Predictive Validity of the Braden Scale for Pressure Ulcer Risk: A Meta-analysis

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.