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Failure of falls risk screening tools to predict outcome: a prospective cohort study
  1. Kristie J Harper1,
  2. Annette D Barton1,
  3. Glenn Arendts2,
  4. Deborah G Edwards1,
  5. Antonio C Petta3,
  6. Antonio Celenza4
  1. 1 Occupational Therapy Department, Sir Charles Gairdner Hospital, Perth, Australia
  2. 2 Department of Emergency Medicine, University of Western Australia, Perth, Australia
  3. 3 Area Rehabilitation and Aged Care Department, Sir Charles Gairdner Hospital, Perth, Australia
  4. 4 Department of Emergency Medicine, University of Western Australia, Perth, Australia
  1. Correspondence to Kristie J Harper, Hospital Avenue, Occupational Therapy Department, G Block Lower Ground Floor, Nedlands 6009; kristie.harper{at}


Objective To compare the Falls Risk for Older Persons—Community Setting Screening Tool (FROP Com Screen) with the Two-Item Screening Tool in older adults presenting to the ED.

Methods A prospective cohort study, comparing the efficacy of the two falls risk assessment tools by applying them simultaneously in a sample of hospital ED presentations.

Results Two hundred and one patients over 65 years old were recruited. Thirty-six per cent reported falls in the 6-month follow-up period. The area under the receiver operating characteristic curve was 0.57 (95% CI 0.48 to 0.66) for the FROP Com Screen and 0.54 (95% CI 0.45 to 0.63) for the Two-Item Screening Tool. FROP Com Screen had a sensitivity of 39% (95% CI 0.27 to 0.51) and a specificity of 70% (95% CI 0.61 to 0.78), while the Two-Item Screening Tool had a sensitivity of 48% (95% CI 0.36 to 0.60) and a specificity of 57% (95% CI 0.47 to 0.66).

Conclusion Both tools have limited predictive ability in the ED setting.

  • accidental falls
  • emergency department
  • frailty
  • geriatrics

Statistics from


  • Contributors KJH, ADB, ACP, DGE and AC were involved in the inception and original planning of the study. KJH and DGE completed the data collection. KJH completed the data analysis with the support of ACP and GA. KJH drafted the manuscript. All authors contributed to writing and revision of the manuscript.

  • Funding Sir Charles Gairdner Hospital Research Advisory Committee.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Sir Charles Gairdner Hospital Human Research Ethics Committee (HREC 2013-074).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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