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

Niamh A Merriman; Mary E Walsh; Niamh O'Regan; Marie Carrigan; Pamela Hickey; Louise Brent; Catherine Blake

doi:10.12688/hrbopenres.13894.2

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 Res. 2024 Sep 3:7:33. doi: 10.12688/hrbopenres.13894.2. eCollection 2024.

Authors

Niamh A Merriman¹, Mary E Walsh¹, Niamh O'Regan², Marie Carrigan³, Pamela Hickey⁴, Louise Brent⁴, Catherine Blake¹

Affiliations

¹ School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
² University Hospital Waterford, Waterford, Ireland.
³ Health Information and Quality Authority, Dublin, Ireland.
⁴ National Office of Clinical Audit, Dublin, Ireland.

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).

Keywords: cognition; delirium; diagnostic accuracy; older adults; systematic review protocol.

Grants and funding

This review is funded by the Health Research Board Ireland through the Applying Research into Policy and Practice fellowship (ARPP-2023-002) as part of the larger project entitled “The HipCog Study: evaluating the impact of cognitive impairment on outcomes for older adults with hip fracture”. The funder will have no input on the interpretation or publication of the study results.