Resumen
Background: Frailty is characterized by loss of biological reserves and is associated with an increased risk of adverse health outcomes. Frailty can be operationalized using a Frailty Index (FI) based on the accumulation of health deficits; items under health evaluation in the well-established Comprehensive Geriatric Assessment (CGA) have been used to generate an FI-CGA. Traditionally, constructing the FI-CGA has relied on paper-based recording and manual data processing. As this can be time-consuming and error-prone, it limits widespread uptake of this proven type of frailty assessment. Here, we report the development of an electronic tool, the eFI-CGA, for use on personal computers by frontline healthcare providers, to collect CGA data and automate FI-CFA calculation. The ultimate goal is to support early identification and management of frailty at points-of-care, and make uptake in Electronic Medical Records (EMR) feasible and transparent. Methods: An electronic CGA (eCGA) form was implemented to operate on Microsoft's WinForms platform and coded using C# programming language. Users complete the eCGA form, from which items under the CGA evaluation are automatically retrieved and processed to output an eFI-CGA score. A user-friendly interface and secured data saving methods were implemented. The software was debugged and tested using systematically designed simulation data, addressing different logic, syntax, and application errors, and then tested with clinical assessment. The user manual and manual scoring were used as ground truth to compare eFI-CGA input and automated eFI score calculations. Frontline health-provider user feedback was incorporated to improve the end-user experience. Results: The Standalone eFI-CGA software tool was developed and optimized for use on personal computers. The user interface adapted the design of paper-based CGA form to facilitate familiarity for clinical users. Compared to known scores, the software tool generated eFI-CGA scores with 100% accuracy to four decimal places. The eFI-CGA allowed secure data storage and retrieval of multiple types, including user input, completed eCGA form, coded items, and calculated eFI-CGA scores. It also permitted recording of actions requiring clinical follow-up, facilitating care planning. Application bugs were identified and resolved at various stages of the implementation, resulting in efficient system performance. Discussion: Accurate, robust, and reliable computerized frailty assessments are needed to promote effective frailty assessment and management, as a key tool in health care systems facing up to frailty. Our research has enabled the delivery of the standalone eFI-CGA software technology to empower effective frailty assessment and management by various healthcare providers at points-of-care, facilitating integrated care of older adults.
| Idioma original | English |
|---|---|
| Número de artículo | 89 |
| Publicación | Frontiers in Public Health |
| Volumen | 8 |
| DOI | |
| Estado | Published - mar. 31 2020 |
Nota bibliográfica
Funding Information:The authors are grateful to Drs. Alison Rodger, Leah Nemiroff, Olga Theou, and Barry Clarke for critical input regarding usage requirements and user guide; Kate Keetch and Sherri Fay for research project management and administrative supports. We sincerely acknowledge Harveer Sihota, Sarah Crowe, Maria Judd, Laura Housden, Sabrina Wong, Drs. Roger Wong, Andrew Sixsmith, John Muscedere, Brenda Hefford, Hui Guo, and Victoria Lee for collaborations and supports with the development of the research project. The authors thank Hilary Low and Tara Arvan for assistance with data processing and analysis and revision of the manuscript. Our sincere acknowledgments also go to Surrey Memorial Hospital, Fraser Health Authority, Nova Scotia Health Authority, Dalhousie University Geriatric Medicine Research Unit, Simon Fraser University, Doctors of BC, and the Canadian Frailty Network for supports. Funding. This study was supported by an operating research grant from the Canadian Institutes of Health Research (CIHR; Grant # CIHR-PJT-156210). Additional trainee support was from Surrey Hospital Foundation.
Funding Information:
This study was supported by an operating research grant from the Canadian Institutes of Health Research (CIHR; Grant # CIHR-PJT-156210). Additional trainee support was from Surrey Hospital Foundation.
Publisher Copyright:
© Copyright © 2020 Sepehri, Braley, Chinda, Zou, Tang, Park, Garm, McDermid, Rockwood and Song.
ASJC Scopus Subject Areas
- Public Health, Environmental and Occupational Health
ODS de las Naciones Unidas
Este resultado contribuye a los siguientes Objetivos de Desarrollo Sostenible
