Relative Energy Deficiency in Sport (REDs), caused by problematic low energy availability (LEA), is associated with a wide range of health and performance consequences. The 2023 International Olympic Committee REDs Clinical Assessment Tool Version 2 (IOC REDs CAT2) was developed using a three-step model, including the use of screening questionnaires. The purpose of this review was to explore the development and validation of 13 highly cited REDs screening questionnaires used in athletic populations. Screening questionnaires or clinical interviews recommended by the IOC for REDs screening were evaluated. All studies were retrieved via PubMed. Psychometric properties were described according to results reported in the original investigation and the Psychometric and Pragmatic Evidence Rating Scale (PAPERS) was used for scoring. Studies reported the following psychometric properties: content validity (n = 13), discriminant validity (n = 9), concurrent validity (n = 7), sensitivity and specificity (n = 6), test-retest reliability and internal consistency (n = 6). Total psychometric and pragmatic scores, according to PAPERS, were generally low and ranged from − 1 to 14 (total range − 9 to 36) and 5 to 18 (total range − 5 to 20), respectively. Validation primarily focused on specific sports and/or geographic regions in young female athletes. The use of validated assessment questionnaires is warranted among individuals at risk for LEA/REDs, despite limitations of available screening questionnaires. Improvements in REDs screening and assessment will allow for earlier diagnosis, treatment, and intervention to mitigate the associated adverse health and performance consequences.
Lodge et al. (Sun,) studied this question.
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