Screening for frailty in primary care: a systematic review of the psychometric properties of the frailty index in community-dwelling older people
Screening for frailty in primary care: a systematic review of the psychometric properties of the frailty index in community-dwelling older people
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DOI：
10.1186/1471-2318-14-27
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发表时间：
2014-03-06
期刊：
影响因子：
4.1
通讯作者：
Schuurmans, Marieke J.
中科院分区：
文献类型：
--
作者：
Drubbel, Irene;Numans, Mattijs E.;Schuurmans, Marieke J.
背景：为了更好地满足体弱老年人的复杂护理需求，全科医生必须能够在日常临床实践中轻松识别体弱状况，例如通过使用体弱指数（FI）。为了探讨 FI 是否是一种有效且充分的初级保健筛查工具，我们对其心理测量特性进行了系统回顾。方法：我们检索了 Cochrane、PubMed 和 Embase 数据库，并纳入了关注 FI 在应用于社区老年人时的标准有效性、结构有效性和反应性的原始研究。我们使用预后研究质量 (QUIPS) 工具评估了研究的质量。这项系统评价是根据 PRISMA 声明进行的。 结果：在确定的 20 项研究中，18 项报告了源自研究数据的 FI，一项报告了源自家庭护理客户管理数据库的 FI，一项报告了源自常规初级保健数据的 FI。总体而言，FI表现出良好的标准和结构效度，但缺乏对反应性的研究。与使用出于研究目的收集的数据进行的研究相比，有迹象表明，使用常规初级保健数据的数据集中的 FI 平均得分和范围可能不同；然而，这一发现需要进一步调查。结论：我们的结果表明 FI 是一种有效的衰弱筛查工具。然而，有必要使用常规电子病历数据进行进一步研究，以调查 FI 的心理测量特性是否可推广到初级保健环境，并促进其在日常临床实践中的解释和实施。
Background: To better accommodate for the complex care needs of frail, older people, general practitioners must be capable of easily identifying frailty in daily clinical practice, for example, by using the frailty index (FI). To explore whether the FI is a valid and adequate screening instrument for primary care, we conducted a systematic review of its psychometric properties.Methods: We searched the Cochrane, PubMed and Embase databases and included original studies focusing on the criterion validity, construct validity and responsiveness of the FI when applied in community-dwelling older people. We evaluated the quality of the studies included using the Quality in Prognosis Studies (QUIPS) tool. This systematic review was conducted based on the PRISMA statement.Results: Of the twenty studies identified, eighteen reported on FIs derived from research data, one reported upon an FI derived from an administrative database of home-care clients, and one reported upon an FI derived from routine primary care data. In general, the FI showed good criterion and construct validity but lacked studies on responsiveness. When compared with studies that used data gathered for research purposes, there are indications that the FI mean score and range might be different in datasets using routine primary care data; however, this finding needs further investigation.Conclusions: Our results suggest that the FI is a valid frailty screening instrument. However, further research using routine Electronic Medical Record data is necessary to investigate whether the psychometric properties of the FI are generalizable to a primary care setting and to facilitate its interpretation and implementation in daily clinical practice.