The Yield, Reliability, and Validity of a Postal Survey for Screening Community‐Dwelling Older People

Alessi, Cathy A.; Josephson, Karen R.; Harker, Judith O.; Pietruszka, Fern M.; Hoyl, M. Trinidad; Rubenstein, Laurence Z.

doi:10.1046/j.1532-5415.2003.51058.x

Cited by 26 publications

(21 citation statements)

References 33 publications

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“…Respondents may therefore be drawn from a limited range of the healthier young-old, capable of self-completing a questionnaire and returning it in the post. Persuasive methods may be required to increase response rates and reduce response bias [117]. However, response bias is infrequently reported.…”

Section: Discussionmentioning

confidence: 97%

Quality of life in older people: A structured review of generic self-assessed health instruments

2005

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There is good evidence for reliability, validity and responsiveness for the SF-36, EQ-5D and NHP. There is more limited evidence for the COOP, SF-12 and SIP. The SF-36 is recommended where a detailed and broad ranging assessment of health is required, particularly in community dwelling older people with limited morbidity. The EQ-5D is recommended where a more succinct assessment is required, particularly where a substantial change in health is expected. Instrument content should be assessed for relevance before application. The concurrent evaluation of generic instruments in older people is recommended.

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Section: Discussionmentioning

confidence: 97%

Quality of life in older people: A structured review of generic self-assessed health instruments

2005

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“…The use of mailed questionnaires has been demonstrated to be reliable and valid in screening communitydwelling older adults. 16 The modifiable risk factors enumerated on the questionnaire were as follows: greater than 4 prescription medications; lower-extremity muscle weakness; and balance, foot, and vision problems. The people who reported…”

Section: Methodsmentioning

confidence: 99%

Use of the Berg Balance Scale for Predicting Multiple Falls in Community-Dwelling Elderly People: A Prospective Study

et al. 2008

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Background and Purpose Falls are a significant public health concern for older adults; early identification of people at high risk for falling facilitates the provision of rehabilitation treatment to reduce future fall risk. The objective of this prospective cohort study was to examine the predictive validity of the Berg Balance Scale (BBS) for 3 types of outcomes—any fall (≥1 fall), multiple falls (≥2 falls), and injurious falls—by use of sensitivity, specificity, receiver operating characteristic (ROC) curves, area under the curve, and likelihood ratios. Subjects and Methods A sample of 210 community-dwelling older adults received a comprehensive geriatric assessment at baseline, which included the BBS to measure balance. Data on prospective falls were collected monthly for a year. The predictive validity of the BBS for the identification of future fall risk was evaluated. Results The BBS had good discriminative ability to predict multiple falls when ROC analysis was used. However, the use of the BBS as a dichotomous scale, with a threshold of ≤45, was inadequate for the identification of the majority of people at risk for falling in the future, with sensitivities of 25% and 45% for any fall and for multiple falls, respectively. The use of likelihood ratios, maintaining the BBS as a multilevel scale, demonstrated a gradient of risk across scores, with fall risk increasing as scores decreased. Discussion and Conclusion The use of the BBS as a dichotomous scale to identify people at high risk for falling should be discouraged because it fails to identify the majority of such people. The predictive validity of this scale for multiple falls is superior to that for other types of falls, and the use of likelihood ratios preserves the gradient of risk across the whole range of scores.

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“…In those without a diagnosis of dementia, they are questioned regarding subjective complaints related to rremory. This question has been shown to have a reasonable sensitivity and specificity in screening (24). It is important to emphasize here that, as in the other questions of the screening instrument, the patient's reply is confirmed by a family member or caregiver.…”

Section: Basic Activities Of Daily Living (Badl)mentioning

confidence: 96%

“…Falls over the previous 12 months. We included a query regarding falls, this being a frequent condition affecting older people (27), as well as a useful symptom for selecting patients in need of geriatric assessment (16,24). A period of the previous 12 months was chosen as a reasonable period of time for patient recall (28).…”

Section: Basic Activities Of Daily Living (Badl)mentioning

confidence: 99%

“…A number of studies have described the results of geriatric screening initiatives (16,(22)(23)(24). For example, preventive primary care outreach (PPCO) interventions aimed at older people were recently sho\vn in a metaanalysis of randomized controlled trials to be associated with a 17% reduction of mortality and a 23% increased likelihood for continuing to reside in the community (18).…”

Section: Introductionmentioning

confidence: 99%

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A semi-structured computerized screening interview for the assessment of older patients in the primary care setting

Press¹,

Hazzan²,

Clarfield³

et al. 2009

International Journal on Disability and Human Development

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Preventive primary care outreach (PPCO) interventions aimed at older people are associated with a reduction of mortality and an increased likelihood for continuing to reside in the community. We describe a comprehensive computerized PPCO program and present initial evaluation of the program. We performed an observational cohort study based in community primary care clinics in the southern district of Israel. Patients older than 75 years, or those more than 65 years of age who had undergone two or more acute admissions in the previous year, were screened by means of an interactive computerized questionnaire that consisted of functional, medical, cognitive/affective, medications, social, and preventive domains. The patient response determined whether the appropriate intervention would be implemented by the primary care team (orange pathway) or required geriatric consultation (red pathway). The initial evaluation of the project included 396 patients with an average age of 78.4 years (SD 6.1) of whom 32.8% were men. A total of 253 (64%) patients were determined to be in the "red" pathway and 143 (36%) in the "orange" pathway. Health care use for those in the "red" pathway was significantly higher than for those in the "orange", with screening questions correctly placing patients in the "red" pathway. To the best of our knowledge, this is the first description of an interactive computerized PPCO designed to screen elderly patients systematically in the community. An ongoing national evaluation of this study will determine whether this approach will allow more efficient utilization of health services.

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The Yield, Reliability, and Validity of a Postal Survey for Screening Community‐Dwelling Older People

Cited by 26 publications

References 33 publications

Quality of life in older people: A structured review of generic self-assessed health instruments

Quality of life in older people: A structured review of generic self-assessed health instruments

Use of the Berg Balance Scale for Predicting Multiple Falls in Community-Dwelling Elderly People: A Prospective Study

A semi-structured computerized screening interview for the assessment of older patients in the primary care setting

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