A reliable and record-based frailty assessment method for older medical inpatients
| Autor: | Seham Shahla, Jens M. Bruun, Else Marie Damsgaard, Troels Krarup Hansen, Merete Gregersen |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Intraclass correlation ASSESSING AGREEMENT Diagnostic accuracy Comprehensive geriatric assessment Medical record review VALIDATION 03 medical and health sciences 0302 clinical medicine ONE-YEAR MORTALITY Medicine 030212 general & internal medicine VALIDITY Reliability (statistics) Reproducibility 030214 geriatrics Frailty business.industry Medical record MULTIDIMENSIONAL PROGNOSTIC INDEX SHORT-FORM LENGTH-OF-STAY Gold standard (test) Confidence interval Frailty assessment SAMPLE-SIZE RELIABILITY Physical therapy business REQUIREMENTS |
| Zdroj: | Hansen, T K, Damsgaard, E M, Shahla, S, Bruun, J M & Gregersen, M 2020, ' A reliable and record-based frailty assessment method for older medical inpatients ', European Geriatric Medicine, vol. 11, no. 5, pp. 803-812 . https://doi.org/10.1007/s41999-020-00345-8 |
| DOI: | 10.1007/s41999-020-00345-8 |
| Popis: | To examine the reproducibility and diagnostic accuracy of a comprehensive frailty assessment method based solely on the older medical inpatient’s electronic medical record. We found good reliability, high agreement, and considerable diagnostic accuracy when comparing the record-based method to the bedside method. The record-based MPI is highly desirable. It seems feasible, reproducible, accurate, and worth exploring in larger datasets and other settings. The comprehensive geriatric assessment (CGA) including frailty assessment is considered the gold standard of assessment in geriatric patients. The Multidimensional Prognostic Index (MPI) is a CGA-based bedside assessment tool. Older medical inpatients’ medical records comprehensively describe the MPI-featured components. Consequently, MPI-based frailty assessment may be accomplished retrospectively. We found no previous studies concerning record-based MPI. We studied the reproducibility and diagnostic accuracy of a record-based MPI. The study was designed as a fully crossed, prospective, and cross-sectional study. A total of 50 inpatients aged ≥ 75 years were included from two medical wards. Record-based MPI was assessed by two independent raters in patients who required personal assistance on a daily basis or had a Charlson Comorbidity Index (CCI) ≥ 1. In the same patients, a bedside MPI rating was performed. Inter-rater and inter-method reproducibility and diagnostic accuracy measures were calculated. Evaluating the inter-rater reproducibility; the mean difference was -0.02 points [95% confidence interval (CI) − 0.06 to 0.01, p = 0.20]. Intraclass correlation coefficient (ICC) was 0.71. Evaluating inter-method reproducibility; the mean difference was -0.02 (95% CI − 0.04 to 0.01, p = 0.18); ICC = 0.83. Sensitivity was 100% and specificity 80%. The areas under the receiver operating curves (ROC) was 0.92 (95% CI 0.75–1.00) and 0.77 (95% CI 0.52–1.00). The record-based MPI rating method has an acceptable inter-rater reliability, good inter-method reliability, and high agreement as compared to the bedside-rated MPI. The diagnostic accuracy seems considerable. The record-based MPI seems useful in retrospective frailty assessment among older medical inpatients. |
| Databáze: | OpenAIRE |
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