Validity, reliability and feasibility of tools to identify frail older patients in inpatient hospital care: a systematic review

R. M. J. Warnier; E. van Rossum; E. Van Velthuijsen; W. J. Mulder; J. M. G. A. Schols; G. I. J. M. Kempen

doi:10.1007/s12603-015-0567-z

Validity, reliability and feasibility of tools to identify frail older patients in inpatient hospital care: a systematic review

R. M. J. Warnier^*, E. van Rossum, E. Van Velthuijsen, W. J. Mulder, J. M. G. A. Schols, G. I. J. M. Kempen

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background: The objective of this study is to identify and review screening tools for frailty in older adults admitted to inpatient hospital care with respect to their validity, reliability and feasibility. Methods: Studies were identified through systematically searching PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase and PsycINFO and screening reference lists till June 2014. Papers dealing with screening tools aimed at identifying frail older patients in in-hospital care, and including information about validity, reliability or feasibility, were included in the review. The quality of the included studies was critically appraised via the Quality Assessment of Diagnostic Accuracy Studies (QUADAS). Results: From the originally identified 2001 studies 32 studies met the inclusion criteria, in which 16 screening tools were presented. The screening tools showed different characteristics with respect to the number of items, the method of administration and the domains included. The most frequently studied tools with respect to predictive validity were the Identification Seniors At Risk (ISAR) and Triage Risk Stratification Tool (TRST). Studies retrieved poorer information about reliability and feasibility. Overall sensitivity was fairly good. The ISAR, ISAR-HP (Identification Seniors At Risk Hospitalized Patients) and Multidimensional Prognostic Index (MPI) generally had the best sensitivity. Conclusions: Many screening tools are available for daily practice. These tools to identify frail older patients in inpatient hospital care could be useful. For no tool, however, is clear evidence available yet regarding validity, reliability and feasibility. The overall sensitivity of the included screening tools was fairly good, whereas information on reliability and feasibility was lacking for most tools. In future research more attention should be given to the latter items.

Original language	English
Pages (from-to)	218-230
Number of pages	13
Journal	Journal of Nutrition Health & Aging
Volume	20
Issue number	2
Early online date	7 Jun 2015
DOIs	https://doi.org/10.1007/s12603-015-0567-z
Publication status	Published - Feb 2016

Keywords

Geriatric risk assessment
frailty indicator
hospital
elderly
MULTIDIMENSIONAL PROGNOSTIC INDEX
RISK-STRATIFICATION TOOL
COMPREHENSIVE GERIATRIC ASSESSMENT
IDENTIFICATION
EMERGENCY-DEPARTMENT
PREDICTIVE-VALIDITY
FUNCTIONAL DECLINE
ISAR SCREENING TOOL
ONE-YEAR MORTALITY
ELDERLY-PATIENTS

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Cite this

@article{88deda3ae3634cea897c9265cf80fb21,

title = "Validity, reliability and feasibility of tools to identify frail older patients in inpatient hospital care: a systematic review",

abstract = "Background: The objective of this study is to identify and review screening tools for frailty in older adults admitted to inpatient hospital care with respect to their validity, reliability and feasibility. Methods: Studies were identified through systematically searching PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase and PsycINFO and screening reference lists till June 2014. Papers dealing with screening tools aimed at identifying frail older patients in in-hospital care, and including information about validity, reliability or feasibility, were included in the review. The quality of the included studies was critically appraised via the Quality Assessment of Diagnostic Accuracy Studies (QUADAS). Results: From the originally identified 2001 studies 32 studies met the inclusion criteria, in which 16 screening tools were presented. The screening tools showed different characteristics with respect to the number of items, the method of administration and the domains included. The most frequently studied tools with respect to predictive validity were the Identification Seniors At Risk (ISAR) and Triage Risk Stratification Tool (TRST). Studies retrieved poorer information about reliability and feasibility. Overall sensitivity was fairly good. The ISAR, ISAR-HP (Identification Seniors At Risk Hospitalized Patients) and Multidimensional Prognostic Index (MPI) generally had the best sensitivity. Conclusions: Many screening tools are available for daily practice. These tools to identify frail older patients in inpatient hospital care could be useful. For no tool, however, is clear evidence available yet regarding validity, reliability and feasibility. The overall sensitivity of the included screening tools was fairly good, whereas information on reliability and feasibility was lacking for most tools. In future research more attention should be given to the latter items.",

keywords = "Geriatric risk assessment, frailty indicator, hospital, elderly, MULTIDIMENSIONAL PROGNOSTIC INDEX, RISK-STRATIFICATION TOOL, COMPREHENSIVE GERIATRIC ASSESSMENT, IDENTIFICATION, EMERGENCY-DEPARTMENT, PREDICTIVE-VALIDITY, FUNCTIONAL DECLINE, ISAR SCREENING TOOL, ONE-YEAR MORTALITY, ELDERLY-PATIENTS",

