Frailty assessment instruments: Systematic characterization of the uses and contexts of highly-cited instruments.
Frailty assessment instruments: Systematic characterization of the uses and contexts of highly-cited instruments.
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DOI：
10.1016/j.arr.2015.12.003
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发表时间：
2016-03
影响因子：
13.1
通讯作者：
Varadhan R
中科院分区：
文献类型：
--
作者：
Buta BJ;Walston JD;Godino JG;Park M;Kalyani RR;Xue QL;Bandeen-Roche K;Varadhan R
虚弱的医学综合症已得到广泛认可，但关于如何在临床和研究环境中最好地衡量它的争论仍然存在。本研究回顾了与脆弱性相关的研究文献，（a）全面编目的仪器，已被用来衡量脆弱性，（B）系统分类的不同目的和使用的研究文献中经常引用的脆弱性工具的上下文。我们共确定了67个脆弱的工具;其中9个被高度引用（≥200次引用）。我们随机抽样并回顾了545篇引用至少一种高引用仪器的英文文章。我们估计了使用的总数，并将其分为八类：（占所有使用的31%）;虚弱的病因学研究（22%）;方法学研究（14%）;生物标志物研究（12%）;纳入/排除标准（10%）;估计患病率作为主要目标（5%）;临床决策（2%）;和介入靶向（2%）。最常见的评估背景是对居住在社区的老年人的观察性研究。身体虚弱表型是研究文献中最常用的虚弱工具，其次是赤字积累指数和弱势老年人调查。本研究对脆弱仪器的当前使用进行了实证评估，在选择用于临床或研究目的的仪器时，这可能是重要的考虑因素。我们建议根据预期用途、捕获的领域以及过去如何使用该工具来仔细考虑脆弱工具的选择。需要继续努力研究这些文书的有效性和可行性。
The medical syndrome of frailty is widely recognized, yet debate remains over how best to measure it in clinical and research settings. This study reviewed the frailty-related research literature by (a) comprehensively cataloging the wide array of instruments that have been utilized to measure frailty, and (b) systematically categorizing the different purposes and contexts of use for frailty instruments frequently cited in the research literature. We identified 67 frailty instruments total; of these, nine were highly-cited (≥200 citations). We randomly sampled and reviewed 545 English-language articles citing at least one highly-cited instrument. We estimated the total number of uses, and classified use into eight categories: risk assessment for adverse health outcomes (31% of all uses); etiological studies of frailty (22%); methodology studies (14%); biomarker studies (12%); inclusion/exclusion criteria (10%); estimating prevalence as primary goal (5%); clinical decision-making (2%); and interventional targeting (2%). The most common assessment context was observational studies of older community-dwelling adults. Physical Frailty Phenotype was the most used frailty instrument in the research literature, followed by the Deficit Accumulation Index and the Vulnerable Elders Survey. This study provides an empirical evaluation of the current uses of frailty instruments, which may be important to consider when selecting instruments for clinical or research purposes. We recommend careful consideration in the selection of a frailty instrument based on the intended purpose, domains captured, and how the instrument has been used in the past. Continued efforts are needed to study the validity and feasibility of these instruments.