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Elsman EBM, Mokkink LB, Abma IL, Aiyegbusi OL, Chiarotto A, Haywood KL, Matvienko-Sikar K, Oosterveer DM, Pool JJM, Swinkels-Meewisse IEJ, Offringa M, Terwee CB. Methodological quality of 100 recent systematic reviews of health-related outcome measurement instruments: an overview of reviews. Qual Life Res 2024:10.1007/s11136-024-03706-z. [PMID: 38961010 DOI: 10.1007/s11136-024-03706-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2024] [Indexed: 07/05/2024]
Abstract
PURPOSE Systematic reviews evaluating and comparing the measurement properties of outcome measurement instruments (OMIs) play an important role in OMI selection. Earlier overviews of review quality (2007, 2014) evidenced substantial concerns with regards to alignment to scientific standards. This overview aimed to investigate whether the quality of recent systematic reviews of OMIs lives up to the current scientific standards. METHODS One hundred systematic reviews of OMIs published from June 1, 2021 onwards were randomly selected through a systematic literature search performed on March 17, 2022 in MEDLINE and EMBASE. The quality of systematic reviews was appraised by two independent reviewers. An updated data extraction form was informed by the earlier studies, and results were compared to these earlier studies' findings. RESULTS A quarter of the reviews had an unclear research question or aim, and in 22% of the reviews the search strategy did not match the aim. Half of the reviews had an incomprehensive search strategy, because relevant search terms were not included. In 63% of the reviews (compared to 41% in 2014 and 30% in 2007) a risk of bias assessment was conducted. In 73% of the reviews (some) measurement properties were evaluated (58% in 2014 and 55% in 2007). In 60% of the reviews the data were (partly) synthesized (42% in 2014 and 7% in 2007); evaluation of measurement properties and data syntheses was not conducted separately for subscales in the majority. Certainty assessments of the quality of the total body of evidence were conducted in only 33% of reviews (not assessed in 2014 and 2007). The majority (58%) did not make any recommendations on which OMI (not) to use. CONCLUSION Despite clear improvements in risk of bias assessments, measurement property evaluation and data synthesis, specifying the research question, conducting the search strategy and performing a certainty assessment remain poor. To ensure that systematic reviews of OMIs meet current scientific standards, more consistent conduct and reporting of systematic reviews of OMIs is needed.
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Affiliation(s)
- Ellen B M Elsman
- Department of Epidemiology & Data Science, Amsterdam UMC, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, De Boelelaan 1089a, 1081 HV, Amsterdam, The Netherlands
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
| | - Lidwine B Mokkink
- Department of Epidemiology & Data Science, Amsterdam UMC, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, De Boelelaan 1089a, 1081 HV, Amsterdam, The Netherlands
| | - Inger L Abma
- IQ Health, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Olalekan Lee Aiyegbusi
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Alessandro Chiarotto
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Kirstie L Haywood
- Warwick Applied Health, Warwick Medical School, University of Warwick, Coventry, UK
| | | | | | - Jan J M Pool
- University of Applied Sciences, Utrecht, The Netherlands
| | | | - Martin Offringa
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
| | - Caroline B Terwee
- Department of Epidemiology & Data Science, Amsterdam UMC, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, De Boelelaan 1089a, 1081 HV, Amsterdam, The Netherlands.
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Nguyen TN, Ahmad F, Lindley RI. Frailty in clinical drug trials: Frailty assessments, subgroup analyses and outcomes. Br J Clin Pharmacol 2024. [PMID: 38509766 DOI: 10.1111/bcp.16034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 12/23/2023] [Accepted: 01/18/2024] [Indexed: 03/22/2024] Open
Abstract
With population ageing, drug trials are increasingly turning their attention to including older, frailer people. This review aimed to provide an overview of how frailty was assessed in published studies related to clinical pharmacological trials, and on the interaction of frailty on the efficacy of the treatments. We searched MEDLINE, EMBASE and Cochrane for clinical drug trials in older people. A total of 4031 abstracts were screened and 17 relevant studies were included in this review. We summarized the findings of these 17 trials into five main clinical areas: cardiovascular (eight studies), cognition (one study), vaccination (two studies), cancer (four studies) and other (two studies). Frailty was assessed retrospectively in most of the studies. Frailty was treated as an ordinal variable (with different levels of frailty) or binary variable (frail/non-frail) using cut-offs in some studies, and as a continuous in some other studies. The effect of frailty on the treatment efficacy was not consistent among the studies. While several trials, such as the Action in Diabetes and Vascular Disease-Preterax and Diamicron Modified Release Controlled Evaluation trials, the Systolic Blood Pressure Intervention Trial and the Aspirin in Reducing Events in the Elderly trial, showed some reduced effects of the treatment in frail patients, most of the trials showed that the benefits of the treatment are not affected by frailty. Some trials even showed that the benefits of the treatment were more significant in frailer patients (the Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure and the Dapagliflozin Evaluation to Improve the Lives of Patients with Preserved Ejection Fraction Heart Failure trials). The results of this review suggest that routine measurement of frailty in participants in clinical drug trials would improve our knowledge of the effect of treatment in the frail and identify those who have more or least to gain from treatment.
