Validation of the clinical frailty score (CFS) in French language

Paul Abraham, Delphine S Courvoisier, Cedric Annweiler, Cliff Lenoir, Thomas Millien, Francoise Dalmaz, Hans Flaatten, Rui Moreno, Steffen Christensen, Dylan W de Lange, Bertrand Guidet, Karim Bendjelid, Bernhard Walder, Bernardo Bollen Pinto, Paul Abraham, Delphine S Courvoisier, Cedric Annweiler, Cliff Lenoir, Thomas Millien, Francoise Dalmaz, Hans Flaatten, Rui Moreno, Steffen Christensen, Dylan W de Lange, Bertrand Guidet, Karim Bendjelid, Bernhard Walder, Bernardo Bollen Pinto

Abstract

Background: Very old critical ill patients are a rapid expanding group. To better understand the magnitude of the challenges involved in intensive care practice for an ageing population and discuss a rational allocation of resources, healthcare practitioners need a reliable evaluation of frailty. In order to promote the adequate use of the Clinical Frailty Scale (CFS) in a wider panel of countries, we aimed to develop, validate and characterise a French (FR) version from the original English (EN) CFS.

Methods: We included participants recruited prospectively for the observational "The very old intensive care patient: A multinational prospective observation study" (VIP Study) at Geneva University Hospitals (FR speaking hospital). A FR version of the CFS was obtained by translation (EN- > FR) and back translation (FR- > EN). The final CFS-FR was then evaluated twice on the same participants with at least a 2-week interval by FR-speaking doctors and nurses.

Results: Inter-rater reliability was 0.87 (95%CI: 0.76-0.93) between doctors for the original CFS 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. 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: In this prospective cohort of very old intensive care participants we developed and tested the basic psychometric properties (internal consistency, reproducibility) of a French version of the CFS. This manuscript provides clinically meaningful psychometric properties that have not been previously reported in any other language, including in the original EN version. The French cultural adaptation of this CFS has adequate psychometric properties for doctors or nurses to evaluate frailty in very old intensive care patients.

Keywords: Frailty; ICU; Mortality; Older people; Severity of illness, Back-translation.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Clinical Frailty Scale, Original EN Version (CFS-EN-original). Permission to use the CSF was granted from Dalhousie University, Ca. May 15. 2017
Fig. 2
Fig. 2
Clinical Frailty Scale, French translated final version (CFS-FR). Permission to use the CSF was granted from Dalhousie University, Ca. May 15. 2017
Fig. 3
Fig. 3
Bland et Altman plot for CFS scoring between 2 independent Doctors with CFS-EN (a), between 2 independent Nurses with CFS-FR (b), with the EN then FR version by Doctor (c)

References

    1. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet Lond Engl. 2013;381(9868):752–762. doi: 10.1016/S0140-6736(12)62167-9.
    1. Baldwin MR, Narain WR, Wunsch H, Schluger NW, Cooke JT, Maurer MS, et al. A prognostic model for 6-month mortality in elderly survivors of critical illness. Chest. 2013;143(4):910–919. doi: 10.1378/chest.12-1668.
    1. Flaatten H, De Lange DW, Morandi A, Andersen FH, Artigas A, Bertolini G, et al. The impact of frailty on ICU and 30-day mortality and the level of care in very elderly patients (≥ 80 years) Intensive Care Med. 2017;43(12):1820–1828. doi: 10.1007/s00134-017-4940-8.
    1. Saxton A, Velanovich V. Preoperative frailty and quality of life as predictors of postoperative complications. Ann Surg. 2011;253(6):1223–1229. doi: 10.1097/SLA.0b013e318214bce7.
    1. Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I, et al. A global clinical measure of fitness and frailty in elderly people. CMAJ Can Med Assoc J. 2005;173(5):489–495. doi: 10.1503/cmaj.050051.
    1. Juma S, Taabazuing M-M, Montero-Odasso M. Clinical frailty scale in an acute medicine unit: a simple tool that predicts length of stay. Can Geriatr J CGJ. 2016;19(2):34–39.
    1. WMA Declaration of Helsinki . Ethical Principles for Medical Research Involving Human Subjects. 2013.
    1. Cicchetti Domenic V. Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychological Assessment. 1994;6(4):284–290. doi: 10.1037/1040-3590.6.4.284.

Source: PubMed

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