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Our new meta analysis led by @SylvieAucoin now out in @_Anesthesiology. Seems like a good time for a thread on choosing a frailty instrument for #periop care 1/
2/ There are dozens of frailty instruments (big problem) but in reality 4 are commonly used: Frailty Index, Frailty Phenotype, Clinical Frailty Scale, Edmonton Frail Scale
3/ All 4 Frailty instruments predict/are associated with bad outcomes. Effective sizes vary but are not substantively different. Discrimination generally moderate, calibration WAY under-reported
4/ But important differences exist and in the end, data right now put the #CFS on top (@Krockdoc). Why? Simple-it’s the easiest and fastest to use, but there’s more
5/ Preop risk tools should do a few good things: #1 make you think,#2 predict outcomes that matter to your patients #3 add new info the tools you used before didn’t capture (I’m sure there’s more). We found the #CFS most consistently improves prediction bit.ly/2CgRBVS
6/ the CFS improved prediction of disability, discharge destination and long LOS better than the FP or FI (larger increase in discrimination, calibration, explained variance-consistent in internal validation)
7/ And when we asked clinicians working in preop clinic what tool@was most feasible and acceptable-CFS beat FP, plus it was 5️⃣ times faster (<1min on avg) bit.ly/3eaG9Z7
8/#CFS is also quick and easy to learn to use via this online tutorial bit.ly/2ocyAgD, endorsed by geriatricians like @camilla_wong and @Krockdoc and supported by @OttAnesthesia and @OttawaHospital
9/ And last but not least, if you’re interested in why #frailty matters in #periop care, take a look at this review bit.ly/31X5uTP from @SylvieAucoin, myself and Dave McDonald from @Dal_Anesthesia in @IARS_Journals
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