Finding consensus on Frailty Assessment in Acute Care through Delphi method

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Title: Finding consensus on Frailty Assessment in Acute Care through Delphi method
Authors: Soong, JTY
Poots, AJ
Item Type: Journal Article
Abstract: Objective: We seek to address gaps in knowledge and agreement around optimal frailty assessment in the acute medical care setting. Frailty is a common term describing older persons who are at increased risk of developing multi-morbidity, disability, institutionalisation, and death. Consensus has not been reached on the practical implementation of this concept to assess clinically and manage older persons in the acute care setting. Design: Modified Delphi, via electronic questionnaire. Questions included ranking items that best recognise frailty, optimal timing, location, and contextual elements of a successful tool. Intra-Class Correlation Coefficients for overall levels of agreement; with consensus and stability tested by two-way ANOVA with absolute agreement and Fisher's Exact Test. Participants: A panel of national experts (academics, front-line clinicians, and specialist charities) were invited to electronic correspondence. Results: Variables reflecting accumulated deficit and high resource utilisation were perceived by participants as the most useful indicators of frailty in the acute care setting. The Acute Medical Unit and Care of the older Persons Ward were perceived as optimum settings for frailty assessment. "Clinically meaningful and relevant", "simple (easy to use)" and "Accessible by multidisciplinary team" were perceived as characteristics of a successful frailty assessment tool in the acute care setting. No agreement was reached on optimal timing, number of variables, and organisational structures. Conclusions: This study is a first step in developing consensus for a clinically relevant frailty assessment model for the acute care setting, providing content validation, and illuminating contextual requirements. Testing on clinical datasets is a research priority.
Issue Date: 14-Oct-2016
Date of Acceptance: 6-Sep-2016
ISSN: 2044-6055
Publisher: BMJ Publishing Group
Journal / Book Title: BMJ Open
Volume: 6
Copyright Statement: This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://
Sponsor/Funder: Royal College of Physicians
National Institute for Health Research
Funder's Grant Number: N/A
Publication Status: Published
Article Number: e012904
Appears in Collections:Department of Medicine
Faculty of Medicine
Epidemiology, Public Health and Primary Care

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