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The Prognostic Accuracy of Clinical Judgment Versus a Validated Frailty Screening Instrument in Older Patients at the Emergency Department: Findings of the AmsterGEM Study by Carmen S. van Dam; Marijke C. Trappenburg; Marieke M. ter Wee; Emiel O. Hoogendijk; Riekie de Vet; Yvo M. Smulders; Prabath B. Nanayakkara; Majon Muller; Mike L. Peters is a Medicine article available to read on EtoBox.
What is The Prognostic Accuracy of Clinical Judgment Versus a Validated Frailty Screening Instrument in Older Patients at the Emergency Department: Findings of the AmsterGEM Study about?
## Study objective: To compare the prognostic accuracy of clinical judgment for frailty in older patients at the emergency department with a validated screening instrument and patient-perceived frailty. ## Methods: A prospective cohort study in patients 70 years of age and older in 2 dutch eds with a follow-up of 3 months. a dichotomous question was asked to the physician and patient: "do you consider the patient / yourself to be frail?" the identification of seniors at risk-hospitalized patients (isar-hp) was used as a validated screening instrument. the primary composite outcome consisted of either functional decline, institutionalization, or mortality. ## Results: A total of 736 patients were included. the physician identified 59% as frail, compared with 49% by isar-hp and 43% by patients themselves. the level of agreement was fair (fleiss kappa, 0.31). after 3 months, 31% of the patients experienced at least 1 adverse health outcome. the sensitivity was 79% for the physician, 72% for isar-hp, 61% for the patient, and 48% for all 3 combined. the specificity was 50% for the physician, 63% for isar-hp, 66% for the patient, and 85% for all 3 positive. the highest positive likelihoo
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- Author
- Carmen S. van Dam; Marijke C. Trappenburg; Marieke M. ter Wee; Emiel O. Hoogendijk; Riekie de Vet; Yvo M. Smulders; Prabath B. Nanayakkara; Majon Muller; Mike L. Peters
- Publisher
- Elsevier BV
- Published
- 2022
- Language
- EN
- Field
- Medicine (Health Sciences)