Predictive validity of the braden scale for pressure injury risk assessment in adults: A systematic review and meta-analysis.
Can Huang, Yuxia Ma, Chenxia Wang and 4 others
PMID 33630407WHAT IT FOUND
The Braden Scale flagged 78% of adults who later developed pressure injuries and correctly cleared 72% who did not.
Cut-off values ranged from 10 to 20; the authors recommended 18, but accuracy varied by setting, age and ethnicity.
Key findings
01The Braden Scale flagged 78% of adults who later developed pressure injuries and correctly cleared 72% of those who did not.
02The pooled summary accuracy was 0.82, which the paper's thresholds classify as moderate.
03Subgroup results were lower in long-term care (AUC 0.77) than hospital (0.82), lower in adults 60 or older (0.81) than under 60 (0.87), and lower in Asian (0.82) than Caucasian populations (0.86).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The studies were very heterogeneous, with I2 of 96.10% for sensitivity and 99.17% for specificity. Different cut-off values from 10 to 20 were used, which may explain the inconsistency. Deeks' funnel plot was not fully symmetrical, so publication bias may exist. Only English and Chinese studies were included. The cut-off value of 16 was found in only 4 original studies, so that subgroup has limited interpretation. The optimal cut-off for every clinical setting was not established. Only 11 studies had low risk of bias in patient selection.
Declared interests
The authors declared no conflict of interest. The work was funded by the Natural Science Foundation of Gansu Province.
The easy way to misread this
Do not treat the Braden Scale as a perfect pressure injury screen. It flagged 78% of adults who later developed pressure injuries, so it missed some, and accuracy varied by setting, age and ethnicity. The cut-off of 18 was a pooled recommendation, and the paper says the optimal value for each setting was unknown.