author = "Warnier, {R. M. J.} and {van Rossum}, E. and {Van Velthuijsen}, E. and Mulder, {W. J.} and Schols, {J. M. G. A.} and Kempen, {G. I. J. M.}",

year = "2016",

month = feb,

doi = "10.1007/s12603-015-0567-z",

language = "English",

volume = "20",

pages = "218--230",

journal = "Journal of Nutrition Health & Aging",

issn = "1279-7707",

publisher = "Springer",

number = "2",

}

TY - JOUR

T1 - Validity, reliability and feasibility of tools to identify frail older patients in inpatient hospital care: a systematic review

AU - Warnier, R. M. J.

AU - van Rossum, E.

AU - Van Velthuijsen, E.

AU - Mulder, W. J.

AU - Schols, J. M. G. A.

AU - Kempen, G. I. J. M.

PY - 2016/2

Y1 - 2016/2

N2 - Background: The objective of this study is to identify and review screening tools for frailty in older adults admitted to inpatient hospital care with respect to their validity, reliability and feasibility. Methods: Studies were identified through systematically searching PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase and PsycINFO and screening reference lists till June 2014. Papers dealing with screening tools aimed at identifying frail older patients in in-hospital care, and including information about validity, reliability or feasibility, were included in the review. The quality of the included studies was critically appraised via the Quality Assessment of Diagnostic Accuracy Studies (QUADAS). Results: From the originally identified 2001 studies 32 studies met the inclusion criteria, in which 16 screening tools were presented. The screening tools showed different characteristics with respect to the number of items, the method of administration and the domains included. The most frequently studied tools with respect to predictive validity were the Identification Seniors At Risk (ISAR) and Triage Risk Stratification Tool (TRST). Studies retrieved poorer information about reliability and feasibility. Overall sensitivity was fairly good. The ISAR, ISAR-HP (Identification Seniors At Risk Hospitalized Patients) and Multidimensional Prognostic Index (MPI) generally had the best sensitivity. Conclusions: Many screening tools are available for daily practice. These tools to identify frail older patients in inpatient hospital care could be useful. For no tool, however, is clear evidence available yet regarding validity, reliability and feasibility. The overall sensitivity of the included screening tools was fairly good, whereas information on reliability and feasibility was lacking for most tools. In future research more attention should be given to the latter items.

AB - Background: The objective of this study is to identify and review screening tools for frailty in older adults admitted to inpatient hospital care with respect to their validity, reliability and feasibility. Methods: Studies were identified through systematically searching PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase and PsycINFO and screening reference lists till June 2014. Papers dealing with screening tools aimed at identifying frail older patients in in-hospital care, and including information about validity, reliability or feasibility, were included in the review. The quality of the included studies was critically appraised via the Quality Assessment of Diagnostic Accuracy Studies (QUADAS). Results: From the originally identified 2001 studies 32 studies met the inclusion criteria, in which 16 screening tools were presented. The screening tools showed different characteristics with respect to the number of items, the method of administration and the domains included. The most frequently studied tools with respect to predictive validity were the Identification Seniors At Risk (ISAR) and Triage Risk Stratification Tool (TRST). Studies retrieved poorer information about reliability and feasibility. Overall sensitivity was fairly good. The ISAR, ISAR-HP (Identification Seniors At Risk Hospitalized Patients) and Multidimensional Prognostic Index (MPI) generally had the best sensitivity. Conclusions: Many screening tools are available for daily practice. These tools to identify frail older patients in inpatient hospital care could be useful. For no tool, however, is clear evidence available yet regarding validity, reliability and feasibility. The overall sensitivity of the included screening tools was fairly good, whereas information on reliability and feasibility was lacking for most tools. In future research more attention should be given to the latter items.

KW - Geriatric risk assessment

KW - frailty indicator

KW - hospital

KW - elderly

KW - MULTIDIMENSIONAL PROGNOSTIC INDEX

KW - RISK-STRATIFICATION TOOL

KW - COMPREHENSIVE GERIATRIC ASSESSMENT

KW - IDENTIFICATION

KW - EMERGENCY-DEPARTMENT

KW - PREDICTIVE-VALIDITY

KW - FUNCTIONAL DECLINE

KW - ISAR SCREENING TOOL

KW - ONE-YEAR MORTALITY

KW - ELDERLY-PATIENTS

U2 - 10.1007/s12603-015-0567-z

DO - 10.1007/s12603-015-0567-z

M3 - Article

C2 - 26812520

SN - 1279-7707

VL - 20

SP - 218

EP - 230

JO - Journal of Nutrition Health & Aging

JF - Journal of Nutrition Health & Aging

IS - 2

ER -