Journal article
Clinician Estimates of Frailty Compared to Formal Frailty Assessment in Adults With Heart Failure: A Cross-Sectional Analysis
Heart, Lung and Circulation, Vol.31(9), pp.1241-1246
2022
PMID: 35501244
Abstract
Background: Frailty assessment is recommended for patients with heart failure. Despite the availability of instruments to assess frailty, there are no clear recommendations regarding the optimal instrument to use in a heart failure context. This ambiguity combined with a lack of education and resources, often leads clinicians to rely on subjective estimates of frailty, such as 'the end-of-the-bed' or 'eyeball' test.
Aim: To examine the association between clinician-estimated frailty and formal frailty assessment in adults with heart failure.
Methods: Cross-sectional analysis of the FRAilty MEasurement in Heart Failure (FRAME-HF) study.
Participants: (1) Adults aged ≥18 years in the outpatient heart failure clinic and cardiology ward; (2) and cardiovascular clinicians (nurses, physicians, and allied-health professionals). Following participant recruitment, cardiovascular clinicians were asked to rate the participant's frailty status based on their routine clinical assessment as either: frail, pre-frail, or non-frail, which was then compared to a formal frailty assessment using a modified version of the Frailty Phenotype. The association between clinician-estimated frailty and formal frailty assessment were examined using a weighted Kappa statistic and Spearman's correlation coefficient.
Results: A total of 75 patients and 39 clinicians were recruited, producing 194 paired frailty assessments. Mean age of the patients was 54 (±13) years. Correlation of pooled clinician-estimated frailty to formal frailty was fair (0.52, p=0.00). Correlation was highest between allied-health estimated frailty and formal frailty (0.70, p=0.00). Agreement between pooled clinician-estimated frailty and formal frailty was fair (0.33) and was highest between allied health-estimated frailty and formal frailty (0.45).
Conclusion: Subjective clinician-estimated frailty is not a reliable replacement for formal frailty assessment in adults with heart failure, underscoring the need for assessment using a valid and reliable instrument.
Details
- Title
- Clinician Estimates of Frailty Compared to Formal Frailty Assessment in Adults With Heart Failure: A Cross-Sectional Analysis
- Authors
- Julee McDonagh (Author) - University of Newcastle AustraliaRoslyn Prichard (Author) - University of the Sunshine Coast, Queensland, School of Nursing, Midwifery and Paramedicine - LegacyCaleb Ferguson (Author) - Sydney Local Health DistrictJane L Phillips (Author) - Queensland University of TechnologyPatricia M Davidson (Author) - Johns Hopkins UniversityPeter S Macdonald (Author) - St Vincent's Hospital SydneyPhillip J Newton (Author) - Western Sydney University
- Publication details
- Heart, Lung and Circulation, Vol.31(9), pp.1241-1246
- Publisher
- Elsevier Australia
- Date published
- 2022
- DOI
- 10.1016/j.hlc.2022.04.003
- ISSN
- 1444-2892
- PMID
- 35501244
- Organisation Unit
- School of Health - Nursing; University of the Sunshine Coast, Queensland; School of Nursing, Midwifery and Paramedicine - Legacy
- Language
- English
- Record Identifier
- 99634540602621
- Output Type
- Journal article
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- Domestic collaboration
- Web Of Science research areas
- Cardiac & Cardiovascular Systems
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