A 10-item frailty index based on a comprehensive geriatric assessment (FI-CGA-10) in older adults with cancer: Development and construct validation.
Notice bibliographique
Résumé
e24011 Background: A frailty index based on domain-level deficits in a comprehensive geriatric assessment (FI-CGA) has been previously developed and validated in general geriatric patients (Jones D, Aging Clin Exp Res 2005). Our objectives were to construct an FI-CGA and to assess its construct validity in geriatric oncology setting. Methods: Consecutive older adults with cancer who underwent a CGA on a geriatric oncology service were included. We developed a 10-item frailty index based on deficits in 10 domains (FI-CGA-10): cognition, mood, communication, mobility, balance, nutrition, basic and instrumental activities of daily living, social support and comorbidity. Deficits in each domain were scored as 0 (no problem), 0.5 (minor problem) and 1.0 (major problem). Scores were calculated by dividing the sum of the score of each domain by 10, and categorized as fit ( < 0.2), pre-frail (0.2–0.35), and frail ( > 0.35). Construct validity was tested by comparing the FI-CGA-10 with the following established frailty measures: the Canadian Study of Health and Aging (CSHA) Clinical Frailty Scale (CFS), CSHA rules-based frailty definition and CSHA Function Scale. To evaluate the ability to predict mortality, we tested association between the FI-CGA-10 and validated prognostic indices for mortality: the Lee index and Schonberg index (higher scores reflect a higher risk of mortality). We also examined associations between the FI-CGA-10 and several features commonly seen in frail older adults such as function (Timed Up & Go (TUG) test), cognitive impairment (Mini-Cog), and high comorbidity burden (Charlson Comorbidity Index (CCI)). Results: Of 540 patients (median age 80 years, range 66–96 years), common cancer types were gastrointestinal tract in 37%, hepatobiliary and pancreatic in 22%, and head and neck in 12%. 406 (75%) patients had ECOG PS 0 to 1. The FI-CGA-10 had a right-skewed distribution and was well approximated by the gamma distribution. Overall, 20% of patients were fit, 41% were pre-frail, and 39% were frail. The FI-CGA-10 was highly correlated with CSHA CFS (Pearson's r = 0.83), CSHA rules-based frailty definition (r = 0.67) and CSHA Function Score (r = 0.77). People who were more frail had higher scores on the Lee index (fit: 7.3, prefrail: 8.8, frail: 12.0; p < .0001) and Schonberg index (fit: 10.1, prefrail: 13.1, frail: 15.7; p < .0001), suggesting an increased probability of death. Increasing levels of frailty were significantly associated with a longer TUG (seconds), fit: 11.3, prefrail: 13.0, frail: 26.3; p < .0001, poorer cognitive function (Mini-Cog score, fit: 4.7, prefrail: 4.0, frail: 3.1; p < .0001), and higher comorbidity burden (CCI, fit: 0.8, prefrail: 1.4, frail: 1.9; p < .0001). Conclusions: The FI-CGA-10 is a clinically sensible and construct-validated measure of quantifying frailty from a CGA.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,009 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».