ArticleThe journals of gerontology. Series A, Biological sciences and medical sciences2019
Frailty Screening Using the Electronic Health Record Within a Medicare Accountable Care Organization.
Article in The journals of gerontology. Series A, Biological sciences and medical sciences, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 99 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
99 citing papers in PubMed.
- The Tribulations of Trials: Lessons Learnt Recruiting 777 Older Adults Into REtirement in ACTion (REACT), a Trial of a Community, Group-Based Active Aging Intervention Targeting Mobility Disability.The journals of gerontology. Series A, Biological sciences and medical sciences · 2020Trial
- The Association of an Electronic Frailty Index with Glaucoma Shunt Outcomes.Geriatrics (Basel, Switzerland) · 2026Article
- Identification of Frailty Subtypes in African American Adults With and Without Type 2 Diabetes: A Latent Class Analysis From the Jackson Heart Study.Diabetes, obesity & metabolism · 2026Article
- Trajectory of frailty among the older people in a community setting: A cohort study from the Shizuoka Kokuho Database.Aging clinical and experimental research · 2026Article
- Development and validation of an electronic health record-based frailty index in the UK Biobank.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026Article
- Blood pressure satisfaction and antihypertensive medication adherence effects frailty transitions in older hypertensive patients.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- Leveraging automated machine learning to benchmark, deconstruct, and compare frailty indices for predicting adverse spinal surgery outcomes.Scientific reports · 2026Article
- Challenges and strategies in the care of older adults across the continuum of intensive and post-intensive care medicine.Intensive care medicine · 2026Review
- The Association of Frailty With Post-Hospital Discharge Location and Health Outcomes.Journal of the American Geriatrics Society · 2025Article
- Hospitalist and "SNFist" Clinician Perspectives on Frailty Assessment of Rehab Patients.Journal of general internal medicine · 2025Article
- Using an electronic frailty index and patient reported outcomes to predict sarcopenia risk.Scientific reports · 2025Article
- External validation of an AI-based preoperative frailty index using real-world data.The journals of gerontology. Series A, Biological sciences and medical sciences · 2025Article
- Overcoming data challenges through enriched validation and targeted sampling to measure whole-person health in electronic health records.Journal of biomedical informatics · 2025Article
- Long-Term Blood Pressure Variability and Physical Performance in Older Adults.Journal of clinical hypertension (Greenwich, Conn.) · 2025Observational
- A Large Language Model Approach to Identifying Preoperative Frailty Among Older Adults From Clinical Notes.Journal of the American Geriatrics Society · 2025Article
- Patient-reported pain severity is associated with shorter survival in older adults with newly diagnosed cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- External validation of a proprietary risk model for 1-year mortality in community-dwelling adults aged 65 years or older.Journal of the American Medical Informatics Association : JAMIA · 2025Article
- Innovative models of care supporting people aging with HIV.Current opinion in HIV and AIDS · 2025Review
- Frailty indices based on routinely collected data: a scoping review.The Journal of frailty & aging · 2025Article
- Treatment outcomes in older patients presenting to a radiation oncology clinic based on an electronic health record-based frailty index.Journal of geriatric oncology · 2025Article
39 more citing papers are in PubMed but not listed here.
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Authors and funding
5 authors.
Funding
Abstract
backgroundThe accumulation of deficits model for frailty has been used to develop an electronic health record (EHR) frailty index (eFI) that has been incorporated into British guidelines for frailty management. However, there have been limited applications of EHR-based approaches in the United States.
methodsWe constructed an adapted eFI for patients in our Medicare Accountable Care Organization (ACO, N = 12,798) using encounter, diagnosis code, laboratory, medication, and Medicare Annual Wellness Visit (AWV) data from the EHR. We examined the association of the eFI with mortality, health care utilization, and injurious falls.
resultsThe overall cohort was 55.7% female, 85.7% white, with a mean age of 74.9 (SD = 7.3) years. In the prior 2 years, 32.1% had AWV data. The eFI could be calculated for 9,013 (70.4%) ACO patients. Of these, 46.5% were classified as prefrail (0.10 < eFI ≤ 0.21) and 40.1% frail (eFI > 0.21). Accounting for age, comorbidity, and prior health care utilization, the eFI independently predicted all-cause mortality, inpatient hospitalizations, emergency department visits, and injurious falls (all p < .001). Having at least one functional deficit captured from the AWV was independently associated with an increased risk of hospitalizations and injurious falls, controlling for other components of the eFI.
conclusionsConstruction of an eFI from the EHR, within the context of a managed care population, is feasible and can help to identify vulnerable older adults. Future work is needed to integrate the eFI with claims-based approaches and test whether it can be used to effectively target interventions tailored to the health needs of frail patients.
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