Development and validation of a falls-grading scale.

Mark McIntosh,'s picture
PubMed URL: 
http://www.ncbi.nlm.nih.gov/pubmed/22810170
Author: 
Agrawal Y
Author List: 
Davalos-Bichara M
Lin FR
Carey JP
Walston JD
Fairman JE
Schubert MC
Barron JS
Hughes J
Millar JL
Spar A
Weber KL
Ying HS
Zackowski KM
Zee DS
Agrawal Y
Journal: 
J Geriatr Phys Ther
PubMed ID: 
22810170
Pagination: 
63-7
Volume: 
36
Issue: 
2
Abstract: 
The recording of fall events is usually subjective and imprecise, which limits clinical practice and falls-related research. We sought to develop and validate a scale to grade near-fall and fall events on the basis of their severity represented by the use of health care resources, with the goal of standardizing fall reporting in the clinical and research settings.Qualitative instrument development was based on a literature review and semistructured interviews to assess face and content validity. We queried older individuals and health care professionals with expertise in the care of patients at risk of falling about clinically important differences to detect and how to optimize the scale's ease of use. To assess the scale's interrater reliability, we created 30 video-vignettes of falls and compared how health care professionals and volunteers rated each of the falls according to our grading scale.We developed the illustrated 4-point Hopkins Falls Grading Scale (HFGS). The grades distinguish a near-fall (grade 1) from a fall for which an individual did not receive medical attention (grade 2), a fall associated with medical attention but not hospital admission (grade 3), and a fall associated with hospital admission (grade 4). Overall, the HFGS exhibited good face and content validity and had an intraclass correlation coefficient of 0.998.The 4-point HFGS demonstrates good face and content validity and high interrater reliability. We predict that this tool will facilitate the standardization of falls reporting in both the clinical and research settings.
Published Date: 
March, 2013

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