Zamora-Sánchez Juan-José, Urpí-Fernández Ana-María, Sastre-Rus Meritxell, Lumillo-Gutiérrez Iris, Gea-Caballero Vicente, Jodar-Fernández Lina, Julián-Rochina Iván, Zabaleta-Del-Olmo Edurne
Gerència Territorial de Barcelona, Institut Català de la Salut, Barcelona, Spain; School of Nursing, Universitat de Barcelona, Barcelona, Spain.
Gerència Territorial de Barcelona, Institut Català de la Salut, Barcelona, Spain.
Ageing Res Rev. 2022 Apr;76:101588. doi: 10.1016/j.arr.2022.101588. Epub 2022 Feb 10.
The Tilburg Frailty Indicator (TFI) is one of the most prominent multidimensional frailty assessment instruments. This review aimed to critically appraise and summarise its measurement properties.
Reports were eligible if they included results of studies aimed at developing the TFI or evaluating its measurement properties. We performed a literature search in MEDLINE, CINAHL, and PsycINFO databases from their inception until December 8, 2021. We also searched grey literature databases. We assessed the methodological quality of the included studies using the "COSMIN Risk of Bias". The measurement properties were evaluated using specific criteria. We graded the quality of the evidence using a GRADE approach.
Sixty-three studies were included. We found moderate sufficient evidence for TFI content validity, although it is still insufficient for the comprehensiveness of its items. TFI construct validity was based on sufficient evidence from two studies of its structural validity as well as multiple hypothesis-testing for construct validity studies with inconsistent results. We did not find any studies that assessed cross-cultural validity. Only one of TFI's three dimensions showed sufficient evidence for the internal consistency of its scores, and results in test-retest reliability were inconsistent. The TFI showed high sufficient concurrent validity with the comprehensive geriatric assessment. We identified several studies assessing its predictive validity for adverse frailty-related outcomes, although most of the evidence from these studies was insufficient. We did not find any studies that assessed the responsiveness of TFI scores.
The TFI had evidence gaps in several relevant measurement properties. Further research is needed to strengthen its usefulness as a clinical decision-making tool.
蒂尔堡衰弱指标（TFI）是最著名的多维衰弱评估工具之一。本综述旨在严格评估并总结其测量属性。
若报告包含旨在开发TFI或评估其测量属性的研究结果，则符合纳入标准。我们在MEDLINE、CINAHL和PsycINFO数据库中进行了文献检索，检索时间从各数据库建库起至2021年12月8日。我们还检索了灰色文献数据库。我们使用“COSMIN偏倚风险”评估纳入研究的方法学质量。测量属性采用特定标准进行评估。我们使用GRADE方法对证据质量进行分级。
纳入63项研究。我们发现TFI内容效度有中等充分的证据，但其条目全面性的证据仍不足。TFI结构效度基于两项关于其结构效度的研究以及多项结构效度研究的假设检验的充分证据，但结果不一致。我们未找到评估跨文化效度的研究。TFI的三个维度中只有一个维度的得分内部一致性有充分证据，重测信度结果不一致。TFI与综合老年评估显示出高度充分的同时效度。我们确定了几项评估其对衰弱相关不良结局预测效度的研究，尽管这些研究的大多数证据不足。我们未找到评估TFI得分反应度的研究。
TFI在几个相关测量属性方面存在证据缺口。需要进一步研究以增强其作为临床决策工具的实用性。
