Diagnostic test accuracy of screening tools for the detection of neurocognitive disorders in older adults post-trauma: a protocol for a systematic review [version 2; peer review: 1 approved, 2 approved with reservations]

<p dir="ltr"><b>Background:</b><b> </b>Neurocognitive disorders (NCDs), including delirium, cognitive impairment, or dementia are prevalent in up to 39% of older adults in acute care, particularly older trauma patients. Undiagnosed NCDs result in poor outcomes, such as increased incidence of depressive symptoms, longer length of stay, and mortality. <p dir="ltr"><b>Objective:</b><b> </b>This study aims to identify the diagnostic test accuracy of screening tools for the detection of NCDs in older trauma patients in acute settings. <p dir="ltr"><b>Design:</b><b> </b>Systematic review protocol. <p dir="ltr"><b>Literature search:</b><b> </b>Electronic databases (MEDLINE, Embase, CINAHL, PsycInfo, Cochrane Library) will be searched for journal articles. Search terms related to NCDs, delirium and cognitive screening tools, and diagnostic accuracy will be included. <p dir="ltr"><b>Study selection criteria:</b><b> </b>Cross-sectional, prospective, or retrospective cohort studies of adults aged ≥60 post-trauma, in an acute setting, will be included where the study aimed to validate a screening tool for detection of 1) delirium or 2) cognitive impairment, or dementia against a reference standard of a clinical decision, based on standardised diagnostic criteria or a validated tool. <p dir="ltr"><b>Data synthesis:</b><b> </b>Two review authors will conduct study selection, data extraction, and appraisal. Data will be extracted based on the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) checklist. Studies will be assessed for methodological quality by two independent review authors using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Narrative summaries will be generated describing risk of bias and concerns regarding applicability. Quantitative synthesis of study findings will be conducted. <p dir="ltr"><b>Conclusion:</b><b> </b>This systematic review will aim to identify screening tools with the best diagnostic accuracy for detection of 1) delirium and 2) cognitive impairment or dementia in adults aged ≥60 post-trauma in acute care settings. Results will inform clinical practice to enhance the probability of patients with NCDs receiving appropriate care and management. <p dir="ltr"><b>Registration:</b><b> </b>PROSPERO https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024518730 (11/03/2024).