Validation of the Clinical Frailty Score (CFS) in French language

Abstract

Background The number of elderly patients admitted to the ICU is increasing. To better understand the magnitude of the challenges involved in intensive care practice for this ageing population and discuss a rational allocation of resources (admission, triage and level of care), healthcare practitioners need a reliable evaluation of frailty. In order to promote the adequate use of the clinical frailty Scale (CFS) in French-speaking countries, we aimed to develop, validate and characterise a French (FR) version from the original English (EN) CFS. Methods Translation and back translation method was used to developed and validate a FR version for CFS. Then every patient was assessed by a Doctor a Nurse with another evaluation being perform to evaluate intra inter operator variabilities; We then estimate and compared psychometric properties of the CFS both in FR and EN. Results Inter-rater reliability was 0.87 (95%CI: 0.76-0.93) between doctors for the original CFS-EN version and 0.76 (95%CI: 0.57-0.87) between nurses for the FR version. Inter-rater variability between doctor and nurse was 0.75 (95%CI: 0.56-0.87) for the original version, and 0.73 (95%CI: 0.52-0.85) for the FR version. Test-retest (stability) with the original vs the FR version was 0.86 (95%CI: 0.72-0.93) for doctors and 0.87 (95%CI: 0.76-0.93) for nurses. Differences between the evaluations of the CFS-EN and CSF-FR were not different from 0, with a mean difference of 0.06 (95%CI -0.24, 0.36) for the EN version and -0.03 (95%CI -0.47, 0.41) for the FR version. Agreement between the FR and the EN version for doctors was similar. Average original version ratings were slightly lower than FR version ratings, though this difference did not reach significance: -0.29 (95%CI -0.54, 0.04). Conclusion The CFS-FR version developed and validated in the present study has adequate psychometric properties for doctors or nurses to evaluate frailty in very old intensive care patients.

Cross-sectoral inter-rater reliability of the clinical frailty scale – a Danish translation and validation study

“…In our study, the inter-rater reliability was very high (0.98). A recent validation study of the CFS in both English and French reported similar high inter-rater reliability of 0.87 (95%CI: 0.76–0.93) for native French doctors using the source CFS in English, and 0.76 (95%CI: 0.57–0.87) for native French nurses using the French translation of the CFS [ 24 ].…”

“…Conversely, case vignettes introduce a risk of inflated inter-rater reliability and ICC as raters assess all cases at once, which does not reflect clinical practice.Another limitation to this study is the relatively small number of cases ( n = 15). However, the use of case vignettes allowed a high number of observations of 600 (15 cases, 40 raters), a quadrupling compared to previous investigations of inter-rater reliability following translation of the CFS [ 24 ].…”

“…In this way, we could assess the extent to which the inter-rater reliability was sensitive to the raters’ length of clinical experience and any unobserved variations in raters and cases. Other studies have used a graphical Bland-Altman approach [ 24 ], but this was less appropriate for the current study as our raters came from four different professional groups.…”

Comparison of geriatric assessment tools for frailty among community elderly

“…The screening of frailty is critical because it can decrease disability, morbidity, and mortality and improve the quality of life in elderly individuals. There are many methods to screen frailty in elderly individuals, for example, the Clinical Frailty Scale (CFS), simple FRAIL questionnaire, PRISMA-7 questionnaire, Time Up and Go Test (TUG), Gérontopôle frailty screening tool (GFST) [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ]. These tools are simple, rapid and common for frailty screening in elderly [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ].…”

COVID-19, éthique et confraternité : un nouveau conflit de valeurs ?

“…Cette conception a été largement partagée avec la SFAR (Société française d’anesthésie et de réanimation) ainsi qu’avec la SRLF (Société de réanimation de langue française), qui ont publié des recommandations [6] en ce sens. Les critères de sélection portant essentiellement sur l’état de fragilité de la personne, jugée à l’échelle Clinical Frailty Scale (CFS) [7] , [8] , [9] basée sur l’âge, l’état cognitif et la comorbidité.…”