Evaluation of Frailty Assessment Tools and Their Measurement Properties in CKD
Bibliographic record
Abstract
Background: Frailty is three to seven times more common in people with chronic kidney disease (CKD) than in those with normal kidney function. Although frailty and its impact in CKD is well-recognized, the measurement properties of the tools used to assess this syndrome are not known. The aim of this systematic review was to evaluate frailty assessment tools and their measurement properties in CKD. Methods: The study was conducted using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines and Preferred Reporting Items for Systematic reviews and Meta-Analyses for Protocols (PRISMA-P 2015). We searched ten electronic databases (eg. OVID MEDLINE, OVID EMBASE, OVID Health and Psychosocial Instruments, Cochrane Central Register of Controlled Trials (CENTRAL)) and screened studies as per the following inclusion criteria: peerreviewed original research, adults with CKD (non-dialysis, dialysis or kidney transplant (KT)), examines at least one established multidimensional tool used for the assessment of frailty, and presents information to evaluate the measurements properties of the tool. Methodological quality assessment and data synthesis will be performed as per COSMIN guidelines. This review was registered with PROSPERO (CRD42021234558). Results: We retrieved 647 unique citations with 58 eligible studies (N=16,026) of which 60% were prospective cohort studies. The majority (59%) included patients on dialysis, 19% were KT, and the remaining non-dialysis CKD. The dialysis populations utilized hemodialysis (HD) (38%) and peritoneal dialysis (PD) (34%) modalities. Fried's phenotype was the most commonly tool used to assess frailty (57%). Predictive validity was the most frequently reported measurement property (86%) followed by responsiveness (12%). Thirty-one (53%) of the included studies using the Fried's Phenotype evaluated predictive validity. Conclusions: In this review, a majority of the studies focused on the dialysis and nondialysis populations. Fried's Phenotype, the most commonly administered tool, primarily evaluated predictive validity. Future research is required to identify the tool(s) that will be predictive of adverse health outcomes in the KT population and additional studies evaluating these tool's responsiveness to change are needed.
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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 | 0.003 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| 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".