环境中使用POMA提供有用信息。在本研究中，检索了PubMed、EMBASE、CINHAL、Cochrane图书馆、EBSCO和SCOPUS，以识别1987年至2017年发表的旨在验证POMA并报告具有足够数据以计算敏感性和特异性的预测价值的研究。使用诊断准确性研究质量评估（QUADAS-2）对所选研究的方法学质量进行评估。在121项已识别的研究中，12项符合纳入标准并进入最终分析。纳入研究中的跌倒发生率在5%至61%之间。区分跌倒者和非跌倒者的POMA临界点在15至26之间。POMA的敏感性和特异性分别在24-91至37-97之间。由于研究类型、参与者、跌倒定义以及不同版本POMA的使用存在异质性，因此无法确定POMA的具体临界点。此外，使用相同版本和评分方法的POMA并控制显著的潜在混杂因素（如年龄、性别和合并症）将为POMA对老年人跌倒的预测准确性提供更好的信息。
