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Diagnostic and predictive accuracy of the Clinical Frailty Scale among hospitalised older medical patients: a systematic review and meta-analysis protocol
INTRODUCTION: Frailty is a common condition affecting older adults and is associated with increased mortality and adverse outcomes. Identification of older adults at risk of adverse outcomes is central to subsequent resource planning and targeted interventions. This systematic review and meta-analys...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7818826/ https://www.ncbi.nlm.nih.gov/pubmed/33472780 http://dx.doi.org/10.1136/bmjopen-2020-040765 |
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author | Leahy, Aoife O’Connor, Margaret Condon, Jennifer Heywood, Sarah Shanahan, Elaine Peters, Catherine Galvin, Rose |
author_facet | Leahy, Aoife O’Connor, Margaret Condon, Jennifer Heywood, Sarah Shanahan, Elaine Peters, Catherine Galvin, Rose |
author_sort | Leahy, Aoife |
collection | PubMed |
description | INTRODUCTION: Frailty is a common condition affecting older adults and is associated with increased mortality and adverse outcomes. Identification of older adults at risk of adverse outcomes is central to subsequent resource planning and targeted interventions. This systematic review and meta-analysis will examine the: (1) diagnostic accuracy of the Clinical Frailty Scale (CFS) in identifying hospitalised adults ≥65 years with frailty and a medical diagnosis compared with the reference standard Frailty Index or Frailty Phenotype and (2) predictive value of the CFS in determining those at increased risk of subsequent adverse outcomes. METHODS AND ANALYSIS: We will include cross-sectional, retrospective and prospective cohort studies, and randomised controlled trials that assess either the diagnostic accuracy of the CFS when compared with the reference standard Frailty Index/Frailty Phenotype or the predictive validity of the CFS to predict subsequent adverse outcomes in hospitalised adults over 65 years with medical complaints. Adverse outcomes include falls, functional decline, unplanned Emergency Department attendance, emergency rehospitalisation, nursing home admission or death. A systematic search will be conducted in Embase, AMED, MEDLINE (Ebsco, Ovid, Pubmed), CINAHL, PsycINFO, Cochrane Library. Studies will be limited to those published from 2005 to 30 October 2019. Two independent reviewers will screen all titles and abstracts to identify relevant studies. The methodological quality of studies will be independently assessed using the Quality Assessment of Diagnostic Accuracy Studies-2. A CFS score of >4 will be used to identify frailty. We will construct 2×2 tables and determine true positives, true negatives, false positives and false negatives for each study when compared with the reference standard and for each adverse outcome. A bivariate random effects model will be applied to generate pooled summary estimates of sensitivity and specificity. ETHICS AND DISSEMINATION: Ethical approval is not required for this systematic review. We will disseminate our findings through a peer-reviewed journal. |
format | Online Article Text |
id | pubmed-7818826 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-78188262021-01-25 Diagnostic and predictive accuracy of the Clinical Frailty Scale among hospitalised older medical patients: a systematic review and meta-analysis protocol Leahy, Aoife O’Connor, Margaret Condon, Jennifer Heywood, Sarah Shanahan, Elaine Peters, Catherine Galvin, Rose BMJ Open Geriatric Medicine INTRODUCTION: Frailty is a common condition affecting older adults and is associated with increased mortality and adverse outcomes. Identification of older adults at risk of adverse outcomes is central to subsequent resource planning and targeted interventions. This systematic review and meta-analysis will examine the: (1) diagnostic accuracy of the Clinical Frailty Scale (CFS) in identifying hospitalised adults ≥65 years with frailty and a medical diagnosis compared with the reference standard Frailty Index or Frailty Phenotype and (2) predictive value of the CFS in determining those at increased risk of subsequent adverse outcomes. METHODS AND ANALYSIS: We will include cross-sectional, retrospective and prospective cohort studies, and randomised controlled trials that assess either the diagnostic accuracy of the CFS when compared with the reference standard Frailty Index/Frailty Phenotype or the predictive validity of the CFS to predict subsequent adverse outcomes in hospitalised adults over 65 years with medical complaints. Adverse outcomes include falls, functional decline, unplanned Emergency Department attendance, emergency rehospitalisation, nursing home admission or death. A systematic search will be conducted in Embase, AMED, MEDLINE (Ebsco, Ovid, Pubmed), CINAHL, PsycINFO, Cochrane Library. Studies will be limited to those published from 2005 to 30 October 2019. Two independent reviewers will screen all titles and abstracts to identify relevant studies. The methodological quality of studies will be independently assessed using the Quality Assessment of Diagnostic Accuracy Studies-2. A CFS score of >4 will be used to identify frailty. We will construct 2×2 tables and determine true positives, true negatives, false positives and false negatives for each study when compared with the reference standard and for each adverse outcome. A bivariate random effects model will be applied to generate pooled summary estimates of sensitivity and specificity. ETHICS AND DISSEMINATION: Ethical approval is not required for this systematic review. We will disseminate our findings through a peer-reviewed journal. BMJ Publishing Group 2021-01-20 /pmc/articles/PMC7818826/ /pubmed/33472780 http://dx.doi.org/10.1136/bmjopen-2020-040765 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Geriatric Medicine Leahy, Aoife O’Connor, Margaret Condon, Jennifer Heywood, Sarah Shanahan, Elaine Peters, Catherine Galvin, Rose Diagnostic and predictive accuracy of the Clinical Frailty Scale among hospitalised older medical patients: a systematic review and meta-analysis protocol |
title | Diagnostic and predictive accuracy of the Clinical Frailty Scale among hospitalised older medical patients: a systematic review and meta-analysis protocol |
title_full | Diagnostic and predictive accuracy of the Clinical Frailty Scale among hospitalised older medical patients: a systematic review and meta-analysis protocol |
title_fullStr | Diagnostic and predictive accuracy of the Clinical Frailty Scale among hospitalised older medical patients: a systematic review and meta-analysis protocol |
title_full_unstemmed | Diagnostic and predictive accuracy of the Clinical Frailty Scale among hospitalised older medical patients: a systematic review and meta-analysis protocol |
title_short | Diagnostic and predictive accuracy of the Clinical Frailty Scale among hospitalised older medical patients: a systematic review and meta-analysis protocol |
title_sort | diagnostic and predictive accuracy of the clinical frailty scale among hospitalised older medical patients: a systematic review and meta-analysis protocol |
topic | Geriatric Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7818826/ https://www.ncbi.nlm.nih.gov/pubmed/33472780 http://dx.doi.org/10.1136/bmjopen-2020-040765 |
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