Plenary Oral Presentations
Bibliographic record
Abstract
Introduction: Impaired mobility is associated with increased fall risk, functional decline and diminished quality of life, yet there is no standardized test for assessing mobility in the emergency department (ED).We wished to evaluate the Timed Up and Go (TUG) as a measure of mobility and its relationship with frailty, functional decline, fear of falling and falls in community dwelling elders that present to the ED following minor trauma.Methods: This was a substudy of a prospective cohort study conducted at 8 Canadian teaching EDs from May 2011 -July 2013, which enrolled patients ≥65 years presenting to the ED following minor trauma.Patient evaluations: 1) mobility using TUG scores categorized into <10 seconds, 10-19.9seconds, 20-29.9seconds and >30 seconds; 2) frailty using Study of Osteoporotic Fractures Frailty Index categorized as robust or intermediate/frail; 3) functional decline, defined as a decrease of 2 points in the Older American Resources and Service Functional Scale; 4) fear of falling using Short Falls Efficacy Scale with cut-off <9.8; and 5) self-report falls.Telephone or in-person follow-up at 3 and 6 months was conducted.Generalized linear model with log-binomial distribution was utilized to evaluate association between the measures.Relative risks (RR) and 95% CI were calculated.Results: 504/1,477 patients, with mean age 76.8 (SD 7.9) and 60.2% female, completed the TUG at initial ED visit.There was a significant association between TUG scores and frailty (p < 0.05), functional decline at 3 (p < 0.05) and 6 (p < 0.05) months, fear of falling (p < 0.05) at 0, 3, 6 months and self-reported falls at 0 (p < 0.05) but not at 3 (p = 0.58) or 6 (p = 0.93) months.For TUG scores 10-19.9seconds, 20-29.9seconds and >30 seconds, respectively: 1) frailty RR (CI): 2.0 (1.4-2.8),3.2 (2.2-4.7) and 4.0 (2.8-5.8); 2) functional decline RR (CI): 2.8 (0.9-8.5), 6.0 (1.8-19.5)and 9.6 (2.9-32.6);3) fear of falling RR (CI): 1.5 (1.1-2.1),2.2 (1.6-3.0) and 2.6 (1.9-3.7); and 4) falls RR (CI): 2.1 (1.1-3.9),4.0 (2.0-7.8) and 2.2 (0.8-6.3).Conclusion: In community dwelling elders presenting to the ED following minor trauma, TUG scores are associated with frailty, functional decline and fear of falling.TUG scores were associated with falls at initial ED visit but not predictive of falls at 3 or 6 months.Use of the TUG in the ED will help identify frail patients at risk of functional decline.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.012 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.005 | 0.005 |
| Insufficient payload (model declined to judge) | 0.581 | 0.341 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; the direct Gemma label and the distilled Codex classifier agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".