Muscedere J, Afilalo J, Araujo de Carvalho I, Cesari M, Clegg A, Eriksen H E, Evans K R, Heckman G, Hirdes J P, Kim P M, Laffon B, Lynn J, Martin F, Prorok J C, Rockwood K, Rodrigues Mañas L, Rolfson D, Shaw G, Shea B, Sinha S, Theou O, Tugwell P, Valdiglesias V, Vellas B, Veronese N, Wallace L M K, Williamson P R
John Muscedere, Queen's University and Kingston General Hospital, Canada, E-Mail:
J Frailty Aging. 2020;9(1):14-22. doi: 10.14283/jfa.2019.43.
With aging populations around the world, frailty is becoming more prevalent increasing the need for health systems and social systems to deliver optimal evidence based care. However, in spite of the growing number of frailty publications, high-quality evidence for decision making is often lacking. Inadequate descriptions of the populations enrolled including frailty severity and frailty conceptualization, lack of use of validated frailty assessment tools, utilization of different frailty instruments between studies, and variation in reported outcomes impairs the ability to interpret, generalize and implement the research findings. The utilization of common data elements (CDEs) and core outcome measures (COMs) in clinical trials is increasingly being adopted to address such concerns. To catalyze the development and use of CDEs and COMs for future frailty studies, the Canadian Frailty Network (www.cfn-nce.ca; CFN), a not-for-profit pan-Canadian nationally-funded research network, convened an international group of experts to examine the issue and plan the path forward. The meeting was structured to allow for an examination of current frailty evidence, ability to learn from other COMs and CDEs initiatives, discussions about specific considerations for frailty COMs and CDEs and finally the identification of the necessary steps for a COMs and CDEs consensus initiative going forward. It was agreed at the onset of the meeting that a statement based on the meeting would be published and herein we report the statement.
随着全球人口老龄化,衰弱变得越来越普遍,这增加了卫生系统和社会系统提供基于最佳证据的护理的需求。然而,尽管关于衰弱的出版物数量不断增加,但往往缺乏用于决策的高质量证据。对纳入人群的描述不充分,包括衰弱严重程度和衰弱概念化,缺乏使用经过验证的衰弱评估工具,研究之间使用不同的衰弱工具,以及报告结果的差异,削弱了对研究结果进行解释、推广和实施的能力。临床试验中越来越多地采用通用数据元素(CDE)和核心结局指标(COM)来解决此类问题。为了推动未来衰弱研究中CDE和COM的开发与使用,加拿大衰弱网络(www.cfn-nce.ca;CFN),一个泛加拿大的非营利性国家资助研究网络,召集了一组国际专家来研究这个问题并规划前进的道路。会议的组织方式允许审查当前的衰弱证据、从其他COM和CDE倡议中学习的能力、关于衰弱COM和CDE的具体考虑因素的讨论,以及最终确定COM和CDE共识倡议未来的必要步骤。会议一开始就商定将发表一份基于会议内容的声明,在此我们报告该声明。