创伤后老年人群神经认知障碍检测筛查工具的诊断测试准确性：一项系统评价方案
Diagnostic test accuracy of screening tools for the detection of neurocognitive disorders in older adults post-trauma: A protocol for a systematic review.
作者信息
Merriman Niamh A, Walsh Mary E, O'Regan Niamh, Carrigan Marie, Hickey Pamela, Brent Louise, Blake Catherine
机构信息
School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
University Hospital Waterford, Waterford, Ireland.
出版信息
HRB Open Res. 2024 Sep 3;7:33. doi: 10.12688/hrbopenres.13894.2. eCollection 2024.
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).
背景
神经认知障碍（NCDs），包括谵妄、认知障碍或痴呆，在急性护理机构中高达39%的老年人中普遍存在，尤其是老年创伤患者。未被诊断出的神经认知障碍会导致不良后果，如抑郁症状发生率增加、住院时间延长和死亡率上升。
目的
本研究旨在确定在急性环境中用于检测老年创伤患者神经认知障碍的筛查工具的诊断测试准确性。
设计
系统评价方案。
文献检索
将检索电子数据库（MEDLINE、Embase、CINAHL、PsycInfo、Cochrane图书馆）中的期刊文章。检索词将包括与神经认知障碍、谵妄和认知筛查工具以及诊断准确性相关的词汇。
研究选择标准
将纳入针对≥60岁创伤后成人在急性环境中的横断面、前瞻性或回顾性队列研究，这些研究旨在基于标准化诊断标准或经过验证的工具，针对临床决策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。
数据合成
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的系统评价和Meta分析的首选报告项目（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）工具对研究的方法学质量进行评估。将生成描述偏倚风险和适用性问题的叙述性总结。将对研究结果进行定量合成。
结论
本系统评价旨在确定在急性护理环境中用于检测≥60岁创伤后成人1）谵妄和2）认知障碍或痴呆的诊断准确性最佳的筛查工具。结果将为临床实践提供参考，以提高神经认知障碍患者接受适当护理和管理的可能性。
注册信息
PROSPERO https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024518730（2024年3月11日）。
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