Accuracy and suitability of eating disorder screening tools for binge eating disorder and bulimia nervosa in a primary care setting: a systematic review and narrative summary.

Abstract

Despite available screening tools for eating disorders (EDs), the accuracy and suitability of these in identifying binge eating disorder (BED) and bulimia nervosa (BN) in a primary care setting are undetermined, despite BED and BN being the most common EDs. To evaluate the accuracy and suitability of ED screening tools for BED and BN in a primary care setting. A systematic review with narrative synthesis in a primary care setting. Six databases were searched, including MEDLINE, PsycInfo, and Embase. Two independent reviewers screened studies for inclusion. Studies were included that assessed the accuracy and/or suitability of screening tools for BED and BN in primary care. Quality was assessed using the Mixed Methods Appraisal Tool. A narrative summary was created after integrating the data using a convergent segregated approach. Four studies met inclusion criteria. The included studies reported on Binge Eating Disorder Screener-7 (BEDS-7), Eating Disorder Examination Questionnaire (EDE-Q), and SCOFF (sick, control, one stone, fat, food) screening tools. No studies reported on the accuracy of screening tools for BED and suitability for BN. BEDS-7 and EDE-Q screening tools reported variations in their suitability in primary care. The main barriers to implementation in primary care were time constraints and a lack of trust in screening. SCOFF showed high sensitivity (97.88%-100%) for BN but had lower specificity (89.6%-94.4%), increasing false positives. ED screening tools face feasibility and accuracy concerns for BED and BN. Further research is needed to validate screening tools' accuracy and suitability in a primary care setting for BED and BN in the general population.