Journal of Korean Academy of Nursing (대한간호학회지)

Korean Society of Nursing Science (한국간호과학회)
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Predictive Validity of the Braden Scale for Pressure Ulcer Risk: A Meta-analysis

Braden 욕창위험사정도구의 예측 타당도 메타분석

  • Park, Seong-Hi (School of Nursing, Pai Chai University) ;
  • Park, Yu-Sun (Quality Improvement Team, Korea University Ansan Hospital)
  • 박성희 (배재대학교 간호학과) ;
  • 박유선 (고려대학교 안산병원 적정진료관리팀)
  • Received : 2014.07.28
  • Accepted : 2014.11.10
  • Published : 2014.12.31
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Abstract

Purpose: The Braden Scale is one of the most intensively studied risk assessment scales used in identifying the risk of developing pressure sore. However, not all studies show that the predictive validity of this scale is sufficient. The purpose of this study was to evaluate the Braden Scale for predicting pressure ulcer development. Methods: Articles published 1946 and 2013 from periodicals indexed in Ovid Medline, Embase, CINAHL, KoreaMed, NDSL and other databases were selected, using the following keywords: 'pressure ulcer'. The QUADAS-II was applied to assess the internal validity of the diagnostic studies. Selected studies were analyzed using meta-analysis with MetaDisc 1.4. Results: Thirty-eight diagnostic studies with high methodological quality, involving 17,934 patients, were included. Results of the meta-analysis showed that the pooled sensitivity and specificity of the Braden Scale were 0.74 (95% CI: 0.72-0.76), 0.75 (95% CI: 0.74-0.76) respectively. However the predictive validity of the Braden Scale has limitation because there was high heterogeneity between studies. Conclusion: The Braden Scale's predictive validity of risk for pressure ulcer is interpreted as at a moderate level. However there is a limitation to the interpretation of the results, because of high heterogeneity among the studies.

