VALIDATION OF A CLAIMS-BASED FRAILTY INDEX AGAINST PHYSICAL PERFORMANCE AND CLINICAL OUTCOMES
Bibliographic record
Abstract
Frailty is an important determinant of health outcomes in older adults that is not measured in Medicare data. We recently developed a claims-based frailty index (CFI) to approximate a survey-based deficit-accumulation frailty index. This study aimed to validate the CFI against physical performance, frailty phenotype, and adverse outcomes using data from 3,642 Medicare beneficiaries in the Health and Retirement Study. The median CFI was 0.15 (range: 0.04–0.61). Of the 2,639 beneficiaries with complete performance data, those with higher CFI had a higher prevalence of phenotypic frailty (first vs. fourth quartile: 5.2% vs. 31.4%), slower gait (0.81 vs. 0.59m/sec), and weaker grip strength (29.5 vs. 24.1kg). After adjusting for age, sex, and comorbidity burden, a 0.1-point increase in CFI was associated with a 1.4- to 2.6-fold odds of death, institutionalization, disability, falls, and hospitalizations. The CFI can be useful for research and population health management when clinical frailty assessment is unavailable.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".