Evidence map›Paper›PMID 37833643›Full record

ArticleBMC emergency medicine2023

Assessment of frailty by paramedics using the clinical frailty scale - an inter-rater reliability and accuracy study.

Christophe A Fehlmann, Loric Stuby, Christophe Graf, Matthieu Genoud, Rebecca Rigney, Judah Goldstein, Debra Eagles, Laurent Suppan

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC emergency medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Christophe A FehlmannDivision of Emergency Medicine, Department of Acute Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, Geneva, CH-1211, Switzerland. christophe.fehlmann@hcuge.ch.ORCID http://orcid.org/0000-0002-4163-0338
Loric StubyGenève TEAM Ambulances, Emergency Medical Services, Geneva, CH-1201, Switzerland.ORCID http://orcid.org/0000-0003-1663-5249
Christophe GrafDepartment of rehabilitation and geriatrics, Geneva University Hospitals, Geneva, CH-1211, Switzerland.ORCID http://orcid.org/0000-0002-0235-5046
Matthieu GenoudDivision of Emergency Medicine, Department of Acute Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, Geneva, CH-1211, Switzerland.ORCID http://orcid.org/0009-0004-1945-8318
Rebecca RigneyNational Ambulance Service, Westmeath, Ireland.ORCID http://orcid.org/0000-0003-3879-6326
Judah GoldsteinDalhousie Department of Emergency Medicine, Division of EMS, Halifax, NS, Canada.ORCID http://orcid.org/0000-0002-0182-5202
Debra EaglesSchool of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, K1G 5Z3, Canada.ORCID http://orcid.org/0000-0002-7454-2721
Laurent SuppanDivision of Emergency Medicine, Department of Acute Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, Geneva, CH-1211, Switzerland.ORCID http://orcid.org/0000-0001-6989-6421

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFrailty assessment by paramedics in the prehospital setting is understudied. The goals of this study were to assess the inter-rater reliability and accuracy of frailty assessment by paramedics using the Clinical Frailty Scale (CFS).

methodsThis was a cross-sectional study with paramedics exposed to 30 clinical vignettes created from real-life situations. There was no teaching intervention prior to the study and paramedics were only provided with the French version of the CFS (definitions and pictograms). The primary outcome was the inter-rater reliability of the assessment. The secondary outcome was the accuracy, compared with the expert-based assessment. Reliability was determined by calculating an intraclass correlation coefficient (ICC). Accuracy was assessed through a mixed effects logistic regression model. A sensitivity analysis was carried out by considering that an assessment was still accurate if the score differed from no more than 1 level.

resultsA total of 56 paramedics completed the assessment. The overall assessment was found to have good inter-rater reliability (ICC = 0.87 [95%CI 0.81-0.93]). The overall accuracy was moderate at 60.6% (95%CI 54.9-66.1) when considering the full scale. It was however much higher (94.8% [95%CI 92.0-96.7] when close assessments were considered as accurate. The only factor associated with accurate assessment was field experience.

conclusionThe assessment of frailty by paramedics was reliable in this vignette-based study. However, the accuracy deserved to be improved. Future research should focus on the clinical impact of these results and on the association of prehospital frailty assessment with patient outcomes. REGISTRATION: This study was registered on the Open Science Framework registries ( https://doi.org/10.17605/OSF.IO/VDUZY ).

Indexed as

FrailtyCross-Sectional StudiesHumansLogistic ModelsParamedicsReproducibility of ResultsAccuracyCfsClinical frailty scaleEmergency medical servicesParamedicsPrehospital careReliabilityTriage system

Identifiers

PMID37833643
PMCPMC10576312

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.