Table 2 The issues that a patient-oriented frailty scale might address and those that might emerge
From: A proposal for a self-rated frailty index and status for patient-oriented research
Classifications of the shortcomings | Issues that can be avoided by a patient-oriented frailty scale | Issues merging if patient-oriented frailty scales in use |
|---|---|---|
Index related | 1. Unclear rationales for equal weighting of domain variables that leads to unequal weighting of input variables and inclusion of duplicate information | |
2. Biases introduced by data processing that is not based on evidence | ||
3. Reproducibility limited by measurement devices and data processing | 1. Subjective measurement | |
4. Disconnection between frailty theories and produced indices because of excessive numbers of input variables and biases introduced due to data processing | ||
5. Complex indices that can be simplified | ||
6. Constraints on the regression coefficients of input or domain variables | ||
7. Relatively poorer predictive power regarding mortality than input variables | 2. Predictive power to be tested | |
Frailty theory-related | 8. Arbitrary thresholds of frailty indices for the diagnosis of frailty statuses | |
9. Arbitrary assumptions about frailty distribution, age correlation, and input variable eligibility of input variables | ||
10. Potential disconnection between biology of frailty and the measurement | ||
11. Patients’ and the public’ perspectives ignored | 3. Deviation from researchers’ definitions | |
12. Disconnection to socio-economic determinants | 4. Questions on socioeconomic status may deter some to respond | |
Information generation | 13. Old information shuffled, if frailty estimated based on available research or administrative data | 5. Reliability and validity to be tested |