1. The Diagnostic Accuracy and Clinimetric Properties of Screening Instruments to Identify Frail Older Adults Attending Emergency Departments: A Protocol for a Mixed Methods Systematic Review and Meta-Analysis
- Author
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Elizabeth Moloney, Duygu Sezgin, Mark O’Donovan, Kadjo Yves Cedric Adja, Keith McGrath, Aaron Liew, Jacopo Lenzi, Davide Gori, Kieran O’Connor, David William Molloy, Evelyn Flanagan, Darren McLoughlin, Maria Pia Fantini, Suzanne Timmons, Rónán O’Caoimh, Moloney E., Sezgin D., O'donovan M., Adja K.Y.C., McGrath K., Liew A., Lenzi J., Gori D., O'connor K., Molloy D.W., Flanagan E., McLoughlin D., Fantini M.P., Timmons S., and O'caoimh R.
- Subjects
emergency department ,Frailty ,frailty screening tools ,Health, Toxicology and Mutagenesis ,Frail Elderly ,Public Health, Environmental and Occupational Health ,Frailty screening tool ,Middle Aged ,older adult ,systematic review ,Meta-Analysis as Topic ,Medicine ,Humans ,Mass Screening ,diagnostic accuracy ,Emergency Service, Hospital ,Geriatric Assessment ,Aged ,Systematic Reviews as Topic - Abstract
Background: Prompt and efficient identification and stratification of patients who are frail is important, as this cohort are at high risk of adverse healthcare outcomes. Numerous frailty screening tools have been developed to support their identification across different settings, yet relatively few have emerged for use in emergency departments (EDs). This protocol provides details for a systematic review aiming to synthesize the accumulated evidence regarding the diagnostic accuracy and clinimetric properties of frailty screening instruments to identify frail older adults in EDs. Methods: Six electronic databases will be searched from January 2000 to March 2021. Eligible studies will include adults aged ≥60 years screened in EDs with any available screening instrument to identify frailty (even if not originally designed for this purpose). Studies, including case-control, longitudinal, and cohort studies, will be included, where instruments are compared to a reference standard to explore diagnostic accuracy. Predictive accuracy for a selection of outcomes, including mortality, institutionalization, and readmission, will be assessed. Clinical and methodological heterogeneity will be examined, and a random effects meta-analysis performed if appropriate. Conclusion: Understanding whether frailty screening on presentation to EDs is accurate in identifying frailty, and predicting these outcomes is important for decision-making and targeting appropriate management.
- Published
- 2021