Accuracy of screening tools for sarcopenia in the elderly in community:a network meta-analysis
Objective To evaluate the diagnostic performance of different screening tools for sarcopenia in the community for the elderly with sarcopenia,and to provide evidence-based support for the accurate screening of elderly patients with sarcopenia.Methods The PubMed,Web of Science,Cochrane Library,Embase,CINAHL,VIP,CBM,and WanFang Data databases were searched by computer,and the relevant research on the diagnosis of sarcopenia in the elderly by publicly published risk screening tools was found.The retrieval time was from inception to June 2023.Two researchers independently screened the literature,extracted data,and evaluated the quality of the included studies,and then data analysis was performed by using Stata 15.1 and Meta Disc 1.4 software.Results A total of 24 studies were included,including 10 961 patients,involving 8 risk screening tools for sarcopenia in the elderly:leg circumference,MSRA-5,MSRA-7,upper arm circumference,ring test,Ishii score,SARC-CalF and SARC-F.Meta-analysis showed that the combined sensitivities of eight screening tools were 0.84(95％CI 0.61 to 1.15),0.82(95％CI 0.48 to 1.38),0.80(95％CI 0.47 to 1.36)and 0.72(95％CI 0.33 to 1.55),0.67(95％CI 0.37 to 1.21),0.63(95％CI 0.33 to 1.19),0.49(95％CI 0.38 to 0.63),0.24(95％CI 0.18 to 0.30),and the combined specificities were 0.39(95％CI 0.18 to 0.82)、0.52(95％CI 0.29 to 0.93)、0.54(95％CI 0.29 to 1.03)、0.62(95％CI 0.49 to 0.79)、0.63(95％CI 0.50 to 0.78).The results of reticular meta-analysis showed that the surface under the cumulative ranking curve(SUCRA)of the eight screening tools ranked from high to low according to the cumulative sensitivity:calf circumference(67.4％)＞MSRA-5(65.3％)＞MSRA-7(64.1％)＞upper arm circumference(54.5％)＞ring test(46.5％)＞Ishii score.The values of specificity SUCRA from highest to lowest were as follows:SARC-F(72.2％)＞SARC-CALF(71.3％)＞Ishii score(60.2％)＞ring test(57.1％)＞upper arm circumference(40.1％)＞lower leg circumference(36.2％)＞MSRA-5.Conclusion The simple screening tool for common sarcopenia has high sensitivity and high specificity,so medical staff can give priority to the combination of the two screening tools,namely SARC-CalF.Due to the limited quantity and quality of the included studies,more high-quality studies are needed to verify the above conclusion.
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