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Is the Timed Up and Go test a useful predictor of risk of falls in community dwelling older adults: a systematic review and meta-analysis.

Barry E, Galvin R, Keogh C, Horgan F, Fahey T - BMC Geriatr (2014)

Bottom Line: A TUG score of ≥13.5 seconds was used to identify individuals at higher risk of falling.All included studies were combined using a bivariate random effects model to generate pooled estimates of sensitivity and specificity at ≥13.5 seconds.Twenty-five studies were included in the systematic review and 10 studies were included in meta-analysis.

View Article: PubMed Central - HTML - PubMed

Affiliation: HRB Centre for Primary Care research, Department of General Practice, Royal College of Surgeons in Ireland, 123 St, Stephens Green, Dublin 2, Republic of Ireland. rosegalvin@rcsi.ie.

ABSTRACT

Background: The Timed Up and Go test (TUG) is a commonly used screening tool to assist clinicians to identify patients at risk of falling. The purpose of this systematic review and meta-analysis is to determine the overall predictive value of the TUG in community-dwelling older adults.

Methods: A literature search was performed to identify all studies that validated the TUG test. The methodological quality of the selected studies was assessed using the QUADAS-2 tool, a validated tool for the quality assessment of diagnostic accuracy studies. A TUG score of ≥13.5 seconds was used to identify individuals at higher risk of falling. All included studies were combined using a bivariate random effects model to generate pooled estimates of sensitivity and specificity at ≥13.5 seconds. Heterogeneity was assessed using the variance of logit transformed sensitivity and specificity.

Results: Twenty-five studies were included in the systematic review and 10 studies were included in meta-analysis. The TUG test was found to be more useful at ruling in rather than ruling out falls in individuals classified as high risk (>13.5 sec), with a higher pooled specificity (0.74, 95% CI 0.52-0.88) than sensitivity (0.31, 95% CI 0.13-0.57). Logistic regression analysis indicated that the TUG score is not a significant predictor of falls (OR = 1.01, 95% CI 1.00-1.02, p = 0.05).

Conclusion: The Timed Up and Go test has limited ability to predict falls in community dwelling elderly and should not be used in isolation to identify individuals at high risk of falls in this setting.

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Related in: MedlinePlus

Methodological quality of the studies included in the review.
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Figure 2: Methodological quality of the studies included in the review.

Mentions: The summary diagram of the quality assessment is shown in Figure 2. All twenty five articles were quality assessed. The overall quality of the studies included was moderate with six studies [23,27,30,35,36,39] rated as low in all domains in both risk of bias and concerns about applicability. Ten studies [22,24-26,31,33,37,38,41,43] rated as having an unclear risk of bias and nine studies [28,29,32,34,40,42,44-46] were rated as having a high risk of bias. This was primarily attributed to a lack of information provided with respect to methods of patient recruitment (selection bias) and criteria used to ascertain of a subsequent fall (reference standard).


Is the Timed Up and Go test a useful predictor of risk of falls in community dwelling older adults: a systematic review and meta-analysis.

Barry E, Galvin R, Keogh C, Horgan F, Fahey T - BMC Geriatr (2014)

Methodological quality of the studies included in the review.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3924230&req=5

Figure 2: Methodological quality of the studies included in the review.
Mentions: The summary diagram of the quality assessment is shown in Figure 2. All twenty five articles were quality assessed. The overall quality of the studies included was moderate with six studies [23,27,30,35,36,39] rated as low in all domains in both risk of bias and concerns about applicability. Ten studies [22,24-26,31,33,37,38,41,43] rated as having an unclear risk of bias and nine studies [28,29,32,34,40,42,44-46] were rated as having a high risk of bias. This was primarily attributed to a lack of information provided with respect to methods of patient recruitment (selection bias) and criteria used to ascertain of a subsequent fall (reference standard).

Bottom Line: A TUG score of ≥13.5 seconds was used to identify individuals at higher risk of falling.All included studies were combined using a bivariate random effects model to generate pooled estimates of sensitivity and specificity at ≥13.5 seconds.Twenty-five studies were included in the systematic review and 10 studies were included in meta-analysis.

View Article: PubMed Central - HTML - PubMed

Affiliation: HRB Centre for Primary Care research, Department of General Practice, Royal College of Surgeons in Ireland, 123 St, Stephens Green, Dublin 2, Republic of Ireland. rosegalvin@rcsi.ie.

ABSTRACT

Background: The Timed Up and Go test (TUG) is a commonly used screening tool to assist clinicians to identify patients at risk of falling. The purpose of this systematic review and meta-analysis is to determine the overall predictive value of the TUG in community-dwelling older adults.

Methods: A literature search was performed to identify all studies that validated the TUG test. The methodological quality of the selected studies was assessed using the QUADAS-2 tool, a validated tool for the quality assessment of diagnostic accuracy studies. A TUG score of ≥13.5 seconds was used to identify individuals at higher risk of falling. All included studies were combined using a bivariate random effects model to generate pooled estimates of sensitivity and specificity at ≥13.5 seconds. Heterogeneity was assessed using the variance of logit transformed sensitivity and specificity.

Results: Twenty-five studies were included in the systematic review and 10 studies were included in meta-analysis. The TUG test was found to be more useful at ruling in rather than ruling out falls in individuals classified as high risk (>13.5 sec), with a higher pooled specificity (0.74, 95% CI 0.52-0.88) than sensitivity (0.31, 95% CI 0.13-0.57). Logistic regression analysis indicated that the TUG score is not a significant predictor of falls (OR = 1.01, 95% CI 1.00-1.02, p = 0.05).

Conclusion: The Timed Up and Go test has limited ability to predict falls in community dwelling elderly and should not be used in isolation to identify individuals at high risk of falls in this setting.

Show MeSH
Related in: MedlinePlus