Predictive accuracy of the Braden Q Scale in risk assessment for paediatric pressure ulcer: A meta-analysis.
Yaoji Liao, Guozhen Gao, Lulu Mo
PMID 31406858WHAT IT FOUND
The Braden Q scale in hospitalised children identified 0.73 of those who later developed pressure ulcers and correctly cleared 0.61 of those who did not.
Nurses should use it cautiously, especially for neonates and non-critically ill children.
Key findings
01Across 11 studies of 2508 hospitalised children, the Braden Q scale had pooled sensitivity 0.73 and pooled specificity 0.61.
02The pooled diagnostic odds ratio was 3.47 and the overall weighted AUC was 0.7078 ± 0.0421.
03Most included studies were conducted in intensive care units, and only two focused on all hospitalised children.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
None of the included studies fulfilled all QUADAS-2 quality criteria, and the most frequent risks were in patient selection and index test. The pooled studies had significant heterogeneity, with I2 for the pooled diagnostic odds ratio of 61.7%, and meta-regression did not explain it by country, blinding, or cut-off score. Most evidence came from intensive care units, and no study tested general wards, so accuracy for normally ill children is unclear. The paper states no clear age limitation of the scale was confirmed, and only three studies used a range from 21 days after birth to 8 years. The reference standard was actual pressure ulcer development, and preventive measures may bias sensitivity and specificity estimates. The Braden Q scale does not assess skin breakdown caused by pressure from medical devices. Information from original studies was limited, so variables such as age and enrolment method could not be analysed.
Declared interests
The authors declared no conflicts of interest, and no funding was declared.
The easy way to misread this
Do not read sensitivity 0.73 as proof that the Braden Q scale identifies all children who will develop pressure ulcers. The specificity was 0.61, most studies were intensive care, and the authors advise caution for neonates and non-critically ill children.