title: Evaluation of the "medication fall risk score".
abstract: OBJECTIVE
  Results of a study evaluating the predictive validity of a fall screening tool in hospitalized patients are reported.
  
  
  METHODS
  Administrative claims data from two hospitals were analyzed to determine the discriminatory ability of the "medication fall risk score" (RxFS), a medication review fall-risk screening tool that is designed for use in conjunction with nurse-administered tools such as the Morse Fall Scale (MFS). Through analysis of data on administered medications and documented falls in a population of adults who underwent fall-risk screening at hospital admission over a 15-month period (n = 33,058), the predictive value of admission MFS scores, alone or in combination with retrospectively calculated RxFS-based risk scores, was assessed. Receiver operating characteristic (ROC) curve analysis and net reclassification improvement (NRI) analysis were used to evaluate improvements in risk prediction with the addition of RxFS data to the prediction model.
  
  
  RESULTS
  The area under the ROC curve for the predictive model for falls compromising both MFS and RxFS scores was computed as 0.8014, which was greater than the area under the ROC curve associated with use of the MFS alone (0.7823, p = 0.0030). Screening based on MFS scores alone had 81.25% sensitivity and 61.37% specificity. Combined use of RxFS and MFS scores resulted in 82.42% sensitivity and 66.65% specificity (NRI = 0.0587, p = 0.0003).
  
  
  CONCLUSIONS
  Reclassification of fall risk based on coadministration of the MFS and the RxFS tools resulted in a modest improvement in specificity without compromising sensitivity.
authors.affiliation: Department of Pharmacy Services, HonorHealth John C. Lincoln Medical Center, Phoenix, AZ. cyrus.yazdani@honorhealth.com.
authors.forename: Cyrus
authors.initials: C
authors.lastname: Yazdani
authors.affiliation: Department of Pharmacy Services, HonorHealth John C. Lincoln Medical Center, Phoenix, AZ.
authors.forename: Scott
authors.initials: S
authors.lastname: Hall
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000328:Adult; D000368:Aged; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity
keywords: accidental falls; hospitalization; retrospective study; risk assessment; sensitivity; specificity