title: National Survey of Geriatricians to Define Functional Decline in Elderly People with Minor Trauma.
abstract: BACKGROUND
  This study was designed to determine a clinically significant point drop in function to define functional decline and the required sensitivity for a clinical decision tool to identify elderly patients at high risk of functional decline following a minor injury.
  
  
  METHODS
  After a rigorous development process, a survey questionnaire was administered to a random sample of 178 geriatricians selected from those registered in a national medical directory. The surveys were distributed using a modified Dillman technique.
  
  
  RESULTS
  We obtained a satisfactory response rate of 70.5%. Ninety percent of the geriatricians required a sensitivity of 90% or less for a clinical decision tool to identify injured seniors at high risk of functional decline 6 months post injury. Our results indicate that 90% of the respondents considered a drop in function of at least 2 points in activities of daily living (ADL) as clinically significant when considering all 14 ADL items. Considering only the 7 basic ADL items, 90% of physicians considered a 1 point drop as clinically significant.
  
  
  CONCLUSIONS
  A tool with a sensitivity of 90% to detect patients at risk of functional decline at 6 months post minor injury would meet or exceed the sensitivity required by 90% of geriatric specialists. These findings clearly define what is a clinically significant decline following a "minor injury."
authors.affiliation: Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, ON;; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON;
authors.forename: Kasim
authors.initials: K
authors.lastname: Abdulaziz
authors.affiliation: Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, ON;; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON;; Department of Emergency Medicine, University of Ottawa, Ottawa, ON;
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Perry
authors.affiliation: Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, ON;; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON;
authors.forename: Monica
authors.initials: M
authors.lastname: Taljaard
authors.affiliation: Department of Family and Emergency Medicine, Université Laval, Laval, QC;; Unité de recherche en traumatologie-urgence-soins intensifs du Centre de recherche FRQ-S du CHA de Québec, Laval, QC;
authors.forename: Marcel
authors.initials: M
authors.lastname: Émond
authors.affiliation: Department of Emergency Medicine, University of Toronto, Clinical Epidemiology Unit, Sunnybrook Health Sciences Center, Toronto.
authors.forename: Jacques S
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, University of Ottawa, Ottawa, ON;
authors.forename: Laura
authors.initials: L
authors.lastname: Wilding
authors.affiliation: Département de réadaptation, Université Laval, Laval, QC;; Unité de recherche en traumatologie-urgence-soins intensifs du Centre de recherche FRQ-S du CHA de Québec, Laval, QC;
authors.forename: Marie-Josée
authors.initials: MJ
authors.lastname: Sirois
authors.affiliation: Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, ON;; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON;
authors.forename: Jamie
authors.initials: J
authors.lastname: Brehaut
keywords: Older Americans Resources and Services (OARS); activities of daily living (ADL); clinical decision rules; functional decline; geriatric assessment