Broad Antoinette, Carter Ben, Mckelvie Sara, Hewitt Jonathan
Community Services, Oxford Health NHS Foundation Trust, Oxford OX3 7JX, UK.
Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK.
Geriatrics (Basel). 2020 Nov 9;5(4):88. doi: 10.3390/geriatrics5040088.
Different scales are being used to measure frailty. This study examined the convergent validity of the electronic Frailty Index (eFI) with the Clinical Frailty Scale (CFS). The cross-sectional study recruited patients from three regional community nursing teams in the South East of England. The CFS was rated at recruitment, and the eFI was extracted from electronic health records (EHRs). A McNemar test of paired data was used to compare discordant pairs between the eFI and the CFS, and an exact McNemar Odds Ratio (OR) was calculated. Of 265 eligible patients consented, 150 (57%) were female, with a mean age of 85.6 years (SD = 7.8), and 78% were 80 years and older. Using the CFS, 68% were estimated to be moderate to severely frail, compared to 91% using the eFI. The eFI recorded a greater degree of frailty than the CFS (OR = 5.43, 95%CI 3.05 to 10.40; < 0.001). This increased to 7.8 times more likely in men, and 9.5 times in those aged over 80 years. This study found that the eFI overestimates the frailty status of community dwelling older people. Overestimating frailty may impact on the demand of resources required for further management and treatment of those identified as being frail.
目前使用了不同的量表来衡量衰弱程度。本研究检验了电子衰弱指数（eFI）与临床衰弱量表（CFS）的收敛效度。这项横断面研究从英格兰东南部的三个地区社区护理团队招募患者。在招募时对CFS进行评分，并从电子健康记录（EHRs）中提取eFI。使用配对数据的McNemar检验来比较eFI和CFS之间的不一致配对，并计算精确的McNemar优势比（OR）。在265名同意参与的合格患者中，150名（57%）为女性，平均年龄为85.6岁（标准差=7.8），78%的患者年龄在80岁及以上。使用CFS评估，68%的患者为中度至重度衰弱，而使用eFI评估的这一比例为91%。eFI记录的衰弱程度高于CFS（OR=5.43，95%置信区间3.05至10.40；P<0.001）。在男性中，这一可能性增加到7.8倍，在80岁以上的人群中增加到9.5倍。本研究发现，eFI高估了社区居住老年人的衰弱状态。高估衰弱可能会影响对被认定为衰弱者进行进一步管理和治疗所需资源的需求。