Keywords

References

  1. Armstrong DG, Ayello EA, Capitulo KL, Fowler E, Krasner DL, Levine JM, et al. New opportunities to improve pressure ulcer prevention and treatment: Implications of the CMS inpatient hospital care present on admission indicators/hospital-acquired conditions policy: A consensus paper from the international expert wound care advisory panel. Advances in Skin & Wound Care. 2008;21(10):469-478. http://dx.doi.org/10.1097/01.asw.0000323562.52261.40
  2. National Pressure Ulcer Advisory Panel. NPUAP pressure ulcer stages/categories [Internet]. Washington, DC: National Pressure Ulcer Advisory Panel; 2007 [cited 2010 July 12]. Available from: http://www.npuap.org/.
  3. Cowan LJ, Stechmiller JK, Rowe M, Kairalla JA. Enhancing Braden pressure ulcer risk assessment in acutely ill adult veterans. Wound Repair and Regeneration. 2012;20(2):137-148. http://dx.doi.org/10.1111/j.1524-475X.2011.00761.x
  4. The Joint Commission. Strategies for preventing pressure ulcers. Joint Commission Perspectives on Patient Safety. 2008;8(1):5-7.
  5. Vangilder C, Macfarlane GD, Meyer S. Results of nine international pressure ulcer prevalence surveys: 1989 to 2005. Ostomy/Wound Management. 2008;54(2):40-54.
  6. Cho MS, Park IS, Kim GH, Woo KS, Joo YH, Jung EH, et al. Evaluation of predictive validity for the pressure ulcer risk assessment tool in a medical ward inpatient: Using Braden scale. The Korean Nurse. 2004; 43(2):68-82.
  7. Lee JK. The relationship of risk assessment using Braden scale and development of pressure sore in neurologic intensive care unit. Journal of Korean Academy of Adult Nursing. 2003;15(2):267-277.
  8. Song HJ, Kim SM, Kim NC. A study of voiding patterns and pressure ulcer for the residents of long term care facilities. Journal of the Korean Continence Society. 2003;7(2):91-97. https://doi.org/10.5213/jkcs.2003.7.2.91
  9. Lee EJ, Yang SO. Clinical knowledge and actual performance of pressure ulcer care by hospital nurses. Journal of Korean Clinical Nursing Research. 2011;17(2):251-261.
  10. Jeong IS, Kim S, Jeong JS, Hong EY, Lim EY, Seo HJ, et al. Development of pressure ulcer management guideline by adaptation process. Journal of Korean Clinical Nursing Research. 2014;20(1):40-52.
  11. Choi KS, Song MS. Test of predictive validity for the new pressure risk assessment scale. Journal of Korean Academy of Adult Nursing. 1991;3 (1):19-28.
  12. Bergstrom N, Braden BJ, Laguzza A, Holman V. The Braden scale for predicting pressure sore risk. Nursing Research. 1987;36(4):205-210. https://doi.org/10.1097/00006199-198705000-00025
  13. Chou R, Dana T, Bougatsos C, Blazina I, Starmer AJ, Reitel K, et al. Pressure ulcer risk assessment and prevention: A systematic comparative effectiveness review. Annals of Internal Medicine. 2013;159(1):28-38. http://dx.doi.org/10.7326/0003-4819-159-1-201307020-00006
  14. Defloor T, Grypdonck MF. Pressure ulcers: Validation of two risk assessment scales. Journal of Clinical Nursing. 2005;14(3):373-382. http://dx.doi.org/10.1111/j.1365-2702.2004.01058.x
  15. Bergquist S. Subscales, subscores, or summative score: Evaluating the contribution of Braden scale items for predicting pressure ulcer risk in older adults receiving home health care. Journal of Wound, Ostomy, and Continence Nursing. 2001;28(6):279-289.
  16. Suriadi, Sanada H, Sugama J, Thigpen B, Kitagawa A, Kinosita S, et al. A new instrument for predicting pressure ulcer risk in an intensive care unit. Journal of Tissue Viability. 2006;16(3):21-26. https://doi.org/10.1016/S0965-206X(06)63006-4
  17. Jalali R, Rezaie M. Predicting pressure ulcer risk: Comparing the predictive validity of 4 scales. Advances in Skin & Wound Care. 2005;18(2): 92-97. https://doi.org/10.1097/00129334-200503000-00013
  18. Deeks JJ, Bossuyt PM, Gatsonis C, editors. Cochrane handbook for systematic reviews of diagnostic test accuracy version 1.0.0. Oxford, UK: The Cochrane Collaboration 2010.
  19. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Annals of Internal Medicine. 2009;151(4):264-269. https://doi.org/10.7326/0003-4819-151-4-200908180-00135
  20. Whiting PF, Rutjes AW, Westwood ME, Mallett S, Deeks JJ, Reitsma JB, et al. QUADAS-2: A revised tool for the quality assessment of diagnostic accuracy studies. Annals of Internal Medicine. 2011;155(8):529-536. http://dx.doi.org/10.7326/0003-4819-155-8-201110180-00009
  21. Greiner M, Pfeiffer D, Smith RD. Principles and practical application of the receiver-operating characteristic analysis for diagnostic tests. Preventive Veterinary Medicine. 2000;45(1-2):23-41. https://doi.org/10.1016/S0167-5877(00)00115-X
  22. Walter SD. Properties of the summary receiver operating characteristic (SROC) curve for diagnostic test data. Statistics in Medicine. 2002;21(9):1237-1256. http://dx.doi.org/10.1002/sim.1099
  23. Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Statistics in Medicine. 2002;21(11):1539-1558. http://dx.doi.org/10.1002/sim.1186
  24. Song M, Choi KS. Factors predicting development of decubitus ulcers among patients admitted for neurological problems. The Journal of Nurses Academic Society. 1991;21(1):16-26.
  25. Lowthian P. The classification and grading of pressure sores. Care: Science and Practice. 1987;5:5-9.
  26. Knottnerus JA. The evidence base of clinical diagnosis. Park SH, Kang CB, translator. Seoul: E-Public; 2008.
  27. Schoonhoven L, Haalboom JR, Bousema MT, Algra A, Grobbee DE, Grypdonck MH, et al. Prospective cohort study of routine use of risk assessment scales for prediction of pressure ulcers. BMJ: British Medical Journal. 2002;325(7368):797. https://doi.org/10.1136/bmj.325.7368.797
  28. Sousa MR, Ribeiro AL. Systematic review and meta-analysis of diagnostic and prognostic studies: A tutorial. Arquivos Brasileiros de Cardiologia. 2009;92(3):229-238, 235-245.
  29. Moore ZE, Cowman S. Risk assessment tools for the prevention of pressure ulcers. The Cochrane Database of Systematic Reviews. 2008;16(3):CD006471. http://dx.doi.org/10.1002/14651858.CD006471.pub2

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