Availability and convenience of sarcopenia screening and diagnostic tools in Chinese primary care

Although several guidelines recommend tools for sarcopenia screening and diagnosis, their feasibility in Chinese primary health care (PHC) remains unclear. This study evaluated the availability and convenience of sarcopenia-related tools from the perspective of routine PHC practice.

This two-stage expert-based evaluation was conducted between March 2023 and June 2024. In phase 1, a multidisciplinary core panel (n = 6) used a modified nominal group technique to define availability and convenience and to establish rating rules. In phase 2, an independent panel of PHC experts (n = 7) assessed 15 tools identified from major sarcopenia guidelines; ultrasonography was included as an emerging option. Inter-rater agreement was examined using Kendall's coefficient of concordance.

Availability was defined as the ease with which clinicians could obtain the required equipment or tool and use it in routine practice, whereas convenience was defined as the overall practicality of the test in terms of operational difficulty, acceptability, and portability. Screening tools were consistently rated as the most feasible options for PHC. Among strength and performance assessments, the chair stand test, gait speed, the Short Physical Performance Battery, and the Timed Up and Go test were rated as highly available and highly convenient. Handgrip strength was highly convenient but only moderately available because dynamometers were not routinely stocked in many PHC institutions. For confirmatory assessment of muscle mass, ultrasonography showed the most favorable overall profile, with high availability and moderate convenience, whereas bioelectrical impedance analysis showed moderate convenience but limited availability. Inter-rater agreement was high for both convenience (Kendall's W = 0.86, 95% CI 0.84-0.96, p < 0.001) and availability (Kendall's W = 0.92, 95% CI 0.90-0.98, p < 0.001).

In this exploratory expert-based assessment, Chinese PHC appeared well suited to sarcopenia case finding and first-line functional assessment, but confirmatory evaluation of muscle mass remained a major implementation bottleneck. A staged pathway may emphasize screening in PHC, selective referral, and targeted investment in feasible technologies such as bioelectrical impedance analysis and ultrasonography.