Pilot validation study of a new screening tool for chronic kidney disease early identification.

 

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https://storage.unitedwebnetwork.com/files/1099/9c329f153d674843f4798758555fd4c1.pdf
Pilot validation study of a new screening tool for chronic kidney disease early identification.

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Lorna
Suen
Lorna Suen lornasuen@twc.edu.hk Tung Wah College School of Nursing Hong Kong Hong Kong, China *
Simon Lam simonlam@twc.edu.hk Tung Wah College School of Nursing Hong Kong Hong Kong, China -
Margaret Wong margaretwong@twc.edu.hk Tung Wah College School of Nursing Hong Kong Hong Kong, China -
Mark Tsang marktsang@twc.edu.hk Tung Wah College School of Arts and Humanities Hong Kong Hong Kong, China -
Bonnie Tam bonnietam@twc.edu.hk Tung Wah College School of Nursing Hong Kong Hong Kong, China -
Wilson Leung wilsonleung@twc.edu.hk Tung Wah College School of Nursing Hong Kong Hong Kong, China -
Stoney Shi stoneyshi@twc.edu.hk Tung Wah College School of Nursing Hong Kong Hong Kong, China -
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Early identification of chronic kidney disease (CKD) plays a vital role in slowing disease progression and minimizing related health complications. The SCreening for Occult REnal Disease (SCORED) tool is a commonly used instrument for CKD risk assessment, yet its length and inclusion of less informative items may reduce its usability in certain clinical contexts. This study sought to evaluate the validity of a streamlined version, the modified SCORED (SCORED-M) tool, designed with fewer questions and enhanced predictive accuracy.

A cross-sectional pilot study was undertaken to assess the diagnostic validity of the modified screening tool (SCORED-M). Receiver operating characteristic analysis was applied to examine its discriminative ability, alongside calculations of sensitivity, specificity, positive predictive value, and negative predictive value (NPV). Item inclusion or removal was guided by statistical significance, odds ratios, and clinical relevance to CKD risk. The most suitable cutoff score for CKD detection was established through comparative evaluation.

In this pilot study, 116 eligible participants were recruited. The streamlined SCORED-M, containing six items instead of the original nine, showed enhanced screening accuracy, yielding a greater area under the curve (0.89 vs. 0.79), higher sensitivity (0.97), and strong negative predictive value (0.97). These results highlight its improved capacity to detect CKD and exclude non-cases. The age-related scoring was adjusted from 2–4 points to a narrower 1–3 range, reducing the disproportionate impact of age as an isolated risk factor. Items with low predictive utility were eliminated. Highly relevant indicators were retained. A cutoff score of ≥4 emerged as the optimal balance between sensitivity and specificity, enabling efficient use of screening resources.

This pilot study offers initial evidence that the SCORED-M tool provides a simpler yet more precise method for CKD risk screening. Although the results are encouraging, further evaluation in larger and more heterogeneous cohorts is needed to verify its generalizability and enhance its suitability for widespread clinical use.

Kewords