Are “Gold Standard” Prospective Daily Self-Report Fall Calendars Accurate? A Comparison with a Real-Time Body-Worn Self-Report Device in Multiple Sclerosis (P4.404)

Objective: To compare the accuracy of fall counting in people with multiple sclerosis (MS) using prospective daily fall calendars, the current gold standard, and a novel real-time body-worn device. Background: Accidental falls are common and impactful but accurate fall counting is challenging. Daily self-report fall calendars are recommended but require recall over a day, can be lost, and allow the person to complete a page all at once. A real-time body-worn fall counting device may be more accurate. Design/Methods: For eight weeks ten ambulatory people with MS completed prospective daily paper fall calendars and reported their falls during the day in real-time with a body-worn device with a button on it. Participants were instructed to write how many times they fell each day on the calendar and to mail each calendar page back at the end of each month, and also to press the button on the device whenever they fell. The number and day of falls reported with these methods were compared. Results: The 10 subjects reported 50 falls on the calendars and 56 falls with button presses. Rarely did the total number of falls/individual, or the day of falls with the two methods agree. Two subjects reported the same number of falls with both methods, and these were not on the same day. Only 21 (42%) of the falls documented on the calendars had one reported with a button press on the same day. 85 falls were recorded on distinct days with one method and/or the other. Conclusions: Although limited by small sample size, this study suggests that neither prospective daily fall calendars nor a body-worn button capture all falls. Calendars missed around 40% of probable falls and the button press missed around 30% of probable falls. Further research is needed to develop an accurate fall detection method. Study Supported by: Department of Veterans Affairs, Rehabilitation Research & Development Service, Merit Award # RX001831-01A1 Disclosure: Dr. Chowdhury has nothing to disclose. Dr. Hildebrand has nothing to disclose. Dr. Folsom has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with MotioSens. Dr. Jacobs has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with MotioSens. Dr. Cameron has nothing to disclose.