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Affiliation(s)
- Tu N Nguyen
- Westmead Applied Research Centre, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Fahed Ahmad
- Westmead Applied Research Centre, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Richard I Lindley
- Westmead Applied Research Centre, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- George Institute for Global Health, Sydney, New South Wales, Australia
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Gong C, Ma R, Li B, Wen L, Ding Z. Effect of ultrasound-guided thoracic paravertebral block on perioperative analgesia in elderly patients undergoing video-assisted thoracic lobectomy in China: An interventional clinical randomized controlled trial. Thorac Cancer 2023; 14:3406-3414. [PMID: 37853927 PMCID: PMC10693941 DOI: 10.1111/1759-7714.15135] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 09/30/2023] [Accepted: 10/03/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND The aim of this study was to investigate the analgesic effect and safety of ultrasound-guided thoracic paravertebral block (UG-TPVB) in Chinese elderly patients undergoing video-assisted thoracic lobectomy (VATL) and to study the influence of aging factors on these effects. METHODS This study was a single-center, single-blind, prospective, randomized, controlled trial. A total of 300 patients scheduled for VATL were recruited and randomly divided into the UG-TPVB group (T group) and conventional anesthesia group (C group) according to the recruitment order, and subgroups were set up according to whether the age was ≥65 years old or not. The postoperative 12, 24, and 48 h static/dynamic visual analog scale (VAS) scores, intraoperative fentanyl consumption, postoperative extubation time, post-anesthesia care unit (PACU) stay time, hospitalization days, postoperative complications, and other indicators were compared between the two groups. RESULTS The postoperative 12, 24, and 48 h static/dynamic VAS scores of the T group were significantly lower than those of the C group. The intraoperative fentanyl consumption, postoperative extubation time, PACU stay time, and postoperative hospitalization days were significantly lower than those of the C group. The incidence of postoperative 48 h urinary retention in the T group was significantly lower than that in the C group. These advantages showed no significant difference or slight difference between elderly patients and nonelderly patients, indicating that UG-TPVB did not influence the analgesic effect and safety of VATL patients by age or age difference. CONCLUSION UG-TPVB is an effective and safe perioperative analgesia method for elderly VATL patients. Its application improves the quality of life and prognosis of elderly VATL patients.
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Affiliation(s)
- Chanjuan Gong
- Department of Anesthesiology and Perioperative MedicineThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Rong Ma
- Department of Anesthesiology and Perioperative MedicineThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Bing Li
- Department of Anesthesiology and Perioperative MedicineThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Li Wen
- Division of Emergency MedicineBeijing HospitalBeijingChina
| | - Zhengnian Ding
- Department of Anesthesiology and Perioperative MedicineThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
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Jin U, Yoon M, Ha J, Lee S, Yun D, Kim J, Oh J, Park S, Lee S, Kang S, Lee CJ. Association between frailty and physical performance in older patients with heart failure. Clin Cardiol 2023; 46:1530-1537. [PMID: 37675764 PMCID: PMC10716321 DOI: 10.1002/clc.24142] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/10/2023] [Accepted: 08/21/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Frailty is an issue in patients with heart failure (HF). A Korean version of the frailty scale (K-FRAIL) has been developed. HYPOTHESIS We aimed to analyze the relationship between the K-FRAIL scale and physical performance in patients with HF. METHODS This study included 142 patients with HF aged ≥65 years from a single center. Muscular fitness was assessed using the handgrip test and knee extensor strength measurement. Aerobic capacity was assessed using the cardiopulmonary exercise test and 6-min walk test (6MWT). Frailty was assessed using the K-FRAIL questionnaire. RESULTS Peak VO2 and 6MWT scores significantly decreased as frailty worsened, but handgrip and knee extensor strength did not. In the multivariate analysis, peak VO2 (β = -.31; p = .002) and 6MWT score (β = -.38; p < .001) showed significant inverse associations with the K-FRAIL score. Based on the receiver operating characteristic curve analysis, the cut-off values of peak VO2 (hazard ratio, 5.08; p = .023) and 6MWT (hazard ratio, 3.99; p = .020) were independent predictors of frailty. CONCLUSION In older patients with HF, physical performance correlates with the degree of frailty. The K-FRAIL scale is correlated with the peak VO2 and 6MWT.
