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Development and Testing of a Visual Tool for Assessing Risk of Falls

Arihisa, Katsuhiko MS; Yamamoto, Akihiko Diploma in Medical Care; Hayashi, Tatsuhiro Diploma in Medical Care; Hayashi, Ayu MA; Ishizuki, Chinami PhD; Miyaguchi, Hideki PhD

doi: 10.1097/QMH.0000000000000213
Original Research

Background: To develop a “Time Pressure-Kiken Yochi Training (TP-KYT) system” for measuring risk prediction ability of health care professionals.

Methods: The TP-KYT was developed using responses from 51 experts with at least 5 years of clinical experience (8.7 ± 5.3 years). Participants extracted risk items by scoring 5 illustrations depicting fall-related medical accidents. With 77 “Experts” (34.0 ± 5.6 years old; clinical experience, 9.1 ± 4.8 years), 34 “Competents” (26.8 ± 5.5 years old; clinical experience, 1.1 ± 0.9 years), 34 “Advanced Beginners” (21.9 ± 0.7 years old), and 44 “Novices” (18.7 ± 1.9 years old), TP-KYT was validated using 1-way analysis of variance and Tukey's HSD (honestly significant difference) test. Risk prediction ability was evaluated using receiver operating characteristic curve analysis.

Results: Experts scored significantly higher than others (Competents: P < .05; Advanced Beginners: P = 6.32E-10; and Novices: P = 4.53E-13). Area under the curve for Experts versus Competents was 0.73 and for Competents versus Advanced Beginners was 0.66. Sensitivity and specificity for Expert scores set at 212/213 were 54.5% and 82.4%, respectively, and for Competent scores set at 137/138 were 76.5% and 52.9%, respectively. The TP-KYT scores varied on the basis of the test taker's clinical experience.

Conclusions: Validity and reliability of the TP-KYT were demonstrated. The TP-KYT can be a useful tool to quantify health professionals' ability to predict patients' fall risk under time pressure.

Department of Occupational Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare, Fukuoka, Japan (Mr Arihisa); Department of Occupational Therapy, Osaka College of Medical and Welfare, Osaka, Japan (Messrs Akihiko Yamamoto and Tatsuhiro Hayashi and Ms Ayu Hayashi); and Department of Occupational Therapy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan (Drs Ishizuki and Miyaguchi).

Correspondence: Hideki Miyaguchi, PhD, Department of Occupational Therapy, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima-shi, Hiroshima 734-8553, Japan (

The authors gratefully acknowledge all the participants and the members of the study group (Life Risk Communication Study Group for Clinicians and Educators, who participated in this study and Professor Kenzo Haraguchi who provided invaluable guidance for this study. This work was supported by MEXT KAKENHI grant, number JP17K13044. The study received funds from the Ministry of Education, Culture, Sports, Science and Technology of Japan. Editorial support, in the form of medical writing, assembling tables, and creating high-resolution images based on authors' detailed directions, collating author comments, copy editing, fact checking, and referencing, was provided by Editage, Cactus Communications.

At present, no commercial organizations are involved in this project. The copyright for the current brochure is with the Life Risk Communication Study Group for Clinicians and Educators to which the authors belong.

This study was conducted after obtaining the approval of the ethical committee of School of Health Sciences at Fukuoka, International University of Health and Welfare (approval number: 14-Ifh-08).

There are no conflicts of interest to declare.

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