An Evaluation of the Performance of Five Burnout Screening Tools: A Multicentre Study in Anaesthesiology, Intensive Care, and Ancillary Staff

Abstract

Burnout is an important occupational hazard and early detection is paramount in preventing negative sequelae in physicians, patients, and healthcare systems. Several screening tools have been developed to replace lengthy diagnostic tools for large-scale screening, however, comprehensive head–to–head evaluation for performance and accuracy are lacking. The primary objective of this study was to compare the diagnostic performance of five burnout screening tools, including a novel rapid burnout screening tool (RBST). This was a cross-sectional study involving 493 hospital staff (anaesthesiology and intensive care doctors, nurses, and ancillary staff) at the COVID-19 frontline across four hospitals in Singapore between December 2020 and April 2021. The Maslach Burnout Inventory-Human Services Survey (MBI-HSS) was used as the reference standard. Five burnout screening tools, the single-item MBI measure of burnout (SI-MBI), dual-item MBI (DI-MBI), abbreviated MBI (aMBI), Single Item Burnout Question (SIBOQ), and the RBST, were administered via a 36-item online survey. Tools were administered simultaneously and responses were anonymised. Burnout prevalence was 19.9%. The RBST and the SI-MBI had the two highest accuracies (87.8% and 81.9% respectively) and AUROC scores (0.86, 95% CI: 0.83–0.89 and 0.86, 95% CI: 0.82–0.89 respectively). However, the accuracy of the RBST was significantly higher than the SI-MBI (p < 0.0001), and it had the highest positive likelihood ratio (+LR = 7.59, 95% CI 5.65–10.21). Brief screening tools detect burnout albeit with a wide range of accuracy. This can strain support services and resources. The RBST is a free screening tool that can detect burnout with a high degree of accuracy.

Diagnostic accuracy of the Single‐item Measure of Burnout (Japanese version) for identifying medical resident burnout

“…Regarding diagnostic characteristics, such as sensitivity and specificity, past studies have found a wide range of sensitivity (approximately 50%–80%) and high specificity (approximately 80%–90%). 12 , 13 Our findings are similar to those of Knox et al, suggesting that the Japanese version has the same level of diagnostic performance as the original SMB. 12 However, the Knox et al study further pointed out that the SMB may estimate a lower prevalence of burnout than the MBI.…”

“…There are other simple scales unrelated to the MBI, such as the Rapid Burnout Screening Tool (RBST), which is a free instrument developed by Ong et al 13 The RBST consists of four questions, one for each of the three dimensions of burnout and one for self‐assessment of burnout. The RBST has a higher diagnostic performance than the SMB 13 .…”

“…The RBST has a higher diagnostic performance than the SMB. 13 However, since the instrument is new and has only been validated among medical staff on the COVID‐19 frontline in Singapore, evaluation of its validity and diagnostic properties in a wider range of target populations and regions is needed.…”

“…In a study including 1010 participants, the SMB was able to identify burnout with 50.4% sensitivity, and the absence of burnout with 94.7% specificity in primary care physicians, and with 58.6% sensitivity and 94.7% specificity in medical staff, compared to the MBI diagnosis 12 . In a study conducted among COVID‐19 frontline healthcare workers in Singapore, the diagnostic performance of the SMB was 80.6% sensitivity and 78.7% specificity to identify burnout 13 . Dolan et al found that the SMB identified a positive result for one of the major items of EE in the MBI, with 83.2% sensitivity and 87.4% specificity 14 …”

“… 12 In a study conducted among COVID‐19 frontline healthcare workers in Singapore, the diagnostic performance of the SMB was 80.6% sensitivity and 78.7% specificity to identify burnout. 13 Dolan et al found that the SMB identified a positive result for one of the major items of EE in the MBI, with 83.2% sensitivity and 87.4% specificity. 14 …”