Cargando…
Diagnostic Accuracy of Frailty Screening Instruments Validated for Use among Older Adults Attending Emergency Departments: A Systematic Review and Meta-Analysis
Early identification of frailty can prevent functional decline. Although multiple frailty screens exist for use in Emergency Departments (EDs), few are validated against diagnostic standards such as comprehensive geriatric assessment. To examine the diagnostic accuracy of ED screens for frailty, sci...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10341387/ https://www.ncbi.nlm.nih.gov/pubmed/37444127 http://dx.doi.org/10.3390/ijerph20136280 |
_version_ | 1785072249769820160 |
---|---|
author | Moloney, Elizabeth O’Donovan, Mark R. Sezgin, Duygu Flanagan, Evelyn McGrath, Keith Timmons, Suzanne O’Caoimh, Rónán |
author_facet | Moloney, Elizabeth O’Donovan, Mark R. Sezgin, Duygu Flanagan, Evelyn McGrath, Keith Timmons, Suzanne O’Caoimh, Rónán |
author_sort | Moloney, Elizabeth |
collection | PubMed |
description | Early identification of frailty can prevent functional decline. Although multiple frailty screens exist for use in Emergency Departments (EDs), few are validated against diagnostic standards such as comprehensive geriatric assessment. To examine the diagnostic accuracy of ED screens for frailty, scientific databases were searched for prospective diagnostic accuracy test studies from January 2000 to September 2022. Studies were assessed for risk of bias using QUADAS-C. Psychometric properties were extracted and analysed using R. Six studies involving 1,663 participants describing seven frailty screening instruments (PRISMA-7, CFS, VIP, FRESH, BPQ, TRST, and ISAR), representing 13 unique data points, were included. The mean age of participants ranged from 76 to 86 years. The proportion that was female ranged from 45 to 60%. The pooled prevalence rate of frailty was high at 59%. The pooled estimate for sensitivity was 0.85 (95% CI: 0.76–0.91) versus 0.77 (95% CI: 0.62–0.88) for specificity. Pooled accuracy based on area under the ROC curve was 0.89 (95% CI: 0.86–0.90). Although few studies were found, limiting the ability to conduct a meta-analysis of individual instruments, available frailty screens can accurately diagnose frailty in older adults attending the ED. As specificity was comparatively low, additional assessment may be required to identify those requiring inpatient management or onward community referral. Further study is therefore required. |
format | Online Article Text |
id | pubmed-10341387 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-103413872023-07-14 Diagnostic Accuracy of Frailty Screening Instruments Validated for Use among Older Adults Attending Emergency Departments: A Systematic Review and Meta-Analysis Moloney, Elizabeth O’Donovan, Mark R. Sezgin, Duygu Flanagan, Evelyn McGrath, Keith Timmons, Suzanne O’Caoimh, Rónán Int J Environ Res Public Health Review Early identification of frailty can prevent functional decline. Although multiple frailty screens exist for use in Emergency Departments (EDs), few are validated against diagnostic standards such as comprehensive geriatric assessment. To examine the diagnostic accuracy of ED screens for frailty, scientific databases were searched for prospective diagnostic accuracy test studies from January 2000 to September 2022. Studies were assessed for risk of bias using QUADAS-C. Psychometric properties were extracted and analysed using R. Six studies involving 1,663 participants describing seven frailty screening instruments (PRISMA-7, CFS, VIP, FRESH, BPQ, TRST, and ISAR), representing 13 unique data points, were included. The mean age of participants ranged from 76 to 86 years. The proportion that was female ranged from 45 to 60%. The pooled prevalence rate of frailty was high at 59%. The pooled estimate for sensitivity was 0.85 (95% CI: 0.76–0.91) versus 0.77 (95% CI: 0.62–0.88) for specificity. Pooled accuracy based on area under the ROC curve was 0.89 (95% CI: 0.86–0.90). Although few studies were found, limiting the ability to conduct a meta-analysis of individual instruments, available frailty screens can accurately diagnose frailty in older adults attending the ED. As specificity was comparatively low, additional assessment may be required to identify those requiring inpatient management or onward community referral. Further study is therefore required. MDPI 2023-07-03 /pmc/articles/PMC10341387/ /pubmed/37444127 http://dx.doi.org/10.3390/ijerph20136280 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Moloney, Elizabeth O’Donovan, Mark R. Sezgin, Duygu Flanagan, Evelyn McGrath, Keith Timmons, Suzanne O’Caoimh, Rónán Diagnostic Accuracy of Frailty Screening Instruments Validated for Use among Older Adults Attending Emergency Departments: A Systematic Review and Meta-Analysis |
title | Diagnostic Accuracy of Frailty Screening Instruments Validated for Use among Older Adults Attending Emergency Departments: A Systematic Review and Meta-Analysis |
title_full | Diagnostic Accuracy of Frailty Screening Instruments Validated for Use among Older Adults Attending Emergency Departments: A Systematic Review and Meta-Analysis |
title_fullStr | Diagnostic Accuracy of Frailty Screening Instruments Validated for Use among Older Adults Attending Emergency Departments: A Systematic Review and Meta-Analysis |
title_full_unstemmed | Diagnostic Accuracy of Frailty Screening Instruments Validated for Use among Older Adults Attending Emergency Departments: A Systematic Review and Meta-Analysis |
title_short | Diagnostic Accuracy of Frailty Screening Instruments Validated for Use among Older Adults Attending Emergency Departments: A Systematic Review and Meta-Analysis |
title_sort | diagnostic accuracy of frailty screening instruments validated for use among older adults attending emergency departments: a systematic review and meta-analysis |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10341387/ https://www.ncbi.nlm.nih.gov/pubmed/37444127 http://dx.doi.org/10.3390/ijerph20136280 |
work_keys_str_mv | AT moloneyelizabeth diagnosticaccuracyoffrailtyscreeninginstrumentsvalidatedforuseamongolderadultsattendingemergencydepartmentsasystematicreviewandmetaanalysis AT odonovanmarkr diagnosticaccuracyoffrailtyscreeninginstrumentsvalidatedforuseamongolderadultsattendingemergencydepartmentsasystematicreviewandmetaanalysis AT sezginduygu diagnosticaccuracyoffrailtyscreeninginstrumentsvalidatedforuseamongolderadultsattendingemergencydepartmentsasystematicreviewandmetaanalysis AT flanaganevelyn diagnosticaccuracyoffrailtyscreeninginstrumentsvalidatedforuseamongolderadultsattendingemergencydepartmentsasystematicreviewandmetaanalysis AT mcgrathkeith diagnosticaccuracyoffrailtyscreeninginstrumentsvalidatedforuseamongolderadultsattendingemergencydepartmentsasystematicreviewandmetaanalysis AT timmonssuzanne diagnosticaccuracyoffrailtyscreeninginstrumentsvalidatedforuseamongolderadultsattendingemergencydepartmentsasystematicreviewandmetaanalysis AT ocaoimhronan diagnosticaccuracyoffrailtyscreeninginstrumentsvalidatedforuseamongolderadultsattendingemergencydepartmentsasystematicreviewandmetaanalysis |