Davies Jasmine, Whitlock Jennifer, Gutmanis Iris, Kane Sheri-Lynn
Specialized Geriatric Services, St. Joseph's Health Care London, Parkwood Institute, London, ON, Canada.
Lawson Health Research Institute, London, ON, Canada.
Can Geriatr J. 2018 Mar 26;21(1):1-5. doi: 10.5770/cgj.21.263. eCollection 2018 Mar.
Frailty, a common clinical syndrome in older adults associated with increased risk of poor health outcomes, has been retrospectively calculated in previous publications; however, the reliability of retrospectively assigned frailty scores has not been established. The aim of this study was to see if frailty scores, based on chart review data, agreed with clinician-determined scores based on a comprehensive geriatric assessment.
Per standard practice, all patients seen by one nurse clinician (JW) from the Southwestern Ontario Regional Geriatric Program, a tertiary care-based outreach service, between August 15, 2013 and December 31, 2015 received a comprehensive geriatric assessment which included the assignment of an interview-based Clinical Frailty Scale score (CFS-I). Subsequently, a medical student researcher (JD), blinded to the CFS-I, assigned each consenting patient a frailty score based on chart review data (CFS-C). The inter-rater reliability of the CFS-I and CFS-C was then determined.
Of the 41 consented patients, 39 had both a CFS-I and CFSC score. The median CFS score was 6, indicating patients were moderately frail and required assistance for some basic activities of daily living. Cohen's kappa coefficient was 0.64, indicating substantial agreement.
CFS scores can be reliably assigned retrospectively, thereby strengthening the utility of this measure.
衰弱是老年人常见的临床综合征,与不良健康结局风险增加相关,在以往的出版物中已进行回顾性计算;然而,回顾性指定的衰弱评分的可靠性尚未确立。本研究的目的是探讨基于病历审查数据的衰弱评分是否与基于全面老年评估的临床医生确定的评分一致。
按照标准操作流程,2013年8月15日至2015年12月31日期间,安大略西南部地区老年病项目(一个以三级医疗为基础的外展服务机构)的一名护士临床医生(JW)诊治的所有患者均接受了全面老年评估,其中包括基于访谈的临床衰弱量表评分(CFS-I)。随后,一名对CFS-I不知情的医学生研究员(JD)根据病历审查数据为每位同意参与的患者指定了一个衰弱评分(CFS-C)。然后确定CFS-I和CFS-C的评分者间信度。
在41名同意参与的患者中,39名患者同时有CFS-I和CFSC评分。CFS评分中位数为6,表明患者为中度衰弱,一些日常生活基本活动需要帮助。科恩kappa系数为0.64,表明有实质性一致性。
CFS评分可以可靠地进行回顾性指定,从而增强了该测量方法的实用性。