LSO-033 Comparison of the systemic lupus international collaborating clinics frailty index (SLICC-FI) and the FRAIL scale for identifying frailty among individuals with systemic lupus erythematosus
Bibliographic record
Abstract
Background Frailty is associated with adverse health outcomes in systemic lupus erythematosus (SLE). We aimed to assess the agreement between two frailty measures, the SLICC Frailty Index (SLICC-FI) and the FRAIL scale, for identifying frailty among SLE patients. We also evaluated differences in characteristics between frail and non-frail SLE patients according to each frailty definition. Methods This was a cross-sectional study of consecutive adult SLE patients assessed in the Lupus Clinic at a single academic medical centre from December 2020-November 2021. At a single visit, participants were assessed for disease activity, organ damage, comorbidities, medications, and health-related quality of life (HRQoL). A SLICC-FI score was calculated for each patient. The 5-item FRAIL scale was administered at the same visit. Agreement between the SLICC-FI and the FRAIL scale was evaluated. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal threshold SLICC-FI value based on agreement with the FRAIL scale. Results The 181 SLE patients were mostly female (90.1%) with mean (SD) age 54.6 (14.3) years. Mean (SD) baseline SLICC-FI score was 0.17 (0.08), with 57 patients (31.5%) classified as frail (SLICC-FI >0.21). Based on the FRAIL scale, 31 patients (17.1%) were classified as frail (≥3/5 items). There was moderate correlation between the FRAIL scale and the SLICC-FI (r=0.639; p<0.0001). Agreement occurred in 84.5% of cases (κ=0.591; p<0.0001). The ROC curve analysis yielded an AUC of 0.936 (figure 1). The existing SLICC-FI cut-off value of >0.21 was the optimal threshold (sensitivity 96.8%, specificity 82%). For both frailty definitions, there were significant differences between frail and non-frail SLE patients in terms of age, education, employment status, organ damage, HRQoL, CRP levels, and ESR values (table 1). Conclusions There is moderate agreement between the SLICC-FI and the FRAIL scale for identifying frailty in SLE patients. Each frailty metric may have distinct advantages in different settings.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
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 source (direct Gemma or distilled Codex), 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".