Rachel C Ambagtsheer1,2, Renuka Visvanathan1,3, Elsa Dent2,4, Solomon Yu1,3, Timothy J Schultz1,5, Justin Beilby1,2. 1. National Health and Medical Research Council Centre of Research Excellence in Trans-Disciplinary Frailty Research to Achieve Healthy Ageing, Adelaide, South Australia, Australia. 2. Torrens University Australia, Adelaide, South Australia, Australia. 3. Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia. 4. Baker Heart and Diabetes Institute, Melbourne, Victoria. 5. Adelaide Nursing School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.
Abstract
BACKGROUND: Rapid frailty screening remains problematic in primary care. The diagnostic test accuracy (DTA) of several screening instruments has not been sufficiently established. We evaluated the DTA of several screening instruments against two reference standards: Fried's Frailty Phenotype [FP] and the Adelaide Frailty Index [AFI]), a self-reported questionnaire. METHODS: DTA study within three general practices in South Australia. We randomly recruited 243 general practice patients aged 75+ years. Eligible participants were 75+ years, proficient in English and community-dwelling. We excluded those who were receiving palliative care, hospitalized or living in a residential care facility.We calculated sensitivity, specificity, predictive values, likelihood ratios, Youden Index and area under the curve (AUC) for: Edmonton Frail Scale [EFS], FRAIL Scale Questionnaire [FQ], Gait Speed Test [GST], Groningen Frailty Indicator [GFI], Kihon Checklist [KC], Polypharmacy [POLY], PRISMA-7 [P7], Reported Edmonton Frail Scale [REFS], Self-Rated Health [SRH] and Timed Up and Go [TUG]) against FP [3+ criteria] and AFI [>0.21]. RESULTS: We obtained valid data for 228 participants, with missing scores for index tests multiply imputed. Frailty prevalence was 17.5% frail, 56.6% prefrail [FP], and 48.7% frail, 29.0% prefrail [AFI]. Of the index tests KC (Se: 85.0% [70.2-94.3]; Sp: 73.4% [66.5-79.6]) and REFS (Se: 87.5% [73.2-95.8]; Sp: 75.5% [68.8-81.5]), both against FP, showed sufficient diagnostic accuracy according to our prespecified criteria. CONCLUSIONS: Two screening instruments-the KC and REFS, show the most promise for wider implementation within general practice, enabling a personalized approach to care for older people with frailty.
BACKGROUND: Rapid frailty screening remains problematic in primary care. The diagnostic test accuracy (DTA) of several screening instruments has not been sufficiently established. We evaluated the DTA of several screening instruments against two reference standards: Fried's Frailty Phenotype [FP] and the Adelaide Frailty Index [AFI]), a self-reported questionnaire. METHODS:DTA study within three general practices in South Australia. We randomly recruited 243 general practice patients aged 75+ years. Eligible participants were 75+ years, proficient in English and community-dwelling. We excluded those who were receiving palliative care, hospitalized or living in a residential care facility.We calculated sensitivity, specificity, predictive values, likelihood ratios, Youden Index and area under the curve (AUC) for: Edmonton Frail Scale [EFS], FRAIL Scale Questionnaire [FQ], Gait Speed Test [GST], Groningen Frailty Indicator [GFI], Kihon Checklist [KC], Polypharmacy [POLY], PRISMA-7 [P7], Reported Edmonton Frail Scale [REFS], Self-Rated Health [SRH] and Timed Up and Go [TUG]) against FP [3+ criteria] and AFI [>0.21]. RESULTS: We obtained valid data for 228 participants, with missing scores for index tests multiply imputed. Frailty prevalence was 17.5% frail, 56.6% prefrail [FP], and 48.7% frail, 29.0% prefrail [AFI]. Of the index tests KC (Se: 85.0% [70.2-94.3]; Sp: 73.4% [66.5-79.6]) and REFS (Se: 87.5% [73.2-95.8]; Sp: 75.5% [68.8-81.5]), both against FP, showed sufficient diagnostic accuracy according to our prespecified criteria. CONCLUSIONS: Two screening instruments-the KC and REFS, show the most promise for wider implementation within general practice, enabling a personalized approach to care for older people with frailty.
Authors: Smith Giri; Nabiel Mir; Mustafa Al-Obaidi; Deanna Clark; Kelly M Kenzik; Andrew McDonald; Crystal Young-Smith; Ravi Paluri; Lakshmin Nandagopal; Olumide Gbolahan; Kirsten A Nyrop; Hyman B Muss; Mackenzi Pergolotti; Smita Bhatia; Grant R Williams Journal: Oncologist Date: 2022-02-03 Impact factor: 5.837
Authors: J G Ruiz; E Dent; J E Morley; R A Merchant; J Beilby; J Beard; C Tripathy; M Sorin; S Andrieu; I Aprahamian; H Arai; M Aubertin-Leheudre; J M Bauer; M Cesari; L-K Chen; A J Cruz-Jentoft; P De Souto Barreto; B Dong; L Ferrucci; R Fielding; L Flicker; J Lundy; J Y Reginster; L Rodriguez-Mañas; Y Rolland; A M Sanford; A J Sinclair; J Viña; D L Waters; C Won Won; J Woo; B Vellas Journal: J Nutr Health Aging Date: 2020 Impact factor: 5.285