Abstract
Background: Older adults are at risk of adverse outcomes due to frailty. A number of frailty screening instruments have been developed to identify older adults at increased risk of frailty. This systematic review and meta-analysis will look to examine the diagnostic accuracy of the Program of Research toIntegratethe Services for the Maintenance ofAutonomy 7(PRISMA-7). Methods and analysis: A systematic literature search will be conducted from 2008-February 2020 in PubMed, EMBASE, CINAHL, EBSCO and the Cochrane Library to identify validationstudies of the PRISMA-7 tool. A pre-specified PRISMA-7 score of ≥3 (maximum score 7 points) will be used to identify frailty in older adults. Prospective or retrospective cohort studies, cross-sectional studies and the control arm of randomised controlled trials will be included that attempt to validate the diagnostic accuracy of the PRISMA-7 screening tool in older adults across all healthcare settings when compared to a reference standard. The predictive accuracy of the PRISMA-7 tool will also be explored. Study quality will be assessed by the QUADAS-2 tool. A bivariate random effects model will be used to generate pooled estimates of sensitivity and specificity. Statistical heterogeneity will be explored using validated methods. Ethics and dissemination: Formal ethical approval is not required as primary data will not be collected. The results will be disseminated through a peer-reviewed publication, conference presentation and the popular press. Protocol registration: Awaiting registration with the International Prospective Register for Systematic Reviews (PROSPERO).
Highlights
Global demographic trends suggest that the number of adults aged 65 years or older will more than double by 20501, resulting in an increased burden on healthcare systems and a disproportionate increase in the burden on emergency departments (EDs)
Frailty has recently been defined by a consensus group as a medical syndrome with “multiple causes and contributors which is characterised by diminished strength, endurance, and reduced physiologic function that increases an individual’s vulnerability for developing increased dependency and/or death”[8]
This systematic review aims to synthesise the totality of evidence regarding the diagnostic and predictive accuracy of the PRISMA-7 at identifying frailty in older adults and subsequent risk of adverse outcomes
Summary
Keywords PRISMA-7, Frailty, older adults, diagnostic accuracy, predictive accuracy, sensitivity and specificity, review. Author roles: Higginbotham O: Conceptualization, Data Curation, Investigation, Methodology, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing; O'Neill A: Formal Analysis, Investigation, Validation, Writing – Review & Editing; Barry L: Conceptualization, Writing – Review & Editing; Leahy A: Conceptualization, Writing – Review & Editing; Robinson K: Conceptualization, Writing – Review & Editing; O'Connor M: Conceptualization, Writing – Review & Editing; Galvin R: Conceptualization, Data Curation, Formal Analysis, Funding Acquisition, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Review & Editing.
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