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

BMC Emergency Medicine

Research

Judah Goldstein¹  Christophe Graf²  Matthieu Genoud³  Laurent Suppan³  Christophe A. Fehlmann⁴  Loric Stuby⁵  Rebecca Rigney⁶  Debra Eagles⁷ 

[1] Dalhousie Department of Emergency Medicine, Division of EMS, Halifax, NS, Canada;Department of rehabilitation and geriatrics, Geneva University Hospitals, CH-1211, Geneva, Switzerland;Division of Emergency Medicine, Department of Acute Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, CH-1211, Geneva, Switzerland;Division of Emergency Medicine, Department of Acute Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, CH-1211, Geneva, Switzerland;School of Epidemiology and Public Health, University of Ottawa, K1G 5Z3, Ottawa, ON, Canada;Genève TEAM Ambulances, Emergency Medical Services, CH-1201, Geneva, Switzerland;National Ambulance Service, Westmeath, Ireland;School of Epidemiology and Public Health, University of Ottawa, K1G 5Z3, Ottawa, ON, Canada;Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada;Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada;

关键词: Paramedics;    Clinical frailty scale;    Cfs;    Reliability;    Accuracy;    Emergency medical services;    Prehospital care;    Triage system;   

DOI  :  10.1186/s12873-023-00875-x

 received in 2023-06-09, accepted in 2023-08-25,  发布年份 2023

来源: Springer

【 摘 要 】

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.RegistrationThis study was registered on the Open Science Framework registries (https://doi.org/10.17605/OSF.IO/VDUZY).

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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