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A classification tree to assist with routine scoring of the Clinical Frailty Scale

BACKGROUND: the Clinical Frailty Scale (CFS) was originally developed to summarise a Comprehensive Geriatric Assessment and yield a care plan. Especially since COVID-19, the CFS is being used widely by health care professionals without training in frailty care as a resource allocation tool and for c...

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Autores principales: Theou, Olga, Pérez-Zepeda, Mario Ulises, van der Valk, Alexandra M, Searle, Samuel D, Howlett, Susan E, Rockwood, Kenneth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7929455/
https://www.ncbi.nlm.nih.gov/pubmed/33605412
http://dx.doi.org/10.1093/ageing/afab006
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author Theou, Olga
Pérez-Zepeda, Mario Ulises
van der Valk, Alexandra M
Searle, Samuel D
Howlett, Susan E
Rockwood, Kenneth
author_facet Theou, Olga
Pérez-Zepeda, Mario Ulises
van der Valk, Alexandra M
Searle, Samuel D
Howlett, Susan E
Rockwood, Kenneth
author_sort Theou, Olga
collection PubMed
description BACKGROUND: the Clinical Frailty Scale (CFS) was originally developed to summarise a Comprehensive Geriatric Assessment and yield a care plan. Especially since COVID-19, the CFS is being used widely by health care professionals without training in frailty care as a resource allocation tool and for care rationing. CFS scoring by inexperienced raters might not always reflect expert judgement. For these raters, we developed a new classification tree to assist with routine CFS scoring. Here, we test that tree against clinical scoring. OBJECTIVE/METHODS: we examined agreement between the CFS classification tree and CFS scoring by novice raters (clerks/residents), and the CFS classification tree and CFS scoring by experienced raters (geriatricians) in 115 older adults (mean age 78.0 ± 7.3; 47% females) from a single centre. RESULTS: the intraclass correlation coefficient (ICC) for the CFS classification tree was 0.833 (95% CI: 0.768–0.882) when compared with the geriatricians’ CFS scoring. In 93%, the classification tree rating was the same or differed by at most one level with the expert geriatrician ratings. The ICC was 0.805 (0.685–0.883) when CFS scores from the classification tree were compared with the clerk/resident scores; 88.5% of the ratings were the same or ±1 level. CONCLUSIONS: a classification tree for scoring the CFS can help with reliable scoring by relatively inexperienced raters. Though an incomplete remedy, a classification tree is a useful support to decision-making and could be used to aid routine scoring of the CFS.
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spelling pubmed-79294552021-03-04 A classification tree to assist with routine scoring of the Clinical Frailty Scale Theou, Olga Pérez-Zepeda, Mario Ulises van der Valk, Alexandra M Searle, Samuel D Howlett, Susan E Rockwood, Kenneth Age Ageing Short Report BACKGROUND: the Clinical Frailty Scale (CFS) was originally developed to summarise a Comprehensive Geriatric Assessment and yield a care plan. Especially since COVID-19, the CFS is being used widely by health care professionals without training in frailty care as a resource allocation tool and for care rationing. CFS scoring by inexperienced raters might not always reflect expert judgement. For these raters, we developed a new classification tree to assist with routine CFS scoring. Here, we test that tree against clinical scoring. OBJECTIVE/METHODS: we examined agreement between the CFS classification tree and CFS scoring by novice raters (clerks/residents), and the CFS classification tree and CFS scoring by experienced raters (geriatricians) in 115 older adults (mean age 78.0 ± 7.3; 47% females) from a single centre. RESULTS: the intraclass correlation coefficient (ICC) for the CFS classification tree was 0.833 (95% CI: 0.768–0.882) when compared with the geriatricians’ CFS scoring. In 93%, the classification tree rating was the same or differed by at most one level with the expert geriatrician ratings. The ICC was 0.805 (0.685–0.883) when CFS scores from the classification tree were compared with the clerk/resident scores; 88.5% of the ratings were the same or ±1 level. CONCLUSIONS: a classification tree for scoring the CFS can help with reliable scoring by relatively inexperienced raters. Though an incomplete remedy, a classification tree is a useful support to decision-making and could be used to aid routine scoring of the CFS. Oxford University Press 2021-02-19 /pmc/articles/PMC7929455/ /pubmed/33605412 http://dx.doi.org/10.1093/ageing/afab006 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Short Report
Theou, Olga
Pérez-Zepeda, Mario Ulises
van der Valk, Alexandra M
Searle, Samuel D
Howlett, Susan E
Rockwood, Kenneth
A classification tree to assist with routine scoring of the Clinical Frailty Scale
title A classification tree to assist with routine scoring of the Clinical Frailty Scale
title_full A classification tree to assist with routine scoring of the Clinical Frailty Scale
title_fullStr A classification tree to assist with routine scoring of the Clinical Frailty Scale
title_full_unstemmed A classification tree to assist with routine scoring of the Clinical Frailty Scale
title_short A classification tree to assist with routine scoring of the Clinical Frailty Scale
title_sort classification tree to assist with routine scoring of the clinical frailty scale
topic Short Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7929455/
https://www.ncbi.nlm.nih.gov/pubmed/33605412
http://dx.doi.org/10.1093/ageing/afab006
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