BRITISH JOURNAL OF GENERAL PRACTICE
|
2023年
/
73卷
/
735期
关键词:
electronic medical records;
frailty;
primary health care;
OLDER-PEOPLE;
SEX-DIFFERENCES;
ADULTS;
PREDICTION;
OUTCOMES;
D O I:
10.3399/BJGP.2022.0574
中图分类号:
R1 [预防医学、卫生学];
学科分类号:
1004 ;
120402 ;
摘要:
Background Routinely collected clinical data based on electronic medical records could be used to define frailty. Aim To estimate the ability of four potential frailty measures that use electronic medical record data to identify older patients who were frail according to their GP. Design and setting This retrospective cohort study used data from 36 GP practices in the Dutch PHARMO Data Network. Method The measures were the Dutch Polypharmacy Index, Charlson Comorbidity Index (CCI), Chronic Disease Score (CDS), and Frailty Index. GPs' clinical judgement of patients' frailty status was considered the reference standard. Performance of the measures was assessed with the area under the receiver operating characteristic curve (AUC). Analyses were done in the total population and stratified by age and sex. Results Of 31 511 patients aged & GE;65 years, 3735 (11.9%) patients were classified as frail by their GP. The CCI showed the highest AUC (0.79, 95% confidence interval [CI] = 0.78 to 0.80), followed by the CDS (0.69, 95% CI = 0.68 to 0.70). Overall, the measures showed poorer performance in males and females aged & GE;85 years than younger age groups (AUC 0.55- 0.58 in females and 0.57-0.60 in males). Conclusion This study showed that of four frailty measures based on electronic medical records in primary care only the CCI had an acceptable performance to assess frailty compared with frailty assessments done by professionals. In the youngest age groups diagnostic performance was acceptable for all measures. However, performance declined with older age and was least accurate in the oldest age group, thereby limiting the use in patients of most interest.
机构:
Changi Gen Hosp, Dept Geriatr Med, 2 Simei St 3, Singapore 529889, SingaporeChangi Gen Hosp, Dept Geriatr Med, 2 Simei St 3, Singapore 529889, Singapore
Chen, Christine Yuanxin
Gan, Peiying
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机构:
Changi Gen Hosp, Community Nursing Dept, Singapore, SingaporeChangi Gen Hosp, Dept Geriatr Med, 2 Simei St 3, Singapore 529889, Singapore
Gan, Peiying
How, Choon How
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机构:
Changi Gen Hosp, Dept Care & Hlth Integrat, Singapore, Singapore
Duke NUS Acad Med Ctr, Family Med Acad Clin Programme, Singapore, SingaporeChangi Gen Hosp, Dept Geriatr Med, 2 Simei St 3, Singapore 529889, Singapore
机构:
Abyad Med Ctr, Tripoli, Lebanon
Middle East Acad Med Aging, Tripoli, Lebanon
Middle East & North Africa Assoc Aging & Alzheime, Tripoli, Lebanon
Middle East Journal Family Med, Tripoli, Lebanon
Middle East Journal Age & Aging, Tripoli, LebanonAbyad Med Ctr, Tripoli, Lebanon
机构:
Ann & Robert H Lurie Childrens Hosp Chicago, Dept Child & Adolescent Psychiat, 225 East Chicago Ave, Chicago, IL 60611 USA
Northwestern Univ, Feinberg Sch Med, Evanston, IL 60208 USAAnn & Robert H Lurie Childrens Hosp Chicago, Dept Child & Adolescent Psychiat, 225 East Chicago Ave, Chicago, IL 60611 USA
Lavigne, John V.
Meyers, Kathryn Mendelsohn
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机构:
Ann & Robert H Lurie Childrens Hosp Chicago, Dept Child & Adolescent Psychiat, 225 East Chicago Ave, Chicago, IL 60611 USA
Northwestern Univ, Feinberg Sch Med, Evanston, IL 60208 USAAnn & Robert H Lurie Childrens Hosp Chicago, Dept Child & Adolescent Psychiat, 225 East Chicago Ave, Chicago, IL 60611 USA
Meyers, Kathryn Mendelsohn
Feldman, Marissa
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机构:
Ann & Robert H Lurie Childrens Hosp Chicago, Dept Child & Adolescent Psychiat, 225 East Chicago Ave, Chicago, IL 60611 USA
Northwestern Univ, Feinberg Sch Med, Evanston, IL 60208 USAAnn & Robert H Lurie Childrens Hosp Chicago, Dept Child & Adolescent Psychiat, 225 East Chicago Ave, Chicago, IL 60611 USA
机构:
Charles Univ Prague, Dept Geriatr Med, Fac Med 1, Prague, Czech Republic
Gen Fac Hosp, Prague, Czech RepublicIRCCS INRCA, Geriatr & Geriatr Emergency Care, I-60100 Ancona, Italy
Topinkova, E.
Trotta, F. M.
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机构:
IRCCS INRCA, Geriatr & Geriatr Emergency Care, I-60100 Ancona, ItalyIRCCS INRCA, Geriatr & Geriatr Emergency Care, I-60100 Ancona, Italy
Trotta, F. M.
van Asselt, D. Z. B.
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机构:
Med Ctr Leeuwarden, Dept Geriatr Med, Leeuwarden, NetherlandsIRCCS INRCA, Geriatr & Geriatr Emergency Care, I-60100 Ancona, Italy