title: Diagnosis of fall risk in Parkinson disease: an analysis of individual and collective clinical balance test interpretation.
abstract: OBJECTIVE
  Parkinson disease (PD) results in an increased frequency of falls relative to the frequency in neurologically healthy people. The purpose of this study was to compare the accuracy of PD fall risk diagnosis based on one test with that based on the collective interpretation of multiple tests.
  
  
  METHODS
  Seventy people with PD (mean age=73.91 years) participated in this study.
  
  
  METHODS
  Clinical balance tests were conducted during the initial examinations of people with PD. Validity indices were calculated for individual tests and compared with validity indices calculated for a combination of multiple tests.
  
  
  RESULTS
  Thirty-six participants reported a fall history. Analysis of individual tests revealed broad variations in validity indices, whereas the collective interpretation of multiple tests improved sensitivity and negative likelihood ratios.
  
  
  CONCLUSIONS
  Collective interpretation of clinical balance tests resulted in fewer false-negative results and more substantial adjustments to the posttest probability of being a "faller" than the interpretation of one test alone. These results should be confirmed in a prospective examination of fall risk in PD.
authors.affiliation: Department of Physical Therapy, University of Utah, 520 Wakara Way, Salt Lake City, UT 84108, USA. lee.dibble@hsc.utah.edu
authors.forename: Leland E
authors.initials: LE
authors.lastname: Dibble
authors.forename: Jesse
authors.initials: J
authors.lastname: Christensen
authors.forename: D James
authors.initials: DJ
authors.lastname: Ballard
authors.forename: K Bo
authors.initials: KB
authors.lastname: Foreman
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000465:Algorithms; D003657:Decision Making; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D010300:Parkinson Disease / Q000503:physiopathology*; D004856:Postural Balance / Q000502:physiology*; D018570:Risk Assessment; D012680:Sensitivity and Specificity