Final Research Report
View this project's final research report.
Article Highlight: In a paper in the New England Journal of Medicine, this study reported that having nurses tailor and administer fall-prevention plans for older adults at high risk resulted in about an 8 percent to 10 percent reduction in serious fall injuries, but this effect was not statistically significant. The paper discusses potential barriers to care and other factors that could account for why a more significant reduction in serious fall injuries was not seen when risk-reduction strategies shown to be effective in previous studies were deployed this way in real-world circumstances and settings.
Results of This Project
Related Journal Citations
Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also assesses how the project addressed PCORI’s Methodology Standards. During peer review, experts read a draft report of the research and provide comments about the report. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. These reviewers cannot have conflicts of interest with the study.
The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve descriptions of the conduct of the study or to clarify the connection between results and conclusions. Sometimes, awardees revise their draft reports twice or more to address all of the reviewers’ comments.
Peer reviewers commented and the researchers made changes or provided responses. Those comments and responses included the following:
- The reviewers asked the researchers to add information about the falls case managers used in this study, including their background and training. They also asked the researchers why nurses were chosen for this role. The researchers added information to the text on the training provided for falls case manager. Regarding the use of nurses, the researchers explained that nurses have the professional background and patient access that put them in the best place to conduct standardized assessments and follow treatment protocols.
- The reviewers suggested that the researchers add to their discussion about the lower-than-expected rate of falls among their study sample and how that affected their power to identify treatment effects. The researchers acknowledged that there were fewer falls than expected but assured the reviewers that the study sample was sufficient to run the proposed statistical tests. In addition, the researchers ran simulation studies throughout the study to monitor the study power.
- The reviewers noted that the researchers provided some potential reasons for not reaching the 20% expected reduction in falls that was based on efficacy trials of the same treatments but did not consider whether the patient population in this study was different from the population usually seen in smaller efficacy trials. The researchers explained since this study was a pragmatic trial, they did not collect some of the data that might be important to comparing study samples, such as gait, balance, and other fall risk factors. For the factors they did examine, including age and falls risk, the present study sample was comparable to prior efficacy studies.
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