The Risk Instrument for Screening in the Community (RISC): a new instrument for predicting risk of adverse outcomes in community dwelling older adults

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dc.contributor.author O'Caoimh, Rónán
dc.contributor.author Gao, Yang
dc.contributor.author Svendrovski, Anton
dc.contributor.author Healy, Elizabeth
dc.contributor.author O'Keeffe, Gabrielle
dc.contributor.author Cronin, Una
dc.contributor.author Igras, Estera
dc.contributor.author O'Herlihy, Eileen
dc.contributor.author Fitzgerald, Carol
dc.contributor.author Weathers, Elizabeth
dc.contributor.author Leahy-Warren, Patricia
dc.contributor.author Cornally, Nicola
dc.contributor.author Molloy, D. William
dc.date.accessioned 2016-01-15T15:45:15Z
dc.date.available 2016-01-15T15:45:15Z
dc.date.issued 2015-07-30
dc.identifier.citation O’CAOIMH, R., GAO, Y., SVENDROVSKI, A., HEALY, E., O’CONNELL, E., O’KEEFFE, G., CRONIN, U., IGRAS, E., O’HERLIHY, E., FITZGERALD, C., WEATHERS, E., LEAHY-WARREN, P., CORNALLY, N. & MOLLOY, D. W. 2015. The Risk Instrument for Screening in the Community (RISC): a new instrument for predicting risk of adverse outcomes in community dwelling older adults. BMC Geriatrics, 15:92, 1-9.http://dx.doi.org/10.1186/s12877-015-0095-z en
dc.identifier.volume 15 en
dc.identifier.startpage 1 en
dc.identifier.endpage 9 en
dc.identifier.issn 1471-2318
dc.identifier.uri http://hdl.handle.net/10468/2187
dc.identifier.doi 10.1186/s12877-015-0095-z
dc.description.abstract BACKGROUND: Predicting risk of adverse healthcare outcomes, among community dwelling older adults, is difficult. The Risk Instrument for Screening in the Community (RISC) is a short (2-5 min), global subjective assessment of risk created to identify patients' 1-year risk of three outcomes: institutionalisation, hospitalisation and death. METHODS: We compared the accuracy and predictive ability of the RISC, scored by Public Health Nurses (PHN), to the Clinical Frailty Scale (CFS) in a prospective cohort study of community dwelling older adults (n = 803), in two Irish PHN sectors. The area under the curve (AUC), from receiver operating characteristic curves and binary logistic regression models, with odds ratios (OR), compared the discriminatory characteristics of the RISC and CFS. RESULTS: Follow-up data were available for 801 patients. The 1-year incidence of institutionalisation, hospitalisation and death were 10.2, 17.7 and 15.6 % respectively. Patients scored maximum-risk (RISC score 3,4 or 5/5) at baseline had a significantly greater rate of institutionalisation (31.3 and 7.1 %, p < 0.001), hospitalisation (25.4 and 13.2 %, p < 0.001) and death (33.5 and 10.8 %, p < 0.001), than those scored minimum-risk (score 1 or 2/5). The RISC had comparable accuracy for 1-year risk of institutionalisation (AUC of 0.70 versus 0.63), hospitalisation (AUC 0.61 versus 0.55), and death (AUC 0.70 versus 0.67), to the CFS. The RISC significantly added to the predictive accuracy of the regression model for institutionalisation (OR 1.43, p = 0.01), hospitalisation (OR 1.28, p = 0.01), and death (OR 1.58, p = 0.001). CONCLUSION: Follow-up outcomes matched well with baseline risk. The RISC, a short global subjective assessment, demonstrated satisfactory validity compared with the CFS. en
dc.description.sponsorship en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Biomed Central Ltd. en
dc.rights © 2015 O'Caoimh et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http:// creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. en
dc.rights.uri http://creativecommons.org/licenses/by/4.0/ en
dc.subject Screening en
dc.subject Frailty en
dc.subject Risk en
dc.subject Adverse outcomes en
dc.subject Risk Instrument for Screening in the Community (RISC) en
dc.subject Clinical Frailty Scale (CFS) en
dc.subject Public health nurses (PHNs) en
dc.subject Elderly people en
dc.subject Prognostic significance en
dc.subject Surprise question en
dc.subject Frailty en
dc.subject Mortality en
dc.subject Decline en
dc.title The Risk Instrument for Screening in the Community (RISC): a new instrument for predicting risk of adverse outcomes in community dwelling older adults en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother D. William Molloy, Centre for Gerontology and Rehabilitation, University College Cork, Cork, Ireland. +353-21-492-3311 Email: w.molloy@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.contributor.funder Health Service Executive, Ireland
dc.description.status Peer reviewed en
dc.identifier.journaltitle BMC Geriatrics en
dc.internal.copyrightchecked Open Access articles licensed via CC-BY 4.0 with UCC affiliated authors. Uploaded Jan 2016. en
dc.internal.IRISemailaddress w.molloy@ucc.ie en
dc.identifier.articleid 92


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© 2015 O'Caoimh et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http:// creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Except where otherwise noted, this item's license is described as © 2015 O'Caoimh et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http:// creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
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