Abstract
Using clinical vignettes, this study aimed to determine if a measure of patient frailty would impact management decisions made by geriatricians regarding commonly encountered clinical situations. Electronic surveys consisting of three vignettes derived from cases commonly seen in an acute inpatient ward were distributed to geriatricians. Vignettes included patients being considered for intensive care treatment, rehabilitation, or coronary artery bypass surgery. A frailty index was generated through Comprehensive electronic Geriatric Assessment. For each vignette, respondents were asked to make a recommendation for management, based on either a brief or detailed amount of clinical information and to reconsider their decision after the addition of the frailty index. The study suggests that quantification of frailty might aid the clinical judgment now employed daily to proceed with usual care, or to modify it based on the vulnerability of the person to whom it is aimed.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Hubbard RE, Peel NM, Samanta M, Gray LC, Mitnitski A, Rockwood K. Frailty status at admission to hospital predicts multiple adverse outcomes. Age Ageing. 2017;46:801–6.
Morley JE, Vellas B, Abellan van Kan G, et al. Frailty consensus: a call to action. J Am Med Dir Assoc. 2013;14:392–7.
Widagdo IS, Pratt N, Russell M, Roughead EE. Construct validity of four frailty measures in an older Australian population: a rasch analysis. J Frailty Aging. 2016;5:78–81.
Veloski J, Tai S, Evans AS, Nash DB. Clinical vignette-based surveys: a tool for assessing physician practice variation. Am J Med Qual. 2005;20:151–7.
Spoelhof DG, Davis GL, Licari A. Clinical vignettes in geriatric depression. Am Fam Physician. 2011;84:1149–54.
McCrow J, Beattie E, Sullivan K, Fick DM. Development and review of vignettes representing older people with cognitive impairment. Geriatr Nur (Lond). 2013;34:128–37.
Farrell B, Shamji S, Monahan A, Merkley VF. Clinical vignettes to help you deprescribe medications in elderly patients: Introduction to the polypharmacy case series. Can Fam Physician. 2013;59:1257–8.
Hubbard RE, Peel NM, Samanta M, et al. Derivation of a frailty index from the interRAI acute care instrument. BMC Geriatr. 2015;15.
Zeng A, Song X, Dong J, et al. Mortality in Relation to Frailty in Patients Admitted to a Specialized Geriatric Intensive Care Unit. J Gerontol A Biol Sci Med Sci. 2015;70:1586–94.
Lin H-S, Watts JN, Peel NM, Hubbard RE. Frailty and post-operative outcomes in older surgical patients: a systematic review. BMC Geriatr. 2016;16.
Theou O, Stathokostas L, Roland KP, et al. The effectiveness of exercise interventions for the management of frailty: a systematic review. J Aging Res. 2011;2011:19.
Fergusen MK, Thompson K, Huisingh-Scheetz M, et al. The impact of a frailty education module on surgical resident estimates of lobectomy risk. Ann Thorac Surg. 2015;100:235–41.
Girre V, Falcou MC, Gisselbrecht M, et al. Does a geriatric oncology consultation modify the cancer treatment plan for elderly patients? J Gerontol A Biol Sci Med Sci. 2008;63:724–30.
Perera V, Bajorek BV, Matthews S, Hilmer SN. The impact of frailty on the utilisation of antithromobotic therapy in older patients with atrial fibrillation. Age Ageing. 2009;38:156–62.
Clegg A, Bates C, Young J, et al. Development and validation of an electronic frailty index using routine primary care electronic health record data. Age Ageing. 2016;45:353–60.
Author information
Authors and Affiliations
Corresponding author
Electronic supplementary material
Rights and permissions
About this article
Cite this article
Khatry, K., Peel, N.M., Gray, L.C. et al. The Utility of the Frailty Index in Clinical Decision Making. J Frailty Aging 7, 138–141 (2018). https://doi.org/10.14283/jfa.2018.7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.14283/jfa.2018.7