School of Health and Wellbeing, University of Glasgow, Glasgow, UK.
AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
Age Ageing. 2024 Nov 1;53(11). doi: 10.1093/ageing/afae258.
Frailty is of increasing interest in trials, either as a target of intervention, as an outcome or as a potential treatment modifier. However, frailty measurement is often highly variable. This scoping review assessed how frailty is quantified in randomised controlled trials (RCTs), in what context and for what purposes.
We searched five electronic databases for RCTs in which frailty was measured among trial participants. We extracted data on intervention type, the frailty measure used and the purpose for which frailty was assessed. We then compared these data according to reasons for frailty assessment.
We identified 415 RCTs assessing frailty across a range of interventions. Frailty was used to define the target population (166 trials), as an outcome (156 trials), as an effect modifier examining interaction of frailty on treatment effect (61 trials), as a purely descriptive characteristic (42 trials) or as a prognostic marker examining the impact of frailty on future health outcome (78 trials). The trials used 28 different measures of frailty (plus 29 additional trial-specific measures). The frailty phenotype model was the most common overall (164 trials), for defining the target population (90/166 trials) and as an outcome (81/156 trials). The cumulative deficit model frailty index was also frequently used (102 trials) and was most common among trials assessing treatment effect modification (21/61 trials).
Frailty measurement in RCTs is highly variable. Understanding the properties of respective frailty measures and how these relate to frailty as encountered in clinical practice is a priority to ensure that trial findings can inform healthcare delivery for people living with frailty.
衰弱在试验中越来越受到关注，无论是作为干预的目标，还是作为结果或潜在的治疗修饰剂。然而，衰弱的测量往往变化很大。本范围综述评估了衰弱在随机对照试验（RCT）中是如何被量化的，以及在什么情况下和出于什么目的进行量化。
我们在五个电子数据库中搜索了测量了试验参与者衰弱情况的 RCT。我们提取了关于干预类型、使用的衰弱测量方法以及评估衰弱的目的的数据。然后，我们根据评估衰弱的原因比较了这些数据。
我们确定了 415 项评估各种干预措施下衰弱的 RCT。衰弱被用于定义目标人群（166 项试验）、作为结果（156 项试验）、作为检验衰弱对治疗效果的相互作用的效应修饰剂（61 项试验）、作为纯粹描述性特征（42 项试验）或作为检验衰弱对未来健康结果的影响的预后标志物（78 项试验）。这些试验使用了 28 种不同的衰弱测量方法（外加 29 种额外的特定于试验的测量方法）。衰弱表型模型总体上最为常见（164 项试验），用于定义目标人群（90/166 项试验）和作为结果（81/156 项试验）。累积缺陷模型衰弱指数也经常被使用（102 项试验），并且在评估治疗效果修饰的试验中最为常见（21/61 项试验）。
RCT 中衰弱的测量变化很大。了解各自衰弱测量方法的特性以及这些方法与临床实践中遇到的衰弱之间的关系，是优先考虑的事项，以确保试验结果能够为衰弱患者的医疗保健提供信息。
