Assessing the psychometric properties of the his "Think Frailty" tool

Taylor-Rowan, M. et al. (2018) Assessing the psychometric properties of the his "Think Frailty" tool. Age and Ageing, 47(S 3), iii20-iii23. (doi: 10.1093/ageing/afy127.02)

Abstract

Introduction: Identifying frailty in older adults can highlight those at risk of poor health outcomes and potential requirement for additional specialist input. We evaluated the psychometric properties of a brief 5-point frailty assessment designed by Healthcare Improvement Scotland (HIS) for use in acute settings. The HIS “think frailty” tool assesses each patient on ‘FRAIL’: Functional impairment; Resident in a care home; Altered mental state; Immobility/instability; Likely to require support for discharge. Method: Older adult patients admitted to five Scottish hospitals were recruited. Each patient was assessed for frailty using the HIS “think frailty” tool and Clinical Frailty Scale by staff in the acute unit. Using the Clinical Frailty Scale (CFS) as the gold standard comparator, we assessed the concurrent validity (Spearman’s Rho), as well as the sensitivity, specificity, positive predictive value and negative predictive value (Receiver operating characteristic) of the HIS “think frailty” tool. Results: 700 patients were assessed. The HIS “think frailty” tool and CFS demonstrated a strong (Rho = 0.736), significant (p < 0.01) correlation. At the optimal ‘Frailty positive’ cut-off point (1+), sensitivity of the HIS “think frailty” tool was 94% and specificity61%. At a frailty population prevalence of 58.83% (95%CI = 55.04–62.55), the HIS “think frailty” tool positive predictive value was 77.66% (95%CI = 74.97–80.14); and negative predictive value was 87.82% (CI = 82.87–91.48). Total area under the curve explained by the HIS “think frailty” tool was 0.775. Conclusion: The HIS “think frailty” tool has promising discriminatory ability for assessment of frailty. When frailty is highly prevalent within the population, the tool appears better suited to ruling out frailty than identifying it.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Quinn, Professor Terry and Taylor-Rowan, Dr Martin and Ellis, Dr Graham
• Authors: Taylor-Rowan, M., Quinn, T., Smith, P., Ellis, G., Keir, R., McAlpine, C., Marsh, G., Murtagh, J., McElroy, M., Mitchell, L., Waddell, G., Williams, A., Duffy, L., Oswald, S., Myles, A., Bann, A., Rodger, K., Reid, J., Kellichan, L., Docharty, D., Marshall, T., McGurn, B., Ritchie, C., Wells, A., Talbot, A., McInnes, C., Reynish, E., Coleman, D., Flynn, B., Scott, A., Coull, A., and Dingwall, L.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
• Journal Name: Age and Ageing
• Publisher: Oxford University Press
• ISSN: 0002-0729
• ISSN (Online): 1468-2834