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

doi:10.3390/ijerph19031380

. 2022 Jan 26;19(3):1380.

doi: 10.3390/ijerph19031380.

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

Elizabeth Moloney^{1

2}, Duygu Sezgin³, Mark O'Donovan¹, Kadjo Yves Cedric Adja⁴, Keith McGrath², Aaron Liew^{5

6}, Jacopo Lenzi⁴, Davide Gori⁴, Kieran O'Connor², David William Molloy^{2

7}, Evelyn Flanagan¹, Darren McLoughlin⁸, Maria Pia Fantini⁴, Suzanne Timmons⁷, Rónán O'Caoimh^{1

2}

Affiliations

¹ Health Research Board Clinical Research Facility, Mercy University Hospital, T12 WE28 Cork, Ireland.
² Department of Geriatric Medicine, Mercy University Hospital, T12 WE28 Cork, Ireland.
³ School of Nursing and Midwifery, College of Medicine, Nursing and Health Sciences, National University of Ireland, H92 N2R2 Galway, Ireland.
⁴ Department of Biomedical & Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy.
⁵ Clinical Sciences Institute, National University of Ireland, H91 TK33 Galway, Ireland.
⁶ Department of Endocrinology, Portiuncula University Hospital, H53 T971 Galway, Ireland.
⁷ Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, T12 WE28 Cork, Ireland.
⁸ Department of Emergency Medicine, Mercy University Hospital, T12 WE28 Cork, Ireland.

PMID: 35162397
PMCID: PMC8834939
DOI: 10.3390/ijerph19031380

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

Elizabeth Moloney et al. Int J Environ Res Public Health. 2022.

. 2022 Jan 26;19(3):1380.

doi: 10.3390/ijerph19031380.

Authors

Affiliations

¹ Health Research Board Clinical Research Facility, Mercy University Hospital, T12 WE28 Cork, Ireland.
² Department of Geriatric Medicine, Mercy University Hospital, T12 WE28 Cork, Ireland.
³ School of Nursing and Midwifery, College of Medicine, Nursing and Health Sciences, National University of Ireland, H92 N2R2 Galway, Ireland.
⁴ Department of Biomedical & Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy.
⁵ Clinical Sciences Institute, National University of Ireland, H91 TK33 Galway, Ireland.
⁶ Department of Endocrinology, Portiuncula University Hospital, H53 T971 Galway, Ireland.
⁷ Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, T12 WE28 Cork, Ireland.
⁸ Department of Emergency Medicine, Mercy University Hospital, T12 WE28 Cork, Ireland.

PMID: 35162397
PMCID: PMC8834939
DOI: 10.3390/ijerph19031380

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.

Keywords: diagnostic accuracy; emergency department; frailty; frailty screening tools; older adult; systematic review.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
Example of the PRISMA flow diagram to be used in this study.

See this image and copyright information in PMC

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Moloney E, O'Donovan MR, Carpenter CR, Salvi F, Dent E, Mooijaart S, Hoogendijk EO, Woo J, Morley J, Hubbard RE, Cesari M, Ahern E, Romero-Ortuno R, Mcnamara R, O'Keefe A, Healy A, Heeren P, Mcloughlin D, Deasy C, Martin L, Brousseau AA, Sezgin D, Bernard P, Mcloughlin K, Sri-On J, Melady D, Edge L, O'Shaughnessy I, Van Damme J, Cardona M, Kirby J, Southerland L, Costa A, Sinclair D, Maxwell C, Doyle M, Lewis E, Corcoran G, Eagles D, Dockery F, Conroy S, Timmons S, O'Caoimh R. Moloney E, et al. Age Ageing. 2024 Feb 1;53(2):afae013. doi: 10.1093/ageing/afae013. Age Ageing. 2024. PMID: 38369629 Free PMC article.
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References