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Affiliation(s)
- Uram Jin
- Department of CardiologyAjou University School of MedicineSuwon‐siRepublic of Korea
| | - Minjae Yoon
- Division of CardiologySeverance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of MedicineSeoulRepublic of Korea
| | - Jaehyung Ha
- Division of CardiologySeverance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of MedicineSeoulRepublic of Korea
| | - Seung‐Hyun Lee
- Division of CardiologySeverance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of MedicineSeoulRepublic of Korea
| | - Doeun Yun
- Division of CardiologySeverance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of MedicineSeoulRepublic of Korea
| | - Ji‐Su Kim
- Division of CardiologySeverance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of MedicineSeoulRepublic of Korea
| | - Jaewon Oh
- Division of CardiologySeverance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of MedicineSeoulRepublic of Korea
| | - Sungha Park
- Division of CardiologySeverance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of MedicineSeoulRepublic of Korea
| | - Sang‐Hak Lee
- Division of CardiologySeverance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of MedicineSeoulRepublic of Korea
| | - Seok‐Min Kang
- Division of CardiologySeverance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of MedicineSeoulRepublic of Korea
| | - Chan Joo Lee
- Division of CardiologySeverance Cardiovascular Hospital and Cardiovascular Research Institute, Yonsei University College of MedicineSeoulRepublic of Korea
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Amsalu E, Zhang Y, Harrison C, Nguyen TV, Nguyen TN. Exploring Frailty in the Intersection of Cardiovascular Disease and Cancer in Older People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7105. [PMID: 38063535 PMCID: PMC10706810 DOI: 10.3390/ijerph20237105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/04/2023] [Accepted: 11/21/2023] [Indexed: 12/18/2023]
Abstract
Advances in cardiovascular therapies and cancer treatments have resulted in longer patient survival. The coexistence of cancer and cardiovascular disease has been recognized as a complex clinical scenario. In addition to cardiovascular disease, older people with cancer are at greater risk of experiencing multimorbidity and geriatric syndromes, such as frailty. In older people, the concurrent presence of cancer and cardiovascular disease increases the risk of mortality, and the presence of frailty can exacerbate their conditions and hinder treatment effectiveness. Given the significant intersection among frailty, cardiovascular disease, and cancer in older people, this paper aims to provide an overview of the current research in this field and identifies gaps in the research to understand the burden and impact of frailty in these populations. While many studies have examined the prevalence and impact of frailty on adverse outcomes in patients with cancer or cardiovascular disease, evidence of frailty in individuals with both conditions is lacking. There is no universally accepted definition of frailty, which leads to inconsistencies in identifying and measuring frailty in older adults with cardiovascular disease and cancer. The frailty index seems to be a preferred frailty definition in studies of patients with cancer, while the frailty phenotype seems to be more commonly used in cardiovascular research. However, differences in how the frailty index was categorized and in how patients were classified as 'frail' depending on the cut points may have a negative effect on understanding the impact of frailty in the studied populations. This makes it challenging to compare findings across different studies and limits our understanding of the prevalence and impact of frailty in these populations. Addressing these research gaps will contribute to our understanding of the burden of frailty in older people with cardiovascular disease and cancer, and improve clinical care protocols in this vulnerable population.
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Affiliation(s)
- Erkihun Amsalu
- Westmead Applied Research Centre, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2145, Australia;
| | - Ying Zhang
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2050, Australia; (Y.Z.); (C.H.)
| | - Christopher Harrison
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2050, Australia; (Y.Z.); (C.H.)
