Open Access Research article

Definitions and methods of measuring and reporting on injurious falls in randomised controlled fall prevention trials: a systematic review

Michael Schwenk1*, Andreas Lauenroth2, Christian Stock23, Raquel Rodriguez Moreno1, Peter Oster1, Gretl McHugh4, Chris Todd4 and Klaus Hauer1

Author Affiliations

1 Department of Geriatric Research, AGAPLESION Bethanien-Hospital/Geriatric Center at the University of Heidelberg, Rohrbacherstr.149, Heidelberg 69126, Germany

2 Network Aging Research, University of Heidelberg, Heidelberg, Germany

3 Division of Clinical Epidemiology and Aging Research, German Cancer Research Center Heidelberg, Heidelberg, Germany

4 School of Nursing, Midwifery and Social Work and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK

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BMC Medical Research Methodology 2012, 12:50  doi:10.1186/1471-2288-12-50

Published: 17 April 2012

Abstract

Background

The standardisation of the assessment methodology and case definition represents a major precondition for the comparison of study results and the conduction of meta-analyses. International guidelines provide recommendations for the standardisation of falls methodology; however, injurious falls have not been targeted. The aim of the present article was to review systematically the range of case definitions and methods used to measure and report on injurious falls in randomised controlled trials (RCTs) on fall prevention.

Methods

An electronic literature search of selected comprehensive databases was performed to identify injurious falls definitions in published trials. Inclusion criteria were: RCTs on falls prevention published in English, study population ≥ 65 years, definition of injurious falls as a study endpoint by using the terms "injuries" and "falls".

Results

The search yielded 2089 articles, 2048 were excluded according to defined inclusion criteria. Forty-one articles were included. The systematic analysis of the methodology applied in RCTs disclosed substantial variations in the definition and methods used to measure and document injurious falls. The limited standardisation hampered comparability of study results. Our results also highlight that studies which used a similar, standardised definition of injurious falls showed comparable outcomes.

Conclusions

No standard for defining, measuring, and documenting injurious falls could be identified among published RCTs. A standardised injurious falls definition enhances the comparability of study results as demonstrated by a subgroup of RCTs used a similar definition. Recommendations for standardising the methodology are given in the present review.

Keywords:
Systematic review; Injurious falls; Elderly; Fall-related outcomes; Fall prevention trials