title: Validation of the STRATIFY falls risk-assessment tool for acute-care hospital patients and nursing home residents: study protocol.
abstract: OBJECTIVE
  To evaluate the accuracy of the STRATIFY tool in detecting and predicting fall risk in acute-care hospitals and nursing homes for the older people.
  
  
  BACKGROUND
  Falls are the predominant cause of injury in people aged over 65 years. Testing the falls risk-assessment tools in settings other than those for which they were originally developed obtained conflicting results and has highlighted difficulties in their adoption for widespread use. Current guidelines for practice call into question the appropriateness of using these instruments.
  
  
  METHODS
  Two-stage study: a cross-cultural adaptation and psychometric validation; and a longitudinal, prospective follow-up of the cohort of patients recruited.
  
  
  METHODS
  A cross-cultural adaptation of STRATIFY, followed by its empirical validation will be performed, on a total sample of 2097 patients. The diagnostic validity will be assessed by calculating the sensitivity, specificity, positive and negative predictive values and the ratios of positive and negative probability. Data for statistical reliability and the internal consistency of the instrument will be calculated; construct validity will be assessed by factor analysis and criterion validity determined according to the Downton index. The incidence and the hazard ratio of falls will be analysed for the study factors included. Funding of the review was confirmed in December 2013.
  
  
  CONCLUSIONS
  The rigorous assessment of STRATIFY using large samples, in populations with different levels of risk and implementing a longitudinal follow-up to determine the effect of revaluation on the incidence of falls, will give stronger evidence for the establishment of future recommendations in Clinical Practice Guidelines.
authors.affiliation: Department of Nursing, Agencia Sanitaria Costa del Sol, Marbella, Malaga, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Aranda-Gallardo
authors.affiliation: Department of Nursing, Agencia Sanitaria Costa del Sol, Marbella, Malaga, Spain.
authors.forename: Margarita
authors.initials: M
authors.lastname: Enriquez de Luna-Rodriguez
authors.affiliation: Department of Nursing, Agencia Sanitaria Costa del Sol, Marbella, Malaga, Spain.
authors.forename: Jose Carlos
authors.initials: JC
authors.lastname: Canca-Sanchez
authors.affiliation: Department of Nursing, Agencia Sanitaria Costa del Sol, Marbella, Malaga, Spain.
authors.forename: Ana Belen
authors.initials: AB
authors.lastname: Moya-Suarez
authors.affiliation: Faculty of Health Sciences, University of Malaga, Spain.
authors.forename: Jose Miguel
authors.identifier: http://orcid.org/0000-0001-7911-7487
authors.initials: JM
authors.lastname: Morales-Asencio
mesh_terms: D000058:Accidental Falls; D006761:Hospitals; D006801:Humans; D007297:Inpatients; D009735:Nursing Homes; D018570:Risk Assessment
keywords: STRATIFY; adverse events; clinical safety; falls; inpatient; institutionalized patient; nursing; reliability; risk assessment; validity