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 and BN being the most common EDs. AIM: To evaluate the accuracy and suitability of ED screening tools for BED and 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 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. RESULTS: 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. CONCLUSION: 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.