Diagnostic test accuracy of screening tools for the detection of neurocognitive disorders in older adults post-trauma: A protocol for a systematic review.

HRB open research Pub Date : 2024-09-03 eCollection Date: 2024-01-01 DOI:10.12688/hrbopenres.13894.2
Niamh A Merriman, Mary E Walsh, Niamh O'Regan, Marie Carrigan, Pamela Hickey, Louise Brent, Catherine Blake
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Abstract

Background: Neurocognitive disorders (NCDs), including delirium, cognitive impairment, or dementia are prevalent in up to 39% of older adults in acute care, particularly older trauma patients. Undiagnosed NCDs result in poor outcomes, such as increased incidence of depressive symptoms, longer length of stay, and mortality.

Objective: This study aims to identify the diagnostic test accuracy of screening tools for the detection of NCDs in older trauma patients in acute settings.

Design: Systematic review protocol.

Literature search: Electronic databases (MEDLINE, Embase, CINAHL, PsycInfo, Cochrane Library) will be searched for journal articles. Search terms related to NCDs, delirium and cognitive screening tools, and diagnostic accuracy will be included.

Study selection criteria: Cross-sectional, prospective, or retrospective cohort studies of adults aged ≥60 post-trauma, in an acute setting, will be included where the study aimed to validate a screening tool for detection of 1) delirium or 2) cognitive impairment, or dementia against a reference standard of a clinical decision, based on standardised diagnostic criteria or a validated tool.

Data synthesis: Two review authors will conduct study selection, data extraction, and appraisal. Data will be extracted based on the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) checklist. Studies will be assessed for methodological quality by two independent review authors using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Narrative summaries will be generated describing risk of bias and concerns regarding applicability. Quantitative synthesis of study findings will be conducted.

Conclusion: This systematic review will aim to identify screening tools with the best diagnostic accuracy for detection of 1) delirium and 2) cognitive impairment or dementia in adults aged ≥60 post-trauma in acute care settings. Results will inform clinical practice to enhance the probability of patients with NCDs receiving appropriate care and management.

Registration: PROSPERO https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024518730 (11/03/2024).

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用于检测创伤后老年人神经认知障碍的筛查工具的诊断测试准确性:系统综述方案。
背景:神经认知障碍(NCD),包括谵妄、认知障碍或痴呆,在接受急症护理的老年人,尤其是老年创伤患者中的发病率高达 39%。未确诊的 NCD 会导致不良后果,如抑郁症状发生率增加、住院时间延长和死亡率上升:本研究旨在确定筛查工具的诊断测试准确性,以检测急性环境下老年创伤患者的非传染性疾病:设计:系统综述方案:将在电子数据库(MEDLINE、Embase、CINAHL、PsycInfo、Cochrane Library)中搜索期刊论文。研究选择标准:将纳入在急性环境中对创伤后年龄≥60 岁的成人进行的横断面、前瞻性或回顾性队列研究,研究的目的是根据标准化诊断标准或经验证的工具,对照临床决定的参考标准,验证用于检测 1) 谵妄或 2) 认知障碍或痴呆的筛查工具:两位综述作者将进行研究选择、数据提取和评估。将根据诊断测试准确性研究系统综述和荟萃分析首选报告项目(PRISMA-DTA)清单提取数据。两位独立的综述作者将使用诊断准确性研究质量评估(QUADAS-2)工具对研究进行方法学质量评估。将生成叙述性摘要,说明偏倚风险和适用性方面的问题。将对研究结果进行定量综合:本系统性综述旨在确定具有最佳诊断准确性的筛查工具,以检测急性护理环境中创伤后年龄≥60 岁的成人中的 1) 谵妄和 2) 认知障碍或痴呆。结果将为临床实践提供参考,以提高非传染性疾病患者接受适当护理和管理的概率:prospero https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024518730 (11/03/2024).
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