| Objective To systematically assess available screening tools and to identify the most appropriate tool for screening sarcopenia among community-dwelling elderly. Methods PubMed, Web of Science, CNKI, Wanfang Data, and VIP databases were searched to collect studies on the diagnostic accuracy of sarcopenia screening tools from database establishment to December 2022. Literature screening, data extraction, and risk bias evaluation were conducted by two researchers independently. Meta-analysis and network meta-analysis were performed using Stata 16.0 and R 4.4.2 software. Results A total of 22 studies comprising 10 969 participants were included. Eight screening tools were identified, including SARC-F (strength, assistance walking, rise from a chair, climb stairs and falls), CC (calf circumference), SARC-CALF (a combination of SARC-F with calf circumference), Mini Sarcopenia Risk Assessment questionnaire (MSRA-7, MSRA-5), SARC-F+EBM (SARC-F combined with age and BMI), Ishii test, and the finger ring test. The meta-analysis revealed that the area under the summary receiver operating characteristic curve (AUC) was 0.86 in SARC-CALF (95%CI: 0.82, 0.88), 0.85 in CC (95%CI: 0.81, 0.89), 0.80 in SARC-F (95%CI: 0.76, 0.83), 0.77 in MSRA-5 (95%CI: 0.73, 0.81), and 0.67 in MSRA-7 (95%CI: 0.63, 0.71), respectively. SARC-CALF, CC, and SARC-F showed relatively high accuracy, with SARC-CALF boasting the highest accuracy. The network meta-analysis revealed that SARC-CALF yielded higher diagnostic odds ratios (DOR) and superiority indices (SI) compared with SARC-F using the golden diagnostic criteria of AWGS 1, EWGSOP 1, EWGSOP 2, IWGS, and SCWD. Specifically, under the AWGS 1 criteria，both DOR and SI of SARC-CALF were found to surpass those of SARC-F and CC. Conclusion SARC-CALF should be advocated as the preferred screening tool for sarcopenia screening in the community-dwelling elderly. Further researches combined with risk prediction and interventions is needed to validate the comprehensive effectiveness of SARC-CALF. |