scholarly journals Development and internal validation of a risk prediction model for falls among older people using primary care electronic health records

2021 ◽  
Author(s):  
Noman Dormosh ◽  
Martijn C Schut ◽  
Martijn W Heymans ◽  
Nathalie van der Velde ◽  
Ameen Abu-Hanna
Keyword(s):  
Primary Care ◽  
High Risk ◽  
Older People ◽  
Prediction Model ◽  
Community Dwelling ◽  
Receiver Operating Curve ◽  
Free Text ◽  
Medical Conditions ◽  
History Of ◽  
Community Dwelling Older People

Abstract Background Currently used prediction tools have limited ability to identify community-dwelling older people at high risk for falls. Prediction models utilizing Electronic Heath Records (EHR) provide opportunities but up to now showed limited clinical value as risk stratification tool; because of among others the underestimation of falls prevalence. The aim of this study was to develop a fall prediction model for community-dwelling older people using a combination of structured data and free text of primary care EHR and to internally validate its predictive performance. Methods EHR data of individuals aged 65 or over. Age, sex, history of falls, medications and medical conditions were included as potential predictors. Falls were ascertained from the free text. We employed the Bootstrap-enhanced penalized logistic regression with the least absolute shrinkage and selection operator to develop the prediction model. We used 10-fold cross-validation to internally validate the prediction strategy. Model performance was assessed in terms of discrimination and calibration. Results Data of 36,470 eligible participants were extracted from the dataset. The number of participants who fell at least once was 4,778 (13.1%). The final prediction model included age, sex, history of falls, two medications and five medical conditions. The model had a median area under the receiver operating curve of 0.705 (IQR 0.700-0.714) . Conclusions Our prediction model to identify older people at high risk for falls achieved fair discrimination, and had reasonable calibration. It can be applied in clinical practice as it relies on routinely collected variables and does not require mobility assessment tests.

Association between a history of falls and the ability to multi-task in community-dwelling older people

2010 ◽  
Vol 22 (5-6) ◽  
pp. 427-432 ◽  
Author(s):  
Hyuma Makizako ◽  
Taketo Furuna ◽  
Hiroyuki Shimada ◽  
Hikaru Ihira ◽  
Mika Kimura ◽  
...  
Keyword(s):  
Older People ◽  
Community Dwelling ◽  
History Of ◽  
Community Dwelling Older People

scholarly journals How primary care providers promote active aging in community-dwelling older people with mental disorders: A qualitative study

2018 ◽  
Vol 7 (1) ◽  
pp. 31 ◽  
Author(s):  
Kedsaraporn Kenbubpha ◽  
Isabel Higgins ◽  
Amanda Wilson ◽  
Sally Wai-Chi Chan
Keyword(s):  
Primary Care ◽  
Mental Disorders ◽  
Older People ◽  
Primary Care Providers ◽  
Community Dwelling ◽  
Active Aging ◽  
Care Providers ◽  
New Instrument ◽  
Aging In Community ◽  
Community Dwelling Older People

The promotion of active aging in community-dwelling older people with mental disorders is an under-researched area. Primary care providers play an important role in engaging older people with mental health disorders to optimize active aging and increase their quality of life. This study explored how primary care providers apply the concept of active aging in community-dwelling older people with mental disorders and to identify factors that facilitate or hinder such application for promoting active aging in this group. Two focus groups were conducted. Fourteen primary care providers were recruited by purposive sampling from two primary care units located in Ubonratchathani province, the northeast region of Thailand. Content analysis was used to analyse the data. The study found that the majority of primary care providers were unfamiliar with the notion of active aging and that older people with mental disorders were not encouraged to join the health promotion activities organised by the community centre. Thai primary care providers need to be supported with training to enhance skills for promoting active ageing in this group. They also lack resources from the national and local government. The findings of this study were used to help develop a new instrument to measure perspectives of primary care providers in a quantitative study.

O3-07-07: An in-home geriatric program for vulnerable community-dwelling older people improves the detection of dementia in primary care

2008 ◽  
Vol 4 ◽  
pp. T175-T175
Author(s):  
Marieke Perry ◽  
René Melis ◽  
Steven Teerenstra ◽  
Irena Drašković ◽  
Theo van Achterberg ◽  
...  
Keyword(s):  
Primary Care ◽  
Older People ◽  
Community Dwelling ◽  
Vulnerable Community ◽  
Community Dwelling Older People

An in-home geriatric programme for vulnerable community-dwelling older people improves the detection of dementia in primary care

2008 ◽  
Vol 23 (12) ◽  
pp. 1312-1319 ◽  
Author(s):  
M. Perry ◽  
R. J. F. Melis ◽  
S. Teerenstra ◽  
I. Drašković ◽  
T. van Achterberg ◽  
...  
Keyword(s):  
Primary Care ◽  
Older People ◽  
Community Dwelling ◽  
Vulnerable Community ◽  
Community Dwelling Older People

scholarly journals Development of a prediction model to aid primary care physicians in early identification of women at high risk of developing endometriosis: cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e030346
Author(s):  
Nina Julie Verket ◽  
Ragnhild Sørum Falk ◽  
Erik Qvigstad ◽  
Tom Gunnar Tanbo ◽  
Leiv Sandvik
Keyword(s):  
Primary Care ◽  
Family History ◽  
High Risk ◽  
Prediction Model ◽  
Early Identification ◽  
Primary Care Physicians ◽  
Lasso Regression ◽  
Cross Sectional ◽  
Predictive Values ◽  
History Of

ObjectivesTo identify predictors of disease among a few factors commonly associated with endometriosis and if successful, to combine these to develop a prediction model to aid primary care physicians in early identification of women at high risk of developing endometriosis.DesignCross-sectional anonymous postal questionnaire study.SettingWomen aged 18–45 years recruited from the Norwegian Endometriosis Association and a random sample of women residing in Oslo, Norway.Participants157 women with and 156 women without endometriosis.Main outcome measuresLogistic and least absolute shrinkage and selection operator (LASSO) regression analyses were performed with endometriosis as dependent variable. Predictors were identified and combined to develop a prediction model. The predictive ability of the model was evaluated by calculating the area under the receiver operating characteristic curve (AUC) and positive predictive values (PPVs) and negative predictive values (NPVs). To take into account the likelihood of skewed representativeness of the patient sample towards high symptom burden, we considered the hypothetical prevalences of endometriosis in the general population 0.1%, 0.5%, 1% and 2%.ResultsThe predictors absenteeism from school due to dysmenorrhea and family history of endometriosis demonstrated the strongest association with disease. The model based on logistic regression (AUC 0.83) included these two predictors only, while the model based on LASSO regression (AUC 0.85) included two more: severe dysmenorrhea in adolescence and use of painkillers due to dysmenorrhea in adolescence. For the prevalences 0.1%, 0.5%, 1% and 2%, both models ascertained endometriosis with PPV equal to 2.0%, 9.4%, 17.2% and 29.6%, respectively. NPV was at least 98% for all values considered.ConclusionsExternal validation is needed before model implementation. Meanwhile, endometriosis should be considered a differential diagnosis in women with frequent absenteeism from school or work due to painful menstruations and positive family history of endometriosis.

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