| | - Tan Van Nguyen
- Department of Interventional Cardiology, Thong Nhat Hospital, Ho Chi Minh City 70000, Vietnam;
- Department of Geriatrics & Gerontology, University of Medicine and Pharmacy, Ho Chi Minh City 70000, Vietnam
| | - Tu Ngoc Nguyen
- Westmead Applied Research Centre, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2145, Australia;
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Velazquez-Diaz D, Arco JE, Ortiz A, Pérez-Cabezas V, Lucena-Anton D, Moral-Munoz JA, Galán-Mercant A. Use of Artificial Intelligence in the Identification and Diagnosis of Frailty Syndrome in Older Adults: Scoping Review. J Med Internet Res 2023; 25:e47346. [PMID: 37862082 PMCID: PMC10625070 DOI: 10.2196/47346] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/09/2023] [Accepted: 07/27/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Frailty syndrome (FS) is one of the most common noncommunicable diseases, which is associated with lower physical and mental capacities in older adults. FS diagnosis is mostly focused on biological variables; however, it is likely that this diagnosis could fail owing to the high biological variability in this syndrome. Therefore, artificial intelligence (AI) could be a potential strategy to identify and diagnose this complex and multifactorial geriatric syndrome. OBJECTIVE The objective of this scoping review was to analyze the existing scientific evidence on the use of AI for the identification and diagnosis of FS in older adults, as well as to identify which model provides enhanced accuracy, sensitivity, specificity, and area under the curve (AUC). METHODS A search was conducted using PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines on various databases: PubMed, Web of Science, Scopus, and Google Scholar. The search strategy followed Population/Problem, Intervention, Comparison, and Outcome (PICO) criteria with the population being older adults; intervention being AI; comparison being compared or not to other diagnostic methods; and outcome being FS with reported sensitivity, specificity, accuracy, or AUC values. The results were synthesized through information extraction and are presented in tables. RESULTS We identified 26 studies that met the inclusion criteria, 6 of which had a data set over 2000 and 3 with data sets below 100. Machine learning was the most widely used type of AI, employed in 18 studies. Moreover, of the 26 included studies, 9 used clinical data, with clinical histories being the most frequently used data type in this category. The remaining 17 studies used nonclinical data, most frequently involving activity monitoring using an inertial sensor in clinical and nonclinical contexts. Regarding the performance of each AI model, 10 studies achieved a value of precision, sensitivity, specificity, or AUC ≥90. CONCLUSIONS The findings of this scoping review clarify the overall status of recent studies using AI to identify and diagnose FS. Moreover, the findings show that the combined use of AI using clinical data along with nonclinical information such as the kinematics of inertial sensors that monitor activities in a nonclinical context could be an appropriate tool for the identification and diagnosis of FS. Nevertheless, some possible limitations of the evidence included in the review could be small sample sizes, heterogeneity of study designs, and lack of standardization in the AI models and diagnostic criteria used across studies. Future research is needed to validate AI systems with diverse data sources for diagnosing FS. AI should be used as a decision support tool for identifying FS, with data quality and privacy addressed, and the tool should be regularly monitored for performance after being integrated in clinical practice.
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Affiliation(s)
- Daniel Velazquez-Diaz
- ExPhy Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Cádiz, Spain
- Advent Health Research Institute, Neuroscience Institute, Orlando, FL, United States
| | - Juan E Arco
- Department of Communications Engineering, University of Malaga, Málaga, Spain
- Andalusian Research Institute in Data Science and Computational Intelligence, Granada, Spain
- Department of Signal Theory, Networking and Communications, University of Granada, Granada, Spain
| | - Andres Ortiz
- Department of Communications Engineering, University of Malaga, Málaga, Spain
- Andalusian Research Institute in Data Science and Computational Intelligence, Granada, Spain
| | - Verónica Pérez-Cabezas
- MOVE-IT Research Group, Department of Nursing and Physiotherapy, Faculty of Health Sciences, University of Cádiz, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz, Cádiz, Spain
| | - David Lucena-Anton
- Biomedical Research and Innovation Institute of Cádiz, Cádiz, Spain
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, Cádiz, Spain
| | - Jose A Moral-Munoz
- Biomedical Research and Innovation Institute of Cádiz, Cádiz, Spain
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, Cádiz, Spain
| | - Alejandro Galán-Mercant
- MOVE-IT Research Group, Department of Nursing and Physiotherapy, Faculty of Health Sciences, University of Cádiz, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz, Cádiz, Spain
