Observational studyAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine2022
Inter-rater reliability of the Clinical Frailty Scale by staff members in a Swedish emergency department setting.
Observational study in Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 37 citations in OpenAlex.
- Evaluation of a Digital, Self-Administered, Cognitive Test Battery in Older Adult Patients Undergoing Abdominal Surgery: Nonrandomized Feasibility Trial.JMIR formative research · 2025Trial
- Rule-Out yield of the European society of cardiology 0/1-Hour troponin protocol in frail and non-frail octogenarians.Irish journal of medical science · 2026Article
- Frailty classification challenges in the emergency department: agreement and variability in clinical frailty scale scoring.Aging clinical and experimental research · 2026Article
- Psychometric validation of the simplified Chinese clinical frailty scale in older Chinese patients with end-stage knee osteoarthritis.BMC geriatrics · 2025Article
- Can laboratory test-based frailty indices contribute to frailty screening in emergency departments?Age and ageing · 2025Article
- Article
- The impact of frailty on functional recovery and discharge dispositions in patients undergoing urgent neurosurgical care.Neurosurgical review · 2025Article
- Identifying frail patients at the front door: a quality improvement project on improving identifying frailty and accuracy of Clinical Frailty Scale in the emergency department in an acute general hospital.BMJ open quality · 2025Article
- Exploring Hyperkalemia Risk in Frail Older Patients Using RAAS Inhibitors.Drugs & aging · 2025Article
- Frailty and Visual Impairment in Elderly Individuals: Improving Outcomes and Modulating Cognitive Decline Through Collaborative Care Between Geriatricians and Ophthalmologists.Diseases (Basel, Switzerland) · 2024Review
- Comparative Clinical Characteristics of Frail Older Adults in the Emergency Department: Long-Term Care Hospital versus Community Residence.Journal of personalized medicine · 2024Article
- Frailty is associated with 30-day mortality: a multicentre study of Swedish emergency departments.Emergency medicine journal : EMJ · 2024Observational
- Atrial fibrillation accelerates functional decline in older adults: a 15-year follow-up population-based study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Article
- Clinical Frailty Scale at presentation to the emergency department: interrater reliability and use of algorithm-assisted assessment.European geriatric medicine · 2024Article
- The Association Between Frailty Evaluated by Clinical Frailty Scale and Mortality of Older Patients in the Emergency Department: A Prospective Cohort Study.Clinical interventions in aging · 2024Observational
- Prevalence of frailty and associated factors in older adults seeking care at Swedish emergency departments.BMC geriatrics · 2023Article
- Is the clinical frailty scale feasible to use in an emergency department setting? A mixed methods study.BMC emergency medicine · 2023Observational
- Article
- Do-Not-ResuscitateDecision-Making during the COVID-19 Pandemic in a Teaching Hospital: Lessons Learned for the Future.Journal of aging research · 2023Article
- Inter-rater reliability of the Clinical Frailty Scale by staff members in a Swedish emergency department setting.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2022Observational
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAs frailty among the elderly is receiving increasing attention in emergency departments (EDs) around the world, the use of frailty assessment tools is growing. An often used such tool is the Clinical Frailty Scale (CFS), whose inter-rater reliability has been sparingly investigated in ED settings. No inter-rater reliability study regarding CFS has previously been performed within the Scandinavian ED context. The primary aim of this study was to evaluate the inter-rater reliability of the CFS in a Swedish ED setting.
methodsThis was a prospective observational study conducted at three Swedish EDs. Patients ≥65 years were independently assessed with CFS by their responsible physician, registered nurse, and assistant nurse. Demographic information for each assessor was collected, along with frailty status (frail/not frail) on the basis of clinical judgment. Inter-rater reliability was calculated using intraclass correlation coefficient (ICC), whereas agreement of frailty assessed by CFS (dichotomized between frail/not frail, cutoff at ≥5 points) versus solely by clinical judgment was calculated by using cross-tabulation.
resultsOne-hundred patients were included. We found inter-rater reliability to be moderate to good (ICC 0.78, 95% confidence interval [CI] 0.72-0.84), regardless of whether the care team included an emergency physician (ICC 0.74, 95% CI 0.62-0.83) or an intern/resident from another specialty (ICC 0.83, 95% CI 0.74-0.89). The agreement of clinically judged frailty compared to frailty according to CFS was 84%. In the opposing cases, staff tended to assess patients as frail to a higher extent using clinical judgment than by applying CFS on the same patient.
conclusionsThe CFS appears to have a moderate to good inter-rater reliability when used in a clinical ED setting. When guiding clinical decisions, we advise that the CFS score should be discussed within the team. Further research needs to be performed on the accuracy of clinical judgment to identify frailty in ED patients.
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