Background The relationship of claims-based frailty index (CFI), a validated measure to identify frail individuals using Medicare data, and frailty measures used in clinical practice has not yet been fully explored. Methods We identified community-dwelling participants of the 2015 National Health and Aging Trends Study (NHATS) whose CFI scores could be calculated using linked Medicare claims. We calculated 9 commonly used clinical frailty measures from NHATS in-person examination: Study of Osteoporotic Fracture Index (SOF), FRAIL Scale, Frailty Phenotype, Clinical Frailty Scale (CFS), Vulnerable Elder Survey-13 (VES-13), Tilburg Frailty Indicator (TFI), Groningen Frailty Indicator (GFI), Edmonton Frail Scale (EFS), and 40-item Frailty Index (FI). Using equipercentile method, CFI scores were linked to clinical frailty measures. Then, C-statistics and test characteristics of CFI to identify frailty defined by each clinical frailty measure were calculated. Results Of the 3,963 older adults, 44.5% were ≥75 years, 59.4% were female, and 82.3% were non-Hispanic White. A CFI of 0.25 was equipercentile to the following clinical frailty measures scores: SOF 1.4, FRAIL 1.8, Phenotype 1.8, CFS 5.4, VES-13 5.7, TFI 4.6, GFI 5.0, EFS 6.0, and FI 0.26. The C-statistics of using CFI to identify frailty defined by each clinical measure were above ≥0.70 except for CFS and VES-13. The optimal CFI cutpoints to identify frailty per clinical frailty measure ranged from 0.212 to 0.242, with sensitivity and specificity of 0.37-0.83 and 0.66-0.84, respectively. Conclusion Understanding the relationship of CFI and commonly used clinical frailty measures can enhance the interpretability and potential utility of CFI.

中文翻译：

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基于索赔的衰弱指数及其与常用临床衰弱测量的关系

背景 基于索赔的衰弱指数 (CFI) 是一种使用医疗保险数据识别衰弱个体的有效措施，与临床实践中使用的衰弱措施之间的关系尚未得到充分探索。方法 我们确定了 2015 年国家健康和老龄化趋势研究 (NHATS) 的社区参与者，他们的 CFI 分数可以使用链接的医疗保险索赔来计算。我们从 NHATS 现场检查中计算出 9 种常用的临床衰弱指标：骨质疏松骨折指数研究 (SOF)、FRAIL 量表、衰弱表型、临床衰弱量表 (CFS)、弱势老年人调查 13 (VES-13)、蒂尔堡衰弱量表指标 (TFI)、格罗宁根衰弱指数 (GFI)、埃德蒙顿衰弱量表 (EFS) 和 40 项衰弱指数 (FI)。使用等百分位数方法，CFI 评分与临床虚弱指标相关联。然后，计算 C 统计量和 CFI 测试特征，以识别由每个临床衰弱测量定义的衰弱。结果 在 3,963 名老年人中，44.5% ≥75 岁，59.4% 为女性，82.3% 为非西班牙裔白人。 CFI 0.25 与以下临床虚弱测量评分等百分位：SOF 1.4、FRAIL 1.8、表型 1.8、CFS 5.4、VES-13 5.7、TFI 4.6、GFI 5.0、EFS 6.0 和 FI 0.26。除 CFS 和 VES-13 外，使用 CFI 识别每项临床测量定义的衰弱的 C 统计量均高于 ≥0.70。每个临床衰弱测量值识别衰弱的最佳 CFI 切点范围为 0.212 至 0.242，敏感性和特异性分别为 0.37-0.83 和 0.66-0.84。结论 了解 CFI 与常用临床衰弱指标的关系可以增强 CFI 的可解释性和潜在效用。