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Liu Q, Yang L, Shi Z, Yu J, Si H, Jin Y, Bian Y, Li Y, Ji L, Qiao X, Wang W, Liu H, Zhang M, Wang C. Development and validation of a preliminary clinical support system for measuring the probability of incident 2-year (pre)frailty among community-dwelling older adults: A prospective cohort study. Int J Med Inform 2023; 177:105138. [PMID: 37516037 DOI: 10.1016/j.ijmedinf.2023.105138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 06/18/2023] [Accepted: 06/26/2023] [Indexed: 07/31/2023]
Abstract
OBJECTIVE To develop the wed-based system for predicting risk of (pre)frailty among community-dwelling older adults. MATERIALS AND METHODS (Pre)frailty was determined by physical frailty phenotype scale. A total of 2802 robust older adults aged ≥60 years from the China Health and Retirement Longitudinal Study (CHARLS) 2013-2015 survey were randomly assigned to derivation or internal validation cohort at a ratio of 8:2. Logistic regression, Random Forest, Support Vector Machine and eXtreme Gradient Boosting (XGBoost) were used to construct (pre)frailty prediction models. The Grid search and 5-fold cross validation were combined to find the optimal parameters. All models were evaluated externally using the temporal validation method via the CHARLS 2011-2013 survey. The (pre)frailty predictive system was web-based and built upon representational state transfer application program interfaces. RESULTS The incidence of (pre)frailty was 34.2 % in derivation cohort, 34.8 % in internal validation cohort, and 32.4 % in external validation cohort. The XGBoost model achieved better prediction performance in derivation and internal validation cohorts, and all models had similar performance in external validation cohort. For internal validation cohort, XGBoost model showed acceptable discrimination (AUC: 0.701, 95 % CI: [0.655-0.746]), calibration (p-value of Hosmer-Lemeshow test > 0.05; good agreement on calibration plot), overall performance (Brier score: 0.200), and clinical usefulness (decision curve analysis: more net benefit than default strategies within the threshold of 0.15-0.80). The top 3 of 14 important predictors generally available in community were age, waist circumference and cognitive function. We embedded XGBoost model into the server and this (pre)frailty predictive system is accessible at http://www.frailtyprediction.com.cn. A nomogram was also conducted to enhance the practical use. CONCLUSIONS A user-friendly web-based system was developed with good performance to assist healthcare providers to measure the probability of being (pre)frail among community-dwelling older adults in the next two years, facilitating the early identification of high-risk population of (pre)frailty. Further research is needed to validate this preliminary system across more controlled cohorts.
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Affiliation(s)
- Qinqin Liu