Risk prediction in the community: A systematic review of case-finding instruments that predict adverse healthcare outcomes in community-dwelling older adults

• Type: Another Publication in an International Scientific Journal
• Date: 2015

Authors

O'Caoimh, R (Author) Other; Cornally, N (Author) Other; Weathers, E (Author) Other; O'Sullivan, R (Author) Other; Fitzgerald, C (Author) Other; Orfila, F (Author) Other; Clarnette, R (Author) Other; Constança Paúl (Author) ICBAS; Molloy, DW (Author) Other

Journal

Title: Maturitas

Vol. 82

Pages: 3-21

ISSN: 0378-5122

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 61 Citations

Scopus - 67 Citations

Other information

Authenticus ID: P-00G-FZX

DOI: 10.1016/j.maturitas.2015.03.009

Abstract (EN): Few case-finding instruments are available to community healthcare professionals. This review aims to identify short, valid instruments that detect older community-dwellers risk of four adverse outcomes: hospitalisation, functional-decline, institutionalisation and death. Data sources included PubMed and the Cochrane library. Data on outcome measures, patient and instrument characteristics, and trial quality (using the Quality In Prognosis Studies [QUIPS] tool), were double-extracted for derivation-validation studies in community-dwelling older adults (>50 years). Forty-six publications, representing 23 unique instruments, were included. Only five were externally validated. Mean patient age range was 64.2-84.6 years. Most instruments n = 18, (78%) were derived in North America from secondary analysis of survey data. The majority n = 12, (52%), measured more than one outcome with hospitalisation and the Probability of Repeated Admission score the most studied outcome and instrument respectively. All instruments incorporated multiple predictors. Activities of daily living n = 16, (70%), was included most often. Accuracy varied according to instruments and outcomes; area under the curve of 0.60-0.73 for hospitalisation, 0.63-0.78 for functional decline, 0.70-0.74 for institutionalisation and 0.56-0.82 for death. The QUIPS tool showed that 5/23 instruments had low potential for bias across all domains. This review highlights the present need to develop short, reliable, valid instruments to case-find older adults at risk in the community. (C) 2015 The Authors. Published by Elsevier Ireland Ltd.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 19