Identification of frailty in primary care: accuracy of electronically derived measures

Autor: Karin M.A. Swart, Amber A. van der Heijden, Marieke Blom, Jetty Overbeek, Giel Nijpels, Hein P.J. van Hout, Petra J.M. Elders, Ron M.C. Herings
Rok vydání: 2023
Předmět:
Zdroj: British Journal of General Practice. :BJGP.2022.0574
ISSN: 1478-5242
0960-1643
Popis: Background: Routinely collected clinical data based on electronic medical records could be used to define frailty. Aim: To estimate the ability of four potential frailty measures that use electronic medical record data to identify older patients who were frail according to their general practitioner (GP). Design and setting: This retrospective cohort study used data from 36 GP practices of the Dutch PHARMO Data Network. Method: The measures were the Dutch Polypharmacy Index (DPI), Charlson Comorbidity Index (CCI), Chronic Disease Score (CDS), and Frailty Index (FI). GPs’ clinical judgement of patients' frailty status was considered the reference standard. Performance of the measures was assessed with the area under the receiver operating characteristic curve (AUC). Analyses were done in the total population and stratified by age and sex. Results: Of 31,511 patients aged ≥65 years, 3,735 (12%) patients were classified as frail by their GP. The CCI showed the highest AUC (0.79, 95%CI:0.78-0.80), followed by CDS (0.69, 95%CI:0.68-0.70). Overall, the measures showed poorer performance in men and women aged >85 years then younger age groups (AUC 0.55-0.58 in women and 0.57-0.60 in men). Conclusion: This study showed that four frailty measures based on electronic medical records in primary care only the CCI had an acceptable performance to assess frailty compared with frailty assessment done by professionals. In the youngest age groups diagnostic performance was acceptable for all measures. However, performance declined with higher age and was least accurate in the oldest persons, thereby limiting the use in persons of most interest.
Databáze: OpenAIRE
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