# Utility of performance-based outcome measures (PBOMs) used in fall risk assessment tools for older adults

## TL;DR

This study compares the effectiveness of different performance-based outcome measures in assessing fall risk among older adults.

## Contribution

The study identifies the APTA-SR3 cluster as the most effective and efficient tool for fall risk assessment in older adults.

## Key findings

- The APTA-SR3 cluster showed the highest diagnostic accuracy with 88.24% specificity and 62.5% sensitivity in retrospective analysis.
- Prospective analysis found the APTA-SR and APTA-SR3 clusters had identical diagnostic accuracy with 100% sensitivity.
- The APTA-SR3 cluster was most effective in identifying fall risk in community-dwelling older adults.

## Abstract

This study investigated the diagnostic accuracy of different clusters of performance based outcome measures (PBOMs) recommended by two consensus-based guidelines: Stopping Elderly Accidents, Deaths, and Injuries (STEADI), and those recommended by a systematic review completed by the American Physical Therapy Association and Academy of Geriatric Physical Therapy (APTA-SR, APTA-SR3). 33 community-dwelling older adults (25 females, 8 males) aged mean 79.45 ± 7.64 years participated in this study. Participants completed a fall history questionnaire and were evaluated via a battery of PBOMs for comparative analysis. The diagnostic accuracy of each PBOM cluster was analyzed retrospectively (previous 1 year fall history) and prospectively (6 month follow up). Retrospective analysis revealed the APTA-SR3 had the highest clinical utility and diagnostic accuracy: Sp 88.24% (63.56–98.54), Sn 62.5% (35.43–84.8), LR+ 2.35 (1.22–4.53), LR- 0.19 (0.05–0.73), accuracy 70.22% (51.83–84.81). Prospective analysis revealed the cluster of the APTA-SR and APTA-SR3 had identical diagnostic accuracy: Sn 100% (39.76–100), Sp 43.75% (19.75–70.12), LR+ 1.78 (1.15–2.74), LR- 0 (0), accuracy 60.62% (36.63–81.36). The APTA-SR 3 cluster demonstrated the highest diagnostic accuracy and in this study was the most effective and efficient group of PBOMs to identify fall risk in community dwelling older adults.