The 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.

BACKGROUND: 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/BN being the most common EDs. AIM: To evaluate the accuracy and suitability of ED screening tools for BED/BN in a primary care setting. DESIGN & SETTING: A systematic review with narrative synthesis in a primary care setting. METHOD: 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/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. RESULTS: Four studies met inclusion criteria. The included studies reported on BEDS-7, EDE-Q and SCOFF 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 barrier to implementation in primary care was 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. CONCLUSION: ED screening tools face feasibility and accuracy concerns for BED/BN in a primary care setting. Further research is needed to validate screening tools' accuracy and suitability in a primary care setting for BED and BN in the general population.