衰弱量表：预测效度与诊断试验准确性
FRAIL scale: Predictive validity and diagnostic test accuracy.
作者信息
Thompson Mark Q, Theou Olga, Tucker Graeme R, Adams Robert J, Visvanathan Renuka
机构信息
National Health and Medical Research Council (NHMRC) Centre of Research Excellence: Frailty and Healthy Ageing, University of Adelaide, Adelaide, South Australia, Australia.
Faculty of Health and Medical Sciences, Adelaide Geriatrics Training & Research with Aged Care (G-TRAC) Centre, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia.
出版信息
Australas J Ageing. 2020 Dec;39(4):e529-e536. doi: 10.1111/ajag.12829. Epub 2020 Aug 4.
OBJECTIVE
To examine the predictive validity of the FRAIL scale for mortality, and diagnostic test accuracy (DTA) against the frailty phenotype (FP).
MEASUREMENT
Frailty was measured in 846 community-dwelling adults (mean age 74.3 [SD 6.3] years, 54.8% female) using a modified FRAIL scale and modified FP. Mortality was matched to death records.
RESULTS
The FRAIL scale demonstrated significant predictive validity for mortality up to 10 years (Frail adjHR: 2.60, P < .001). DTA findings were acceptable for specificity (86.8%) and Youden index (0.50), but not sensitivity (63.6%), or area under the receiver operator curve (auROC) (0.75). DTA estimates were more acceptable when a cut-point of ≥2 characteristics was used rather than ≥3 in the primary DTA analysis.
CONCLUSION
The FRAIL scale is a valid predictor of mortality. DTA estimates depend on FRAIL scale cut-point used. This instrument is a potentially useful frailty screening tool.
目的
检验衰弱量表（FRAIL量表）对死亡率的预测效度，以及针对衰弱表型（FP）的诊断试验准确性（DTA）。
测量方法
使用改良的FRAIL量表和改良的FP对846名社区居住成年人（平均年龄74.3[标准差6.3]岁，女性占54.8%）进行衰弱测量。将死亡率与死亡记录进行匹配。
结果
FRAIL量表在长达10年的时间里对死亡率显示出显著的预测效度（校正风险比：2.60，P<0.001）。DTA结果在特异性（86.8%）和尤登指数（0.50）方面是可接受的，但在敏感性（63.6%）或受试者工作特征曲线下面积（auROC）（0.75）方面不可接受。在主要DTA分析中，当使用≥2个特征的切点而非≥3个特征的切点时，DTA估计值更可接受。
结论
FRAIL量表是死亡率的有效预测指标。DTA估计值取决于所使用的FRAIL量表切点。该工具是一种潜在有用的衰弱筛查工具。
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