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FRAT-up, a Web-based Fall-Risk Assessment Tool for Elderly People Living in the Community

BACKGROUND: About 30% of people over 65 are subject to at least one unintentional fall a year. Fall prevention protocols and interventions can decrease the number of falls. To be effective, a prevention strategy requires a prior step to evaluate the fall risk of the subjects. Despite extensive resea...

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Autores principales: Cattelani, Luca, Palumbo, Pierpaolo, Palmerini, Luca, Bandinelli, Stefania, Becker, Clemens, Chesani, Federico, Chiari, Lorenzo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications Inc. 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4376110/
https://www.ncbi.nlm.nih.gov/pubmed/25693419
http://dx.doi.org/10.2196/jmir.4064
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author Cattelani, Luca
Palumbo, Pierpaolo
Palmerini, Luca
Bandinelli, Stefania
Becker, Clemens
Chesani, Federico
Chiari, Lorenzo
author_facet Cattelani, Luca
Palumbo, Pierpaolo
Palmerini, Luca
Bandinelli, Stefania
Becker, Clemens
Chesani, Federico
Chiari, Lorenzo
author_sort Cattelani, Luca
collection PubMed
description BACKGROUND: About 30% of people over 65 are subject to at least one unintentional fall a year. Fall prevention protocols and interventions can decrease the number of falls. To be effective, a prevention strategy requires a prior step to evaluate the fall risk of the subjects. Despite extensive research, existing assessment tools for fall risk have been insufficient for predicting falls. OBJECTIVE: The goal of this study is to present a novel web-based fall-risk assessment tool (FRAT-up) and to evaluate its accuracy in predicting falls, within a context of community-dwelling persons aged 65 and up. METHODS: FRAT-up is based on the assumption that a subject’s fall risk is given by the contribution of their exposure to each of the known fall-risk factors. Many scientific studies have investigated the relationship between falls and risk factors. The majority of these studies adopted statistical approaches, usually providing quantitative information such as odds ratios. FRAT-up exploits these numerical results to compute how each single factor contributes to the overall fall risk. FRAT-up is based on a formal ontology that enlists a number of known risk factors, together with quantitative findings in terms of odds ratios. From such information, an automatic algorithm generates a rule-based probabilistic logic program, that is, a set of rules for each risk factor. The rule-based program takes the health profile of the subject (in terms of exposure to the risk factors) and computes the fall risk. A Web-based interface allows users to input health profiles and to visualize the risk assessment for the given subject. FRAT-up has been evaluated on the InCHIANTI Study dataset, a representative population-based study of older persons living in the Chianti area (Tuscany, Italy). We compared reported falls with predicted ones and computed performance indicators. RESULTS: The obtained area under curve of the receiver operating characteristic was 0.642 (95% CI 0.614-0.669), while the Brier score was 0.174. The Hosmer-Lemeshow test indicated statistical significance of miscalibration. CONCLUSIONS: FRAT-up is a web-based tool for evaluating the fall risk of people aged 65 or up living in the community. Validation results of fall risks computed by FRAT-up show that its performance is comparable to externally validated state-of-the-art tools. A prototype is freely available through a web-based interface. TRIAL REGISTRATION: ClinicalTrials.gov NCT01331512 (The InChianti Follow-Up Study); http://clinicaltrials.gov/show/NCT01331512 (Archived by WebCite at http://www.webcitation.org/6UDrrRuaR).
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spelling pubmed-43761102015-04-02 FRAT-up, a Web-based Fall-Risk Assessment Tool for Elderly People Living in the Community Cattelani, Luca Palumbo, Pierpaolo Palmerini, Luca Bandinelli, Stefania Becker, Clemens Chesani, Federico Chiari, Lorenzo J Med Internet Res Original Paper BACKGROUND: About 30% of people over 65 are subject to at least one unintentional fall a year. Fall prevention protocols and interventions can decrease the number of falls. To be effective, a prevention strategy requires a prior step to evaluate the fall risk of the subjects. Despite extensive research, existing assessment tools for fall risk have been insufficient for predicting falls. OBJECTIVE: The goal of this study is to present a novel web-based fall-risk assessment tool (FRAT-up) and to evaluate its accuracy in predicting falls, within a context of community-dwelling persons aged 65 and up. METHODS: FRAT-up is based on the assumption that a subject’s fall risk is given by the contribution of their exposure to each of the known fall-risk factors. Many scientific studies have investigated the relationship between falls and risk factors. The majority of these studies adopted statistical approaches, usually providing quantitative information such as odds ratios. FRAT-up exploits these numerical results to compute how each single factor contributes to the overall fall risk. FRAT-up is based on a formal ontology that enlists a number of known risk factors, together with quantitative findings in terms of odds ratios. From such information, an automatic algorithm generates a rule-based probabilistic logic program, that is, a set of rules for each risk factor. The rule-based program takes the health profile of the subject (in terms of exposure to the risk factors) and computes the fall risk. A Web-based interface allows users to input health profiles and to visualize the risk assessment for the given subject. FRAT-up has been evaluated on the InCHIANTI Study dataset, a representative population-based study of older persons living in the Chianti area (Tuscany, Italy). We compared reported falls with predicted ones and computed performance indicators. RESULTS: The obtained area under curve of the receiver operating characteristic was 0.642 (95% CI 0.614-0.669), while the Brier score was 0.174. The Hosmer-Lemeshow test indicated statistical significance of miscalibration. CONCLUSIONS: FRAT-up is a web-based tool for evaluating the fall risk of people aged 65 or up living in the community. Validation results of fall risks computed by FRAT-up show that its performance is comparable to externally validated state-of-the-art tools. A prototype is freely available through a web-based interface. TRIAL REGISTRATION: ClinicalTrials.gov NCT01331512 (The InChianti Follow-Up Study); http://clinicaltrials.gov/show/NCT01331512 (Archived by WebCite at http://www.webcitation.org/6UDrrRuaR). JMIR Publications Inc. 2015-02-18 /pmc/articles/PMC4376110/ /pubmed/25693419 http://dx.doi.org/10.2196/jmir.4064 Text en ©Luca Cattelani, Pierpaolo Palumbo, Luca Palmerini, Stefania Bandinelli, Clemens Becker, Federico Chesani, Lorenzo Chiari. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 18.02.2015. http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.
spellingShingle Original Paper
Cattelani, Luca
Palumbo, Pierpaolo
Palmerini, Luca
Bandinelli, Stefania
Becker, Clemens
Chesani, Federico
Chiari, Lorenzo
FRAT-up, a Web-based Fall-Risk Assessment Tool for Elderly People Living in the Community
title FRAT-up, a Web-based Fall-Risk Assessment Tool for Elderly People Living in the Community
title_full FRAT-up, a Web-based Fall-Risk Assessment Tool for Elderly People Living in the Community
title_fullStr FRAT-up, a Web-based Fall-Risk Assessment Tool for Elderly People Living in the Community
title_full_unstemmed FRAT-up, a Web-based Fall-Risk Assessment Tool for Elderly People Living in the Community
title_short FRAT-up, a Web-based Fall-Risk Assessment Tool for Elderly People Living in the Community
title_sort frat-up, a web-based fall-risk assessment tool for elderly people living in the community
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4376110/
https://www.ncbi.nlm.nih.gov/pubmed/25693419
http://dx.doi.org/10.2196/jmir.4064
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