Seong-Hi Park; Yu-Sun Park

doi:10.4040/jkan.2014.44.6.595

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Review Article
Predictive Validity of the Braden Scale for Pressure Ulcer Risk: A Meta-analysis: Seong-Hi Park, Yu-Sun Park; Journal of Korean Academy of Nursing 2014;44(6):595-607.
DOI: https://doi.org/10.4040/jkan.2014.44.6.595
Published online: December 31, 2014

¹School of Nursing, Pai Chai University, Daejeon, Korea.

²Quality Improvement Team, Korea University Ansan Hospital, Ansan, Korea.

Address reprint requests to: Park, Yu-Sun. Quality Improvement Team, Korea University Ansan Hospital, 123 Jeokgeum-ro, Danwon-gu, Ansan 425-707, Korea. Tel: +82-31-412-5577, Fax: +82-31-412-6813, ssun104@hotmail.com

• Received: July 28, 2014 • Revised: August 21, 2014 • Accepted: November 10, 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0/) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

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Abstract
REFERENCES
Appendix

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: Pressure sore; Sensitivity; Specificity; Meta-analysis

REFERENCES

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Appendix

APPENDIX

38 selected studies in meta-analysis

Figure 1

Flow diagram of article selection.

Figure 2

Diagnosis test accuracy of Braden scale in total selected studies.

Table 1

Characteristics of Selected Studies

^*Year of publication; PUs=Pressure ulcer; TP=True positive; FP=False positive; FN=False negative; TN=True negative; SN=Sensitivity; SP=Specificity; PLR=Positive likelihood ratio; NLR=Negative likelihood ratio; DOR=Diagnosis odds ratio; R=Retrospective; P=Prospective; ICU=Intensive care unit; OS=Orthopedic surgery; SICU=Surgical intensive care unit; ICD-9=International Classification of Diseases-9; LTCF=Long term care facilities; NPUAP=National Pressure Ulcer Advisory Panel; AHCPR=Agency for Health Care Policy and Research; TDCPS=Torrence Developmental Classification of Pressure Sore.

Table 2

Summary Results of Meta Analysis

ROC curve=Receiver operating characteristic curve; AUC=Area under the curve; SE=Standard error; M=Male; F=Female; ICU=Intensive care unit; LTCF=Long term care facilities; NPUAP=National pressure ulcer advisory panel; AHCPR=Agency for health care policy and research; ICD-9=International Classification of Diseases-9.

Figure & Data

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