ArticlePloS one2014
Thoracic surgeons' perception of frail behavior in videos of standardized patients.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- The Impact of a Frailty Education Module on Surgical Resident Estimates of Lobectomy Risk.The Annals of thoracic surgery · 2015Trial
- Differences in preoperative frailty assessment of surgical candidates by sex, age, and race.Surgery open science · 2024Article
- Translating Frailty Research Into Clinical Practice: Insights From the Successful Aging and Frailty Evaluation Clinic.Journal of the American Medical Directors Association · 2019Article
- Physician Gender Differences in Processing Surgical Risk Features in Videos of Standardized Patients.The Annals of thoracic surgery · 2019Article
- What do we know about frailty in the acute care setting? A scoping review.BMC geriatrics · 2018Article
- The Influence of Physician and Patient Gender on Risk Assessment for Lung Cancer Resection.The Annals of thoracic surgery · 2017Article
- Development and Validation of a Standardized Tool for Prioritization of Information Sources.Online journal of public health informatics · 2016Article
- Quality of Helicobacter pylori Infection Management Through Telemedicine: A Nationwide Cross-Sectional Study.Journal of digestive diseasesObservational
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundFrailty is a predictor of poor outcomes following many types of operations. We measured thoracic surgeons' accuracy in assessing patient frailty using videos of standardized patients demonstrating signs of physical frailty. We compared their performance to that of geriatrics specialists.
methodsWe developed an anchored scale for rating degree of frailty. Reference categories were assigned to 31 videos of standardized patients trained to exhibit five levels of activity ranging from "vigorous" to "frail." Following an explanation of frailty, thoracic surgeons and geriatrics specialists rated the videos. We evaluated inter-rater agreement and tested differences between ratings and reference categories. The influences of clinical specialty, clinical experience, and self-rated expertise were examined.
resultsInter-rater rank correlation among all participants was high (Kendall's W 0.85) whereas exact agreement (Fleiss' kappa) was only moderate (0.47). Better inter-rater agreement was demonstrated for videos exhibiting extremes of behavior. Exact agreement was better for thoracic surgeons (n = 32) than geriatrics specialists (n = 9; p = 0.045), whereas rank correlation was similar for both groups. More clinical years of experience and self-reported expertise were not associated with better inter-rater agreement.
conclusionsVideos of standardized patients exhibiting varying degrees of frailty are rated with internal consistency by thoracic surgeons as accurately as geriatrics specialists when referenced to an anchored scale. Ratings were less consistent for moderate degrees of frailty, suggesting that physicians require training to recognize early frailty. Such videos may be useful in assessing and teaching frailty recognition.
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