1. Wan H., Goodkind D., Kowal P. An Aging World: 2015. United States Census Bureau; Washington, DC, USA: 2016. [(accessed on 21 March 2021)]. Available online: https://www.census.gov/content/dam/Census/library/publications/2016/demo....
1. Beard J., Carvalho I., Sumi Y., Officer A. Healthy Ageing Moving Forward. Bull. World Health Org. 2017;95:730. doi: 10.2471/BLT.17.203745. - DOI - PMC - PubMed
1. Lowthian J., Curtis A., Stoelwinder J., Mcneil J., Cameron P. Emergency demand and repeat attendances by older patients. Intern. Med. J. 2013;43:554–560. doi: 10.1111/imj.12061. - DOI - PubMed
1. Clegg A., Young J., Iliffe S., Rikkert M.O., Rockwood K. Frailty in elderly people. Lancet. 2013;381:752. doi: 10.1016/S0140-6736(12)62167-9. - DOI - PMC - PubMed
1. Adja K.Y.C., Lenzi J., Sezgin D., O’Caoimh R., Morini M., Damiani G., Buja A., Fantini M.P. The Importance of Taking a Patient-Centered, Community-Based Approach to Preventing and Managing Frailty: A Public Health Perspective. Front. Public Health. 2020;8:599170. doi: 10.3389/fpubh.2020.599170. - DOI - PMC - PubMed

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[1] Wan H., Goodkind D., Kowal P. An Aging World: 2015. United States Census Bureau; Washington, DC, USA: 2016. [(accessed on 21 March 2021)]. Available online: https://www.census.gov/content/dam/Census/library/publications/2016/demo....

[2] Wan H., Goodkind D., Kowal P. An Aging World: 2015. United States Census Bureau; Washington, DC, USA: 2016. [(accessed on 21 March 2021)]. Available online: https://www.census.gov/content/dam/Census/library/publications/2016/demo....

[3] Beard J., Carvalho I., Sumi Y., Officer A. Healthy Ageing Moving Forward. Bull. World Health Org. 2017;95:730. doi: 10.2471/BLT.17.203745. - DOI - PMC - PubMed

[4] Beard J., Carvalho I., Sumi Y., Officer A. Healthy Ageing Moving Forward. Bull. World Health Org. 2017;95:730. doi: 10.2471/BLT.17.203745. - DOI - PMC - PubMed

[5] Lowthian J., Curtis A., Stoelwinder J., Mcneil J., Cameron P. Emergency demand and repeat attendances by older patients. Intern. Med. J. 2013;43:554–560. doi: 10.1111/imj.12061. - DOI - PubMed

[6] Lowthian J., Curtis A., Stoelwinder J., Mcneil J., Cameron P. Emergency demand and repeat attendances by older patients. Intern. Med. J. 2013;43:554–560. doi: 10.1111/imj.12061. - DOI - PubMed

[7] Clegg A., Young J., Iliffe S., Rikkert M.O., Rockwood K. Frailty in elderly people. Lancet. 2013;381:752. doi: 10.1016/S0140-6736(12)62167-9. - DOI - PMC - PubMed

[8] Clegg A., Young J., Iliffe S., Rikkert M.O., Rockwood K. Frailty in elderly people. Lancet. 2013;381:752. doi: 10.1016/S0140-6736(12)62167-9. - DOI - PMC - PubMed

[9] Adja K.Y.C., Lenzi J., Sezgin D., O’Caoimh R., Morini M., Damiani G., Buja A., Fantini M.P. The Importance of Taking a Patient-Centered, Community-Based Approach to Preventing and Managing Frailty: A Public Health Perspective. Front. Public Health. 2020;8:599170. doi: 10.3389/fpubh.2020.599170. - DOI - PMC - PubMed

[10] Adja K.Y.C., Lenzi J., Sezgin D., O’Caoimh R., Morini M., Damiani G., Buja A., Fantini M.P. The Importance of Taking a Patient-Centered, Community-Based Approach to Preventing and Managing Frailty: A Public Health Perspective. Front. Public Health. 2020;8:599170. doi: 10.3389/fpubh.2020.599170. - DOI - PMC - PubMed

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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

Affiliations

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

Authors

Affiliations

Abstract

Conflict of interest statement

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