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de Oliveira MPB, Pereira DS, da Silva SLA, Alencar MA, Iunes DH, da Silva Alexandre T. Are assessment measures for components of the International Classification of Functioning, Disability and Health reproducible for use on pre-frail and frail older adults? A systematic review. Exp Gerontol 2023; 182:112300. [PMID: 37769825 DOI: 10.1016/j.exger.2023.112300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 12/06/2022] [Accepted: 09/25/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE To analyze the internal consistency, reliability and measurement error of assessment measures for body structure and function (postural balance, muscle strength, cardiorespiratory function and physical fitness), activity (walking and mobility) and participation (quality of life and social reintegration) outcomes for use on pre-frail and frail older adults. METHODS Searches were performed in six databases (Medline, Embase, ScienceDirect, Web of Science, The Cochrane Library and Lilacs) and reproducibility studies were included. Cronbach's alpha and the classification proposed by Terwee et al. (2007) were used for the interpretation of internal consistency. The intraclass correlation coefficient (ICC) and the Munro classification were used for the determination of reliability. The standard error of measurement (SEM), minimal detectable change (MDC) as well as percentages of error (SEM%) and change (MDC%) were calculated. Methodological quality of the studies was appraised using Boxes 4, 6 and 7 of the COSMIN Risk of Bias checklist. RESULTS Six studies were included in the present systematic review, with a total of 835 (82.4 years; 582 women and 253 men) pre-frail and frail older adults analyzed. Seven measures were identified for the assessment of body structure and function, activity and participation outcomes (Hierarchical Assessment of Balance and Mobility, Self-Assessment of Physical Fitness, Sarcopenia Quality of Life, Reintegration to Normal Living Index, Two-Minute Walking test, Six-Minute Walking test and Ten-Meter Walking test). The following measurement properties were identified: internal consistency = 0.84 (mean Cronbach's alpha); reliability = 0.87 (mean ICC); SEM range = 0.06 to 10.10; MDC range = 0.13 to 28.10; SEM% range = 5.2 % to 9.5 %; and MDC% range = 10.7 % to 28.5 %. CONCLUSION The present systematic review found adequate internal consistency, high reliability and an acceptable measurement error for assessment measures of body structure and function, activity and participation outcomes for use on pre-frail and frail older adults.
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Affiliation(s)
| | - Daniele Sirineu Pereira
- Department of Physical Therapy, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Mariana Asmar Alencar
- Department of Physical Therapy, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Denise Hollanda Iunes
- Department of Physical Therapy, Federal University of Alfenas, Alfenas, Minas Gerais, Brazil.
| | - Tiago da Silva Alexandre
- Department of Gerontology and Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil; Department of Epidemiology and Public Health, University College London, London, United Kingdom.
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Mazya AL, Boström AM, Bujacz A, Ekdahl AW, Kowalski L, Sandberg M, Gobbens RJJ. Translation and Validation of the Swedish Version of the Tilburg Frailty Indicator. Healthcare (Basel) 2023; 11:2309. [PMID: 37628509 PMCID: PMC10454910 DOI: 10.3390/healthcare11162309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/03/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
The Tilburg Frailty Indicator (TFI) is a questionnaire with 15 questions designed for screening for frailty in community-dwelling older people. TFI has a multidimensional approach to frailty, including physical, psychological, and social dimensions. The aim of this study was to translate TFI into Swedish and study its psychometric properties in community-dwelling older people with multimorbidity. A cross-sectional study of individuals 75 years and older, with ≥3 diagnoses of the ICD-10 and ≥3 visits to the Emergency Department in the past 18 months. International guidelines for back-translation were followed. Psychometric properties of the TFI were examined by determining the reliability (inter-item correlations, internal consistency, test-retest) and validity (concurrent, construct, structural). A total of 315 participants (57.8% women) were included, and the mean age was 83.3 years. The reliability coefficient KR-20 was 0.69 for the total sum. A total of 39 individuals were re-tested, and the weighted kappa was 0.7. TFI correlated moderately with other frailty measures. The individual items correlated with alternative measures mostly as expected. In the confirmatory factor analysis (CFA), a three-factor model fitted the data better than a one-factor model. We found evidence for adequate reliability and validity of the Swedish TFI and potential for improvements.
