Original Study
SARC-F for Screening of Sarcopenia Among Older Adults: A Meta-analysis of Screening Test Accuracy

https://doi.org/10.1016/j.jamda.2018.04.001Get rights and content

Abstract

Objective

To examine the screening ability of SARC-F for older adults using a meta-analysis.

Design

Meta-analysis.

Setting and Participants

The literature review was conducted using MEDLINE, Cochrane Database of Systematic Reviews, and ClinicalTrials.gov. Articles written on and after 1960 that included data regarding the sensitivity and specificity of SARC-F's diagnostic criteria for sarcopenia in older adults were searched.

Measures

The bivariate random effects model was used to calculate the summary estimates of sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR). The summary receiver operating characteristic curve was used to summarize the overall test performance.

Results

Seven studies involving a total of 12,800 subjects met the eligibility criteria of our study. The pooled results of sensitivity, specificity, PLR, NLR, and DOR with the European Working Group on Sarcopenia in Older People as the reference standard were 0.21 [95% confidence interval (CI), 0.13-0.31], 0.90 (95% CI, 0.83-0.94), 2.16 (95% CI, 1.51-3.09), 0.87 (95% CI, 0.80-0.95), and 2.47 (95% CI, 1.64-3.74), respectively. Overall, we achieved similar pooled results of sensitivity and specificity for studies using the International Working Group on Sarcopenia and Asian Working Group for Sarcopenia as the reference standards. Because few studies used the Foundation National Institute of Health reference standards, a meta-analysis was not performed.

Conclusions/Implications

Although the screening sensitivity performance of SARC-F was poor, its specificity was high; thus, it is an effective tool for selecting subjects who should undergo further testing for confirming a diagnosis of sarcopenia.

Section snippets

Study Selection

The literature review consisted of a search of Medline, Cochrane Database of Systematic Reviews, and ClinicalTrials.gov on September 1, 2017, for articles written on or after 1960. Because the term “SARC-F” as an index test was considered very specific, it was assumed that the number of relevant articles would be few. To avoid search omissions, we included terms with wider meanings in addition to “SARC-F.”19 Therefore, the search strategy consisted of {“SARC-F” or [(“elderly” or “aged” or

Description and Methodological Quality of Included Studies

A total of 2055 studies were extracted through the literary search, of which 7 studies (12,800 subjects) met the eligibility criteria for our study and were included in our meta-analysis (Figure 1).13, 14, 15, 16, 17, 18, 23 The characteristics of the 7 studies are displayed in Table 1. The mean age of the patients was 75.1 years, and 61.8% of the subjects were females. The prevalence of sarcopenia was measured using the EWGSOP, IWGS, AWGS, and FNIH criteria, and the prevalence were 11.4%,

Discussion

This study demonstrated low sensitivity when EWGSOP, IWGS, AWGS, or FNIH was used as the reference standard, thereby indicating a low utility of SARC-F for the purpose of excluding sarcopenia. Its specificity however was very high, suggesting its high utility as a screening tool for selecting subjects who should undergo further testing for confirming a diagnosis of sarcopenia. Among the results, the accuracy of SARC-F with IWGS as the reference standard was particularly high compared with the

Acknowledgments

The authors would like to thank the staff members of the Department of Metabolic Diseases at the Ise Red Cross Hospital for their cooperation in this study.

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    The authors declare no conflicts of interest.

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