Abstract
Objectives
To study the reliability and construct validity of the EASY-Care Two-step Older persons
Screening (EASY-Care TOS), a practice-based tool that helps family physicians (FPs)
to identify their frail older patients.
Study Design and Setting
This validation study was conducted in six FP practices. We determined the construct
validity by comparing the results of the EASY-Care TOS with other commonly used frailty
constructs [Fried Frailty Criteria (FFC), Frailty Index (FI)] and with other related
constructs (ie, multimorbidity, disability, cognition, mobility, mental well-being,
and social context). To determine interrater reliability, an independent second EASY-Care
TOS assessment was made for a subpopulation.
Results
We included 587 older patients (mean age 77 ± 5 years, 56% women). According to EASY-Care
TOS, 39.4% of patients were frail. EASY-Care TOS frailty correlated better with FI
frailty (0.63) than with FFC frailty (0.52). A high correlation was found with multimorbidity
(0.50), disabilities (0.53), and mobility (0.55) and a moderate correlation with cognition
(0.31) and mental well-being (0.38). Reliability testing showed 89% agreement (Cohen's
κ 0.63) between EASY-Care TOS frailty judgment by two different assessments.
Conclusion
EASY-Care TOS correlated well with relevant physical and psychosocial measures. Accordingly,
these results show that the EASY-Care TOS identifies patients who have a wide spectrum
of interacting problems.
Keywords
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Article info
Publication history
Published online: November 04, 2013
Accepted:
August 13,
2013
Footnotes
Funding: This project was funded by grant 60-61900-98-217 of the Dutch National Care for the Elderly Program, coordinated and sponsored by ZonMw, The Netherlands Organisation for Health Research and Development.
Ethical approval: The Medical Research Ethics Committee (MREC) of the region Arnhem/Nijmegen, The Netherlands, approved the study. Number of approval is 2009/223. All participants gave informed consent before taking part in the study.
Conflict of interest: None.
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