Construct validity of the electronic Veterans Affairs Frailty Index against clinician frailty assessment.
Construct validity of the electronic Veterans Affairs Frailty Index against clinician frailty assessment.
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根据临床医生虚弱评估构建电子退伍军人事务虚弱指数的有效性。
DOI：
10.1111/jgs.18540
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发表时间：
2023
影响因子：
6.3
通讯作者：
Orkaby,ArielaR
中科院分区：
文献类型：
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作者：
DuMontier,Clark;Hennis,Robert;Yilidirim,Cenk;Seligman,BenjaminJ;FonsecaValencia,Carolina;Lubinski,BrookeL;Sison,StephanieM;Dharne,Mayuri;Kim,DaeHyun;Schwartz,AndreaWershof;Driver,JaneA;Fillmore,NathanaelR;Orkaby,ArielaR
背景电子虚弱指数（eFI）可以在研究和实践中扩展虚弱的测量，并已证明与临床结果相关的预测有效性。然而，它们的结构效度研究较少。我们的目的是评估的结构效度的VA‐FI，开发用于在美国的eFI退伍军人事务部医疗保健System.MethodsVeterans谁经历了全面的老年评估之间的一月31日，2019年和2022年6月6日在VA波士顿和有足够的数据记录的全面老年评估虚弱指数（CGA‐FI）被包括在内。计算每例患者的VA‐FI（基于诊断和程序代码）和CGA‐FI（基于老年病医生测量的功能缺损）。老年医学家还评估了临床虚弱量表（CFS），功能状态（ADL和IADL），和4米步态速度（4 MGS）。结果共纳入132名退伍军人，中位年龄81.4岁（IQR 75.8-88.7）。随着VA-FI水平的增加（<0.2; 0.2-0.4; >0.4），平均CGA-FI增加（0.24; 0.30; 0.40）。VA‐FI与CGA‐FI中度相关（r0.45，p < 0.001）。VA‐FI每增加0.1个单位与CGA‐FI增加相关（线性回归β 0.05; 95%置信区间[CI] 0.03-0.06），较高CFS类别（有序回归OR 1.69; 95% CI 1.24-2.30），ADL依赖性的几率更高（逻辑回归OR 1.59; 95% CI 1.20-2.11），IADL依赖性（逻辑回归OR 1.68; 95% CI 1.23-2.30），以及4 MGS降低（线性回归β-0.07，95% CI-0.12至-0.02）。所有模型进行了调整，年龄和种族，协会举行后，进一步调整为Charlson ComorrhythmIndex.ConclusionOur结果表明，通过其与临床措施的脆弱性，包括摘要脆弱性措施，功能状态，客观的物理性能的VA-FI的结构效度。我们的研究结果补充了其他人的研究结果，表明eFI可以捕获不仅仅是合并症的功能和移动领域的脆弱性，并可能有助于衡量人群和个人之间的脆弱性。
BackgroundElectronic frailty indices (eFIs) can expand measurement of frailty in research and practice and have demonstrated predictive validity in associations with clinical outcomes. However, their construct validity is less well studied. We aimed to assess the construct validity of the VA‐FI, an eFI developed for use in the U.S. Veterans Affairs Healthcare System.MethodsVeterans who underwent comprehensive geriatric assessments between January 31, 2019 and June 6, 2022 at VA Boston and had sufficient data documented for a comprehensive geriatric assessment‐frailty index (CGA‐FI) were included. The VA‐FI, based on diagnostic and procedural codes, and the CGA‐FI, based on geriatrician‐measured deficits, were calculated for each patient. Geriatricians also assessed the Clinical Frailty Scale (CFS), functional status (ADLs and IADLs), and 4‐meter gait speed (4MGS).ResultsA total of 132 veterans were included, with median age 81.4 years (IQR 75.8–88.7). Across increasing levels of VA‐FI (<0.2; 0.2–0.4; >0.4), mean CGA‐FI increased (0.24; 0.30; 0.40). The VA‐FI was moderately correlated with the CGA‐FI (r0.45,p< 0.001). Every 0.1‐unit increase in the VA‐FI was associated with an increase in the CGA‐FI (linear regression beta 0.05; 95% confidence interval [CI] 0.03–0.06), higher CFS category (ordinal regression OR 1.69; 95% CI 1.24–2.30), higher odds of ADL dependency (logistic regression OR 1.59; 95% CI 1.20–2.11), IADL dependency (logistic regression OR 1.68; 95% CI 1.23–2.30), and a decrease in 4MGS (linear regression beta −0.07, 95% CI −0.12 to −0.02). All models were adjusted for age and race, and associations held after further adjustment for the Charlson Comorbidity Index.ConclusionOur results demonstrate the construct validity of the VA‐FI through its associations with clinical measures of frailty, including summary frailty measures, functional status, and objective physical performance. Our findings complement others' in showing that eFIs can capture functional and mobility domains of frailty beyond just comorbidity and may be useful to measure frailty among populations and individuals.