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Affiliation(s)
- Amelie Lindh Mazya
- Division of Clinical Geriatrics, Department NVS, Karolinska Institutet, 141 83 Huddinge, Sweden
- Department of Geriatric Medicine of Danderyd Hospital, 182 88 Danderyd, Sweden
| | - Anne-Marie Boström
- Theme Inflammation and Aging, Nursing Unit Aging, Karolinska University Hospital, 141 86 Huddinge, Sweden
- Division of Nursing, Department NVS, Karolinska Institutet, 141 83 Huddinge, Sweden
- R&D Unit, Stockholms Sjukhem, 112 19 Stockholm, Sweden
| | - Aleksandra Bujacz
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Anne W. Ekdahl
- Division of Clinical Geriatrics, Department NVS, Karolinska Institutet, 141 83 Huddinge, Sweden
- Department of Clinical Sciences Helsingborg, Lund University, 251 87 Helsingborg, Sweden
| | - Leo Kowalski
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Magnus Sandberg
- Department of Health Sciences, Lund University, 221 00 Lund, Sweden
| | - Robbert J. J. Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, 1081 HV Amsterdam, The Netherlands
- Zonnehuisgroep Amstelland, 1180 HV Amstelveen, The Netherlands
- Department Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Wilrijk, Belgium
- Tranzo, Tilburg University, 5037 AB Tilburg, The Netherlands
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Bamps J, Capouillez B, Rinaldi R, Patris S. Frailty detection by healthcare professionals: a systematic review of the available English and French tools and their validation. Eur Geriatr Med 2023; 14:773-787. [PMID: 37278921 DOI: 10.1007/s41999-023-00806-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/23/2023] [Indexed: 06/07/2023]
Abstract
BACKGROUND There is a wide variety of frailty detection tools, but no gold standard. Choosing the most appropriate tool can therefore be complicated. Our systematic review seeks to provide useful data on the frailty detection tools available to help healthcare professionals in choosing a tool. METHOD We systematically searched for articles published between January 2001 and December 2022 in three electronic databases. Articles were to be written in English or French and were to discuss a frailty detection tool used by healthcare professionals in a population without specific health conditions. Any self-testing, physical testing or biomarkers were excluded. Systematic reviews and meta-analyses were also excluded. Data were extracted from two coding grids; one for the criteria used by the tools to detect frailty and the other for the evaluation of clinimetric parameters. The quality of the articles was assessed using QUADAS-2. RESULTS A total of 52 articles, covering 36 frailty detection tools, were included and analysed in the systematic review. Forty-nine different criteria were identified, with a median of 9 (IQR 6-15) criteria per tool. Regarding the evaluation of tool performances, 13 different clinimetric properties were identified, with a mean of 3.6 (± 2.2) properties assessed per tool. CONCLUSION There is considerable heterogeneity in the criteria used to detect frailty, as well as in the way tools are evaluated.
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Affiliation(s)
- Julien Bamps
- Clinical Pharmacy Unit, Faculty of Medicine and Pharmacy, University of Mons (UMONS), Chemin du Champ de Mars, 25, Bât. 6, 7000, Mons, Belgium.
| | - Bastien Capouillez
- Clinical Pharmacy Unit, Faculty of Medicine and Pharmacy, University of Mons (UMONS), Chemin du Champ de Mars, 25, Bât. 6, 7000, Mons, Belgium
| | - Romina Rinaldi
- Clinical Orthopedagogy Unit, Faculty of Psychology and Education, University of Mons (UMONS), Mons, Belgium
| | - Stéphanie Patris
- Clinical Pharmacy Unit, Faculty of Medicine and Pharmacy, University of Mons (UMONS), Chemin du Champ de Mars, 25, Bât. 6, 7000, Mons, Belgium
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Zhao J, Liu YWJ, Tyrovolas S, Mutz J. Exploring the concept of psychological frailty in older adults: a systematic scoping review. J Clin Epidemiol 2023; 159:300-308. [PMID: 37156339 DOI: 10.1016/j.jclinepi.2023.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/18/2023] [Accepted: 05/01/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVES We reviewed the existing definitions of psychological frailty and provided a comprehensive overview of the concept and associated measurements. STUDY DESIGN AND SETTING We followed the PRISMA guidelines for scoping reviews and the Joanna Briggs Institute Manual for Evidence Synthesis. The eligibility criteria for including studies were developed based on the participants-concept-context framework. We searched the Cumulative Index to Nursing and Allied Health Literature, Scopus, PubMed, Web of Science and PsycINFO databases, and other sources for relevant studies published between January 2003 and March 2022. RESULTS The final scoping review included 58 studies. Of these, 40 defined psychological frailty, seven provided a novel definition, and 11 focused on the components defining psychological frailty. We proposed four groups of components to better characterize psychological frailty: mood, cognitive, other mental health, and fatigue-related problems. We identified 28 measuring tools across studies, and the Tilburg Frailty Indicator was the most frequently used (46.6%). CONCLUSION Psychological frailty is a complex concept whose definition seems to lack consensus. It could include both psychological and physical features. Depression and anxiety are commonly used to define it. This scoping review outlined future research directions for refining the concept of psychological frailty.
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Affiliation(s)
- Jinlong Zhao
- School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yat Wa Justina Liu
- School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Stefanos Tyrovolas
- School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Julian Mutz
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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11
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Beauchet O, Matskiv J, Gaudreau P, Allali G, Vaillant-Ciszewicz AJ, Guerin O, Gros A. Frailty, Cognitive Impairment, and Incident Major Neurocognitive Disorders: Results of the NuAge Cohort Study. J Alzheimers Dis 2023:JAD230006. [PMID: 37355893 DOI: 10.3233/jad-230006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2023]
Abstract
BACKGROUND Frailty is associated with an increased risk of major neurocognitive disorders (MNCD). OBJECTIVE This study aims to compare the Fried physical model and the CARE deficit accumulation model for their association with incident major neurocognitive disorders (MNCD), and to examine how the addition of cognitive impairment to these frailty models impacts the incidence in community-dwelling older adults. METHODS A subset of community dwellers (n = 1,259) who participated in the "Quebec Longitudinal Study on Nutrition and Successful Aging" (NuAge) were selected in this Elderly population-based observational cohort study with 3 years of follow-up. Fried and CARE frailty stratifications into robust, pre-frail and frail groups were performed using the NuAge baseline assessment. Incident MNCD (i.e., Modified Mini Mental State (3MS) score < 79/100 and Instrumental Activity Daily Living (IADL) score < 6/8) were collected each year over a 3-year follow-up period. RESULTS A greater association with incident MNCD of the CARE frail state was observed with an increased predictive value when combined with cognitive impairment in comparison to Fried's one, the highest incidences being observed using the robust state as the reference. Results with the Fried frail state were more heterogenous, with no association with the frail state alone, whereas cognitive impairment alone showed the highest significant incidence. CONCLUSION The association of the CARE frail state with cognitive impairment increased the predictive value of MNCD, suggesting that the CARE frailty model may be of clinical interest when screening MCND in the elderly population.
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Affiliation(s)
- Olivier Beauchet
- Department of Medicine, University of Montreal and Research Centre of the Geriatric University Institute of Montreal, Montreal, Quebec, Canada
- Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada
| | - Jacqueline Matskiv
- Department of Medicine, University of Montreal and Research Centre of the Geriatric University Institute of Montreal, Montreal, Quebec, Canada
| | - Pierrette Gaudreau
- Research Centre of the Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Gilles Allali
- Leenaards Memory Centre, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | | | - Olivier Guerin
- Centre Hospitalier Universitaire de Nice, Clinique Gériatrique du Cerveau et du Mouvement, Nice, France
| | - Auriane Gros
- Centre Hospitalier Universitaire de Nice, Clinique Gériatrique du Cerveau et du Mouvement, Nice, France
- Laboratoire CoBTeK, Université Côte d'Azur, Nice, France
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12
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Hou YG, Feng SM, Wang SM, Zhao YJ, Yan L. The construction and validation of a frailty risk prediction model for older adults with lung cancer: A cross-sectional study. Eur J Oncol Nurs 2023; 64:102316. [PMID: 37141666 DOI: 10.1016/j.ejon.2023.102316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/18/2023] [Accepted: 03/10/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVE We aimed to construct and internally validate a frailty risk prediction model in older adults with lung cancer. METHOD In total, 538 patients were recruited in a grade A tertiary cancer hospital in Tianjin, and patients were randomly divided into the training group (n = 377) and the testing group (n = 166) at a ratio of 7:3. The Frailty Phenotype scale was used to identify frailty and logistic regression analysis was used to identify the risk factors and establish a frailty risk prediction model. RESULTS In the training group, logistic regression showed that age, fatigue-related symptom cluster, depression, nutritional status, D-dimer level, albumin level, presence of comorbidities, and disease course were independent risk factors for frailty. The areas under the curve (AUCs) of the training and testing groups were 0.921 and 0.872, respectively. A calibration curve of P = 0.447 validated model calibration. The decision curve analysis demonstrated greater clinical benefit when the threshold probability was >20%. CONCLUSION The prediction model had a favorable prediction power for determining the risk of frailty, contributing to the prevention and screening of frailty. Patients with a frailty risk score of more than 0.374 should be regularly monitored for frailty and receive personalized preventive interventions.
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Affiliation(s)
- Ying-Ge Hou
- Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, China; Tianjin Medical University, 300070, China.
| | - Shu-Mei Feng
- Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, China; Tianjin Medical University, 300070, China.
| | - Song-Mei Wang
- Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China.
| | - Ya-Jie Zhao
- Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China.
| | - Ling Yan
- Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, China.
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13
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Fons A, Kalisvaart K, Maljaars J. Frailty and Inflammatory Bowel Disease: A Scoping Review of Current Evidence. J Clin Med 2023; 12:jcm12020533. [PMID: 36675461 PMCID: PMC9860672 DOI: 10.3390/jcm12020533] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/30/2022] [Accepted: 01/02/2023] [Indexed: 01/11/2023] Open
Abstract
Frailty is increasingly recognized as an important concept in patients with Inflammatory Bowel Disease (IBD). The aim of this scoping review is to summarize the current literature on frailty in IBD. We will discuss the definition of frailty, frailty assessment methods, the prevalence of frailty, risk factors for frailty and the prognostic value of frailty in IBD. A scoping literature search was performed using the PubMed database. Frailty prevalence varied from 6% to 53.9%, depending on the population and frailty assessment method. Frailty was associated with a range of adverse outcomes, including an increased risk for all-cause hospitalization and readmission, mortality in non-surgical setting, IBD-related hospitalization and readmission. Therefore, frailty assessment should become integrated as part of routine clinical care for older patients with IBD.
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Affiliation(s)
- Anne Fons
- Department of Gastroenterology and Hepatology, Leiden University Medical Centre, 2333 ZA Leiden, The Netherlands
- Department of Geriatric Medicine, Spaarne Gasthuis, 2035 RC Haarlem, The Netherlands
- Correspondence: ; Tel.: +31-71-526-3507
| | - Kees Kalisvaart
- Department of Geriatric Medicine, Spaarne Gasthuis, 2035 RC Haarlem, The Netherlands
| | - Jeroen Maljaars
- Department of Gastroenterology and Hepatology, Leiden University Medical Centre, 2333 ZA Leiden, The Netherlands
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Li K, Yin R, Li Z. Frailty and long-term survival of patients with ovarian cancer: A systematic review and meta-analysis. Front Oncol 2022; 12:1007834. [PMID: 36324564 PMCID: PMC9618815 DOI: 10.3389/fonc.2022.1007834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 09/20/2022] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Frailty has been related with poor prognosis of various diseases, including ovarian cancer. We performed a systematic review and meta-analysis to evaluate the association between frailty and long-term survival of patients with ovarian cancer. METHODS Relevant cohort studies were retrieved by search of PubMed, Embase, Cochrane's Library, and Web of Science electronic databases. Two authors independently performed literature search, data collection, and statistical analyses. A random-effect model incorporating the possible influence of heterogeneity was used to pool the results. RESULTS Nine cohort studies including 2497 women with confirmed diagnosis of ovarian cancer contributed to the meta-analysis, and 536 (21.5%) of them were with high frailty. The median follow-up durations varied between 24 and 69 months. Compared to patients with low or non-frailty, OC patients with high frailty were associated with poor overall survival (risk ratio [RR]: 1.61, 95% confidence interval [CI]: 1.41 to 1.85, p < 0.001; I2 = 0%) and progression-free survival (RR: 1.51, 95% CI: 1.20 to 1.89, p < 0.001; I2 = 0%). Subgroup analyses according to study design, cancer stage, age of patients, scales for frailty evaluation, follow-up duration, and quality score of the included study showed consistent association between high frailty and poor overall survival in women with ovarian cancer (p for subgroup effects all < 0.05). After considering GRADE criteria for strength of the evidence, it was rated low for both the two outcomes. CONCLUSION High frailty may be an independent risk factor of poor survival in women with ovarian cancer. Evaluating frailty may be important for predicting the prognosis and determining the optimal anticancer treatments in women with ovarian cancer. SYSTEMATIC REVIEW REGISTRATION https://inplasy.com/, identifier INPLASY202290028.
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Affiliation(s)
| | | | - Zhengyu Li
- The Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, China
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15
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Beauchet O, Galery K, Lafontaine C, Sawchuk K, Plonka A, Gros A, Allali G. Frailty, e-health and prevention of late-onset Alzheimer disease and related disorders: it is time to take action. Aging Clin Exp Res 2022; 34:1179-1181. [PMID: 35334089 PMCID: PMC8953956 DOI: 10.1007/s40520-022-02122-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 03/17/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Olivier Beauchet
- Departments of Medicine, University of Montreal, Montreal, QC, Canada.
- Research Centre of the Geriatric University Institute of Montreal, Montreal, QC, Canada.
- Division of Geriatric Medicine, Department of Medicine, Sir Mortimer B. Davis Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada.
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
| | - Kevin Galery
- Research Centre of the Geriatric University Institute of Montreal, Montreal, QC, Canada
| | | | - Kim Sawchuk
- Faculty of Arts and Science, Concordia University, Montreal, QC, Canada
| | - Alexandra Plonka
- Centre Hospitalier Universitaire de Nice, Laboratoire CoBTeK, Service Clinique Gériatrique du Cerveau et du Mouvement, Université Côté d'Azur, Nice, France
| | - Auriane Gros
- Centre Hospitalier Universitaire de Nice, Laboratoire CoBTeK, Service Clinique Gériatrique du Cerveau et du Mouvement, Université Côté d'Azur, Nice, France
| | - Gilles Allali
- Leenaards Memory Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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