Screening instruments for early identification of unmet palliative care needs: a systematic review and meta-analysis

作者：Zhishan Xie, Jinfeng Ding, Jingjing Jiao, Siyuan Tang, Chongmei Huang · 发表于：BMJ Supportive & Palliative Care · 年份：2023 · DOI：10.1136/spcare-2023-004465 · 被引用次数：24 · 研究领域：Palliative Care and End-of-Life Issues、Childhood Cancer Survivors' Quality of Life、Frailty in Older Adults

BACKGROUND: The early detection of individuals who require palliative care is essential for the timely initiation of palliative care services. This systematic review and meta-analysis aimed to (1) Identify the screening instruments used by health professionals to promote early identification of patients who may benefit from palliative care; and (2) Assess the psychometric properties and clinical performance of the instruments. METHODS: A comprehensive literature search was conducted in PubMed, Embase, CINAHL, Scopus, CNKI and Wanfang from inception to May 2023. We used the COnsensus-based Standards for the Selection of Health Measurement INstruments to assess the methodological quality of the development process for the instruments. The clinical performance of the instruments was assessed by narrative summary or meta-analysis. Subgroup analyses were conducted where necessary. The quality of included studies was assessed using the Newcastle-Ottawa Scale and the Cochrane Collaboration's risk of bias assessment tool. RESULTS: We included 31 studies that involved seven instruments. Thirteen studies reported the development and validation process of these instruments and 18 studies related to assessment of clinical performance of these instruments. The content validity of the instruments was doubtful or inadequate because of very low to moderate quality evidence. The pooled sensitivity (Se) ranged from 60.0% to 73.8%, with high heterogeneity (I2 of 88.15% to 99.36%). The pooled sp...