Abstract
Background: While prospective recording is considered as the gold standard, retrospective recall is widely utilized for falls outcomes due to its convenience. This brings about the concern on the validity of falls reporting in Southeast Asian countries, as the reliability of falls recall has not previously been studied. This study aimed to evaluate the reliability of retrospective falls recall compared to prospective falls recording.Methods: A secondary analysis of data from two prospective recording methods, falls diary and falls calendar, from two different research projects were obtained and analyzed. Retrospective falls recall was collected either through phone interview or follow-up clinic by asking the participants if they had fallen in the past 12 months.Results: Two-hundred-sixty-eight and 280 elderly participated in the diary and calendar groups, respectively. Moderate (46%) and poor (11%) return rates were found on completed diary and calendar recording. Under-(32%) and overreporting (24%) of falls were found in diary compared to only 4% of overreporting for the calendar. Retrospective recall method achieved 57% response rate for the diary group (followed up at clinic) and 89% for the calendar group (followed up via telephone interview). Agreement between retrospective and prospective reporting was moderate for the diary (kappa =0.44; p < 0.001) and strong for the calendar (kappa = 0.89; p < 0.001).Conclusion: Retrospective recall is reliable and acceptable in an observation study within healthy community older adults, while the combination of retrospective and prospective falls recording is the best for an intervention study with frailer older population. Telephone interview is convenient, low cost, and yielded a high response rate.
Highlights
Falls among older people may lead to negative consequences to psychological and physical health, functional status, and increased mortality [1]
Accurate falls reporting is important to ensure reliable findings in falls research and help clinicians to identify older people at risk for recurrent falling and plan for future intervention and prevention efficiently. This current study indicates that there is an acceptable and satisfactory agreement between retrospective self-reported falls with prospective falls recording methods in both a hospital-based intervention study involving high risk falls and a community-based cohort study involving the general older population
If prospective falls recording was considered the gold standard, both over- and underestimations occurred with retrospective recall in Malaysian Falls Assessment and Intervention Trial (MyFAIT), while minimal differences occurred in Malaysian Elders Longitudinal Research (MELoR)
Summary
Falls among older people may lead to negative consequences to psychological and physical health, functional status, and increased mortality [1]. It has been advocated that the prospective recording of falls represents the most accurate method of capturing actual incidences of falls, in terms of time and location of falls and the circumstances leading to a fall occurring. The use of prospective falls recording may have several drawbacks; the process is time consuming, requires a high level of commitment from health practitioners and clients, costly, and is susceptible to logistic issues such as inadvertently misplacing the records. While prospective recording is considered as the gold standard, retrospective recall is widely utilized for falls outcomes due to its convenience. This brings about the concern on the validity of falls reporting in Southeast Asian countries, as the reliability of falls recall has not previously been studied. This study aimed to evaluate the reliability of retrospective falls recall compared to prospective falls recording
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