Vind 2009.
| Study characteristics | ||
| Methods | RCT | |
| Participants | Setting: Glostrup, Denmark N = 392 Sample: contacted by post after ED treatment or hospital discharge (74% women) Age (years): mean 74 (SD 6) Inclusion criteria: aged ≥ 65; treated in ED or admitted to hospital because of a fall Exclusion criteria: fall caused by external force or alcohol intoxication; not living locally; institutionalised; unable to walk; terminally ill; impaired communication; described as suffering from dementia in hospital notes or by staff; having a planned geriatric intervention | |
| Interventions | 1. Intervention: comprehensive multifactorial intervention. Assessed by doctor (1 h), and nurse and PT (1.5 h), during 2 visits to geriatric outpatient clinic. Team discussion with senior geriatrician, interventions planned and offered to participants. Carried out in clinic or referred to specialists. Included progressive, individualised exercise, drug modification, treatment of untreated disease, advice or referral to ophthalmologist, etc. (see Table 1 in Vind 2009 for details) 2. Control: usual care as planned in ED or during admission |
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| Outcomes | 1. Rate of falls 2. Number of people falling 3. Number of fractures (not number of people with fractures therefore no usable data) |
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| Duration of the study | 1 year | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | Quote: "Participants were randomized by simple method, 1:1, using a computer‐generated random list and sealed envelopes; a secretary not involved in the intervention performed randomization." |
| Allocation concealment (selection bias) | Low risk | Quote: "… using a computer‐generated random list and sealed envelopes; a secretary not involved in the intervention performed randomization." |
| Blinding of participants and personnel (performance bias) All outcomes | Unclear risk | Participants and/or intervention delivery personnel were not blind to group allocation. There is insufficient information to judge whether participants were blinded, or whether the outcomes were likely to be affected by lack of blinding. |
| Blinding of outcome assessment (detection bias) Falls and fallers | Low risk | Quote: "Research assistants who were not aware of group allocation followed all participants for 12 months. All participants kept a falls diary and were instructed to record falls daily ... Participants were telephoned monthly for collection of falls data." |
| Blinding of outcome assessment (detection bias) Fractures | Low risk | Self reported fractures confirmed from hospital records |
| Incomplete outcome data (attrition bias) Falls | Unclear risk | SeeAppendix 3 for method of assessment |
| Incomplete outcome data (attrition bias) Fallers | Low risk | SeeAppendix 3 for method of assessment |
| Risk of bias in recall of falls | Low risk | Quote: "All participants kept a falls diary and were instructed to record falls daily and whether falls had caused injury resulting in contact with a general practitioner or emergency department or admission to the hospital. Participants were telephoned monthly for collection of falls data." |