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.