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Diagnostic test accuracy of self-reported screening instruments in identifying frailty in community-dwelling older people: A systematic review

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posted on 07.12.2020, 02:01 authored by Rachel AmbagtsheerRachel Ambagtsheer, Mark ThompsonMark Thompson, Mandy Archibald, Mavourneen CaseyMavourneen Casey, Timothy J. Schultz
AIM: Against a backdrop of ageing populations worldwide, it has become increasingly important to identify frailty screening instruments suitable for community settings. Self-reported and/or administered instruments may offer significant simplicity and efficiency advantages over clinician-administered instruments but their comparative diagnostic test accuracy has yet to be systematically examined. The aim of this systematic review was to determine the diagnostic test accuracy of self-reported and/or self-administered frailty screening instruments against two widely accepted frailty reference standards (the Frailty Phenotype and the Frailty Index) within community-dwelling older adult populations.
METHODS:
We conducted a systematic search of the Embase, CINAHL, MEDLINE, PubMed, Web of Science, PEDro, PsycINFO, ProQuest Dissertations, Open Grey and GreyLit databases up to April 2017 (with an updated search conducted over MayJuly 2018) to identify studies reporting comparison of self-reported and/or selfadministered frailty screening instruments against an appropriate reference standard, with a minimum sensitivity threshold of 80% and specificity threshold of 60%.
RESULTS: We identified 24 studies that met our selection criteria. Four self-reported screening instruments across three studies met minimum sensitivity and specificity thresholds. However, in most cases, study design considerations limited the reliability and generalisability of the results. Additionally, metaanalysis was not conducted because no more than three studies were available for any of the unique combinations of index tests and reference standards. CONCLUSIONS: Although our study has demonstrated that a number of self-reported frailty screening instruments reported sensitivity and specificity within a desirable range for community application, additional diagnostic test accuracy studies are needed.

Funding

Frailty Trans-Disciplinary Research To Achieve Healthy Ageing

National Health and Medical Research Council

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2020

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