Trial reportPloS one2014
Support and Assessment for Fall Emergency Referrals (SAFER 1): cluster randomised trial of computerised clinical decision support for paramedics.
Trial report in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 9 syntheses or guidelines pooled it.
- Effectiveness of clinical decision support in fall prevention among older adults: A systematic review and meta-analysis.PloS one · 2026Pooled it
- Ambulance responses to older adults who have fallen: a systematic review.Age and ageing · 2025Pooled it
- Community emergency medical services approaches to fall prevention: a systematic review.Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention · 2024Pooled it
- Pooled it
- Pooled it
- The effectiveness of implementation strategies for promoting evidence informed interventions in allied healthcare: a systematic review.BMC health services research · 2021Pooled it
- Pooled it
- A patient-safety and professional perspective on non-conveyance in ambulance care: a systematic review.Scandinavian journal of trauma, resuscitation and emergency medicine · 2017Pooled it
- What is the economic evidence for mHealth? A systematic review of economic evaluations of mHealth solutions.PloS one · 2017Pooled it
- Challenges and Experiences in Multicenter Prehospital Stroke Research: Narrative Data from the Rapid Intervention with Glyceryl Trinitrate in Hypertensive Stroke Trial-2 (RIGHT-2).Prehospital emergency care · 2024Trial
- Trial
- Factors influencing paramedic conveyance decisions when attending children with minor head injury: a qualitative study.Emergency medicine journal : EMJ · 2025Article
- Prediction of the future number of fall-related emergency medical services calls in older individuals.International journal of emergency medicine · 2024Article
- Information Seeking and Sensemaking in Emergency Medical Service through Simulation Video Review.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2023Article
- Article
- Article
- Reducing ambulance conveyance for older people with and without dementia: evidence of the role of social care from a regional, year-long service evaluation using retrospective routine data.British paramedic journal · 2021Article
- Moving the needle on fall prevention: A Geriatric Emergency Care Applied Research (GEAR) Network scoping review and consensus statement.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2021Article
- A paramedic's role in reducing number of falls and fall-related emergency service use by over 65s: a systematic review.British paramedic journal · 2021Review
- New Horizons in Understanding Appropriate Prehospital Identification and Trauma Triage for Older Adults.Open access emergency medicine : OAEM · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors.
Funding
Abstract
objectiveTo evaluate effectiveness, safety and cost-effectiveness of Computerised Clinical Decision Support (CCDS) for paramedics attending older people who fall.
designCluster trial randomised by paramedic; modelling.
setting13 ambulance stations in two UK emergency ambulance services.
participants42 of 409 eligible paramedics, who attended 779 older patients for a reported fall.
interventionsIntervention paramedics received CCDS on Tablet computers to guide patient care. Control paramedics provided care as usual. One service had already installed electronic data capture.
main outcome measuresEffectiveness: patients referred to falls service, patient reported quality of life and satisfaction, processes of care. SAFETY: Further emergency contacts or death within one month. COST-EFFECTIVENESS: Costs and quality of life. We used findings from published Community Falls Prevention Trial to model cost-effectiveness.
results17 intervention paramedics used CCDS for 54 (12.4%) of 436 participants. They referred 42 (9.6%) to falls services, compared with 17 (5.0%) of 343 participants seen by 19 control paramedics [Odds ratio (OR) 2.04, 95% CI 1.12 to 3.72]. No adverse events were related to the intervention. Non-significant differences between groups included: subsequent emergency contacts (34.6% versus 29.1%; OR 1.27, 95% CI 0.93 to 1.72); quality of life (mean SF12 differences: MCS -0.74, 95% CI -2.83 to +1.28; PCS -0.13, 95% CI -1.65 to +1.39) and non-conveyance (42.0% versus 36.7%; OR 1.13, 95% CI 0.84 to 1.52). However ambulance job cycle time was 8.9 minutes longer for intervention patients (95% CI 2.3 to 15.3). Average net cost of implementing CCDS was £208 per patient with existing electronic data capture, and £308 without. Modelling estimated cost per quality-adjusted life-year at £15,000 with existing electronic data capture; and £22,200 without.
conclusionsIntervention paramedics referred twice as many participants to falls services with no difference in safety. CCDS is potentially cost-effective, especially with existing electronic data capture.
trial registrationISRCTN Register ISRCTN10538608.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.