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Falls
The authors attempted to find a new way of measuring falls -- they were dissatisfied with the previous measure used -- and they argued that all aspects can be measured by the number of events divided by the number of opportunities for that event to occur.
In regards to falls, they argued that if you wanted to know how many falls resulted in fractures you would use the numerator as the number of patient falls that resulted in fractures and the denominator would be the totality of falls. So for instance if there were 20 falls that resulted in fractures and 100 falls altogether it would be 20/100 otherwise read as 20%. The numerator tells you what you want to study / question or investigates, and this -- the authors say -- can be as general or as specific as possible.
The problem is how you define falls. The authors in questions, for instance, say that it took them 8 months to arrive at a mutually agreed definition:
What might seem to a layperson a straightforward concept can be quite complicated.
For example, does a "fall" have to result in the patient being on the floor? Can a patient "fall" if that patient is being assisted onto a chair by a caregiver? Does a "fall" have to be observed by another to distinguish it from a collapse or a faint? (p.30)
Their definition was arrived at only because...
The example that the authors give f falls resulting in fractures is an excellent instance of where it can be used since fractures are clear (we all agree on that) and the term 'falls' has been cohesively defined.
On the other hand, there may be some instances where the measure may result in uncertainty such as when attempting to measure falls that result in decreased quality of life for victim or that result in internal harm. These are definitions that are more abstract, therefore, more difficult to define and more difficult to pin down in a quantitative manner as the author attempt to do in this case.
Even when defining more concrete possibilities, we can sometimes run into difficulties. For instance, if we want to measure the amount of time that patients' falls resulted in death, this may be a difficult measure to use for the following reasons:
1. Death may not follow right away. How long does it take until we use their measure to definitively conclude that death resulted from falls x percent of time/
2. How do we know that death was the result of the fall and not any other additional or…
Measuring Health Care Chapter 2. Fundamentals of Data (Chap. 2)
K.R. Tremblay Jr., and C.E. Barber (2005) Preventing Falls in the Elderly
http://www.ext.colostate.edu/pubs/consumer/10242.html
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