SynthesisAge and ageing2026
Validation of the World Falls Guidelines risk stratification algorithm. A systematic review.
Synthesis in Age and ageing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
Abstract
backgroundFalls are a major cause of morbidity and mortality in older adults. The World Falls Guidelines (WFG) propose a risk stratification algorithm using fall history, three key questions (3KQ), mobility tests and clinical criteria, but it has yet to be systematically evaluated.
objectiveTo assess whether the WFG algorithm, in original or modified form, effectively stratifies community-dwelling older adults into low, intermediate or high risk of future falls; whether it has been prospectively validated; and whether it has been adequately operationalised.
methodsWe conducted a systematic review (PROSPERO CRD420251151506) by searching MEDLINE, Embase and Google Scholar. Two reviewers independently screened studies and extracted data on cohort characteristics, algorithm adaptations, baseline risk distribution and prospective falls outcomes over ≥6 months. Given the heterogeneity of the studies included, quantitative meta-analysis was not conducted.
resultsEight cohort studies (n = 25 027; mean age range 61-82 years) met the inclusion criteria. No study implemented the WFG algorithm as published; two used minor modifications and six had major adaptations due to dataset limitations. Common modifications included rephrasing the 3KQ, replacing 'subjective unsteadiness' question with objective measures, applying mobility test universally, adjusting mobility tests thresholds and omitting fall severity definition components. Across studies, 7.9%-82.6% of participants were classified as low risk, 0.4%-18.3% as intermediate risk and 10.5%-88.7% as high risk. High-risk classification showed modest sensitivity (26.5%-52.3%) and moderate-to-high specificity (34.2%-88.9%) for future falls (1-2 years), with an overall accuracy of 61.2%-74.2%. High-risk groups consistently had a two- to three-fold higher incidence of falls than low-risk groups, while intermediate-risk groups only showed a slightly elevated risk. Use of 3KQ alongside fall history and universal mobility testing improved discrimination and increased the proportion in the intermediate-risk category.
conclusionThe operationalised versions of the WFG algorithm identify older adults at high falls risk with high specificity but limited sensitivity. Proposed pragmatic modifications improve stratification accuracy for intermediate risk group but require prospective validation.
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.