{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T15:28:12Z","timestamp":1777476492712,"version":"3.51.4"},"reference-count":69,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2024,3,26]],"date-time":"2024-03-26T00:00:00Z","timestamp":1711411200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Falls pose a significant challenge in residential aged care facilities (RACFs). Existing falls prediction tools perform poorly and fail to capture evolving risk factors. We aimed to develop and internally validate dynamic fall risk prediction models and create point-based scoring systems for residents with and without dementia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and methods<\/jats:title>\n                  <jats:p>A longitudinal cohort study using electronic data from 27 RACFs in Sydney, Australia. The study included 5492 permanent residents, with a 70%-30% split for training and validation. The outcome measure was the incidence of falls. We tracked residents for 60 months, using monthly landmarks with 1-month prediction windows. We employed landmarking dynamic prediction for model development, a time-dependent area under receiver operating characteristics curve (AUROCC) for model evaluations, and a regression coefficient approach to create point-based scoring systems.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The model identified 15 independent predictors of falls in dementia and 12 in nondementia cohorts. Falls history was the key predictor of subsequent falls in both dementia (HR 4.75, 95% CI, 4.45-5.06) and nondementia cohorts (HR 4.20, 95% CI, 3.87-4.57). The AUROCC across landmarks ranged from 0.67 to 0.87 for dementia and from 0.66 to 0.86 for nondementia cohorts but generally remained between 0.75 and 0.85 in both cohorts. The total point risk score ranged from \u22122 to 57 for dementia and 0 to 52 for nondementia cohorts.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Our novel risk prediction models and scoring systems provide timely person-centered information for continuous monitoring of fall risk in RACFs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Embedding these tools within electronic health records could facilitate the implementation of targeted proactive interventions to prevent falls.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocae058","type":"journal-article","created":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T02:23:16Z","timestamp":1711506196000},"page":"1113-1125","source":"Crossref","is-referenced-by-count":11,"title":["Development and internal validation of a dynamic fall risk prediction and monitoring tool in aged care using routinely collected electronic health data: a landmarking approach"],"prefix":"10.1093","volume":"31","author":[{"given":"Nasir","family":"Wabe","sequence":"first","affiliation":[{"name":"Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University , North Ryde, NSW 2109, Australia"}]},{"given":"Isabelle","family":"Meulenbroeks","sequence":"additional","affiliation":[{"name":"Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University , North Ryde, NSW 2109, Australia"}]},{"given":"Guogui","family":"Huang","sequence":"additional","affiliation":[{"name":"Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University , North Ryde, NSW 2109, Australia"}]},{"given":"Sandun Malpriya","family":"Silva","sequence":"additional","affiliation":[{"name":"Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University , North Ryde, NSW 2109, Australia"}]},{"given":"Leonard C","family":"Gray","sequence":"additional","affiliation":[{"name":"Centre for Health Service Research, Faculty of Medicine, The University of Queensland , Brisbane, QLD 4072, Australia"}]},{"given":"Jacqueline C T","family":"Close","sequence":"additional","affiliation":[{"name":"Neuroscience Research Australia, University of New South Wales , Sydney, NSW 2052, Australia"},{"name":"School of Clinical Medicine, University of New South Wales , Sydney, NSW 2052, Australia"}]},{"given":"Stephen","family":"Lord","sequence":"additional","affiliation":[{"name":"Neuroscience Research Australia, University of New South Wales , Sydney, NSW 2052, Australia"},{"name":"School of Population Health, University of New South Wales , Sydney, NSW 2052, Australia"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1083-8192","authenticated-orcid":false,"given":"Johanna I","family":"Westbrook","sequence":"additional","affiliation":[{"name":"Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University , North Ryde, NSW 2109, Australia"}]}],"member":"286","published-online":{"date-parts":[[2024,3,26]]},"reference":[{"key":"2024041923351102600_ocae058-B1","volume-title":"WHO Global Report on Falls Prevention in Older Age","author":"World Health Organization","year":"2007"},{"issue":"16","key":"2024041923351102600_ocae058-B2","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1056\/NEJM198904203201606","article-title":"Prevention of falls among the elderly","volume":"320","author":"Desforges","year":"1989","journal-title":"N Engl J Med"},{"issue":"9500","key":"2024041923351102600_ocae058-B3","doi-asserted-by":"crossref","first-page":"1885","DOI":"10.1016\/S0140-6736(05)67604-0","article-title":"Prevention of falls and consequent injuries in elderly 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