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. 2012 Sep 12;2012(9):CD007146. doi: 10.1002/14651858.CD007146.pub3

De Vries 2010.

Study characteristics
Methods RCT
Participants Setting: Amsterdam, the Netherlands
N = 217
Sample: people consulting ED or family physician after a fall (71% women)
Age (years): mean 79.8 (SD 7.35)
Inclusion criteria: aged ≥ 65 years; living independently or in assisted living facility; living near University Medical Center; history of fall in previous 3 months
Exclusion criteria: unable sign informed consent or provide a fall history; cognitive impairment (MMSE < 24); fall due to traffic or occupational accident; living in nursing home; acute pathology requiring long‐term rehabilitation, e.g. stroke
Interventions 1. Multidisciplinary assessment in geriatric outpatient clinic and individually tailored treatment in collaboration with patient's GP e.g. withdrawal of psychotropic drugs, balance and strength exercises, home hazard reduction, referral to specialists
2. Control: usual care
Outcomes 1. Number of people falling
2. Number sustaining a fracture
Other outcomes reported but not included in this review
Duration of the study 1 year
Notes Cost‐effectiveness analysis and cost utility analysis reported in Peeters 2011
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Quote: "computer‐generated random sequence"
Allocation concealment (selection bias) Low risk Quote: "…opaque envelopes are numbered and filled with group names. When a participant is designated to the high‐risk group, the interviewer, who is unaware of the content, opens the envelope with the lowest number." (from protocol paper)
Blinding of participants and personnel (performance bias)
All outcomes Unclear risk Quote: "Participants, intervention caregivers, and interviewers could not be blinded to group assignment." but impact of non‐blinding unclear.
Blinding of outcome assessment (detection bias)
Falls and fallers High risk Not completely clear but study personnel stated to be non‐blinded, and falls self reported
Blinding of outcome assessment (detection bias)
Fractures High risk Quote: "By their response to a questionnaire sent 11⁄2 years after the first home visit, participants were asked to indicate whether they had sustained a fracture since the first home visit." Study personnel non‐blinded, and no confirmation of fractures from medical records.
Incomplete outcome data (attrition bias)
Fallers Low risk SeeAppendix 3 for method of assessment
Risk of bias in recall of falls Low risk Quote: "For 1 year, the participants recorded each week whether they had fallen."
"Once per 3 months the participants return a calendar sheet by mail. When no sheet is received, or when the sheet is completed incorrectly, we inquire by telephone whether, and if yes, when the participant has fallen in the past 3 months."