Table 1.

Summary of Study, Patient, Intervention, and Outcome Characteristics for PICO 1 and PICO 2

PICO	1	2
Summary	Population: ≥ 60 years old individuals presenting with a fall for ED care. Intervention: Fall prevention interventions (may include multifactorial risk reduction, medication review, exercise training, models of care (hospital-at-home and others) in ED or peri-ED period). Comparison: Standard of care. Outcome: Quality of ED care metrics, ED operations outcomes (e.g., ED length of stay); patient-centered outcomes (e.g., ED returns for falls, future falls, fear of falling, or functional decline, long-term supports or institutionalization).	Population: ≥ 60 years old individuals from any pre-ED and ED setting (pre-hospital, paramedic, EMS, ED). Intervention: Risk stratification and falls care plan. Comparison: No risk stratification and no falls care plan. Outcome: ED referral (if from pre-ED settings), quality of ED care metrics, ED operations outcomes (e.g., ED length of stay, cost), patient-centered outcomes (e.g., ED returns for falls, future falls, fear of falling, functional decline, long-term supports or institutionalization).
Number of Included Studies n	32	17
Meta-analysis or Systemic Reviews n (%)	3 (13)	4 (24)
Randomized Controlled Trials n (%)	23 (72)	8 (47)
Interventions / Instruments Validated in the ED (n)	9 multifactorial interventions, ranging from: Falls risk assessment and physical rehabilitation sessions, Preventive Education (7), Falls risk assessment, educational guidelines, and follow up with nurse practitioner or physical therapist (15), Medical alert devices (2)	12 Screening Instruments (11 identified): *
		CDC STEADI	Paramedic baseline Assessment
		FROP Com	FRIDs using clinical pathways
		Two-Item Screening Tool	EGS
		FIM/FAM	Bedside functional tests
		Timed Up & Go	Clinical pathways only
		SPPB	Unidentified (2 studies),
		Combined with interventions ranging from:
		Education,	Discharge planning,
		ED-based physical therapy	Preventive education
		Follow up calls	At-home visits.
Total Number of Patients Recruited	571,071	At least 17,232 (Samuel 2017, Beales 2016 did not report sample sizes)
Recruitment Period	1999 - 2019	2011 - 2018
Geographical Locations	11 Countries	9 Countries
Mean Age Range	74.2 – 84.6	74.3 - 83.9
Common Inclusion Criteria (n)	Age 65 and older, Presenting to the ED for a fall or fall related injury, At least one fall in the year prior to the ED visit (5).	Age 65 and older, Admitted to the ED with a falls-related injury, History of falls within the past year (1), Patient eligible for ED discharge.
Patient-centered Primary Outcomes (n)	Proportion of participants experiencing recurrent falls (29), Frequency of falls per subject (11), Time to first fall post ED discharge, Change in anxiety from fear of falling, Quality-adjusted life years (QALYs), Functional ability pre-post fall intervention.	Incidence of recurrent falls (8), Patient participation in fall prevention plans (1), Proportion of positive screens (1), Reduction in falls health care costs (1), Completion of screening (1), Clinical relevance (1), Life-threatening complications (1).
ED-centered Primary Outcomes	Improvement in documenting a fall related history or exam, 9-month incremental cost-effectiveness ratio (ICER).	Feasibility of screening.
Secondary Outcomes	Physical disability, Death.
Follow Up Period Post ED Discharge	1 – 18 months	6 – 12 months
Reference Standard (n)	Usual Care	Usual care FROP com with FIM/FAM (1)
Gold Standard Available	None	None
Risk of Bias in Meta-Analysis / Systematic Review (n)		High (2)

^*CDC STEADI: Center for Disease Control’s Stop Elderly Accidents, Deaths, and Injuries toolkit; FROP Com: Falls Risk for Older People in the Community; FIM/FAM: Modified Functional Independence Measure/Functional Assessment Measure; TUG: Timed Up & Go; SPPB: Short Physical Performance Battery; FRIDs: Fall Risk Increasing Medications; Emergency Geriatric Screening (EGS).