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SARC-F Validation and SARC-F+EBM Derivation in Musculoskeletal Disease: The SPSS-OK Study

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The journal of nutrition, health & aging

Abstract

Objectives

To validate the SARC-F questionnaire for sarcopenia screening in musculoskeletal disease setting, and to assess improvements in diagnostic accuracy by adding “EBM” (elderly and body mass index information) to the SARC-F.

Design

Diagnostic accuracy study.

Setting and Participants

The center involved in this study was located in an urban area of Kobe City, Japan. People with musculoskeletal disease in the knee, hip, or spine who were scheduled for surgical treatment were included.

Measurements

Sarcopenia was evaluated using the Asian Working Group for Sarcopenia (AWGS) and the European Working Group on Sarcopenia in Older People (EWGSOP2), which included bioimpedance, handgrip strength, and gait speed. Patients answered the SARC-F questionnaire and their body mass index was measured. SARC-F and “EBM” information were combined into an original score. The sensitivities, specificities, and areas under the receiver operating characteristic curve (AUC) were estimated and compared to identify sarcopenia.

Results

A total of 959 patients were included. Sarcopenia by AWGS criteria was identified in 36 (3.8%) patients. SARC-F had a sensitivity of 41.7% and specificity of 68.5%. SARC-F+EBM had a sensitivity of 77.8% and specificity of 69.6%, with substantial improvement in sensitivity (P<0.001). The AUCs for SARC-F and SARC-F+EBM were 0.557 (95% confidence interval [CI] 0.452–0.662) and 0.824 (95% CI 0.762–0.886), respectively (P<0.001). Similar results were obtained when EWGSOP2 criteria were used as the reference standard.

Conclusion

The SARC-F alone is not adequate for finding cases in musculoskeletal disease settings. SARC-F+EBM significantly improved the sensitivity and overall diagnostic accuracy of the SARC-F for screening sarcopenia. SARC-F+EBM is potentially useful for screening sarcopenia in different ethnic and disease settings.

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Acknowledgments

The authors greatly thank the following research assistant and medical staff members for their assistance in collecting the clinical information used in this study Takehiro Kaga, Tomohiro Oka, Yoriko Tamura, Hiroshi Nishi, Yuichi Isaji, Yutaka Sato, Tomohiro Takagi, Kaho Shibata, Maho Wakai, Chisato Shindoh, Kenta Hirose, Takuma Ota, Tatsuya Arita, Yuuki Ikawa, Tsuyoshi Fukui, Riuji Nakagawa, Taisuke Hayashida, Shuto Fujii, Keisuke Yoneya, Kazuaki Mori (Anshin Hospital, Kobe), Asako Tamura, Yuka Masuda (St. Marianna Medical University), Lisa Shimokawa (Fukushima Medical University Hospital, Fukushima-city, Fukushima).

Funding

Funding sources: This study was supported by JSPS KAKENHI (Grant Number: JP15K16518). The JSPS had no role in the study, except for providing funding.

Author information

Authors and Affiliations

  1. Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima, 960-1295, Japan

    Noriaki Kurita

  2. Department of Innovative Research and Education for Clinicians and Trainees (DiRECT), Fukushima Medical University Hospital, Fukushima City, Fukushima, Japan

    Noriaki Kurita

  3. Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima City, Fukushima, Japan

    Noriaki Kurita

  4. Department of Sociology, Kansai University, Suita City, Osaka, Japan

    T. Wakita

  5. Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan

    T. Kamitani

  6. Anshin Hospital, Kobe City, Hyogo, Japan

    O. Wada & K. Mizuno

Authors
  1. Noriaki Kurita
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  2. T. Wakita
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  3. T. Kamitani
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  4. O. Wada
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  5. K. Mizuno
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Corresponding author

Correspondence to Noriaki Kurita.

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Conflicts of Interest: The authors have nothing to disclose.

Ethical Standards: The study was conducted in accordance with the Declaration of Helsinki and the ethical guidelines for Ethical Guidelines for Medical and Health Research Involving Human Subjects in Japan.

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Kurita, N., Wakita, T., Kamitani, T. et al. SARC-F Validation and SARC-F+EBM Derivation in Musculoskeletal Disease: The SPSS-OK Study. J Nutr Health Aging 23, 732–738 (2019). https://doi.org/10.1007/s12603-019-1222-x

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  • DOI: https://doi.org/10.1007/s12603-019-1222-x

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