assessing predictive validity of pressure ulcer risk scales- a sys-tematic review and meta-analysis

pressure ulcer sensitivity specificity meta analysis background the purpose of this study was to present a scientific reason for pressure ulcer risk scales cubbin& jackson modified braden norton and waterlow as a nursing diagnosis tool by utilizing predictive validity of pressure sores. methods articles published between 1966 and 2013 from periodicals indexed in the ovid medline embase cinahl koreamed ndsl and other databases were selected using the key word “pressure ulcer”. quadas ⅱ was applied for assessment for internal validity of the diagnostic studies. selected studies were analyzed using meta analysis with metadisc 1.4. results seventeen diagnostic studies with high methodological quality involving 5 185 patients were included. in the results of the meta analysis sroc auc of braden norton and waterflow scale was over 0.7 showing moderate predictive validity but they have limited interpretation due to significant differences between studies. in addition waterlow scale is insufficient as a screening tool owing to low sensitivity compared with other scales. conclusion the contemporary pressure ulcer risk scale is not suitable for uninform practice on patients under standardized criteria. therefore in order to provide more effective nursing care for bedsores a new or modified pressure ulcer risk scale should be developed upon strength and weaknesses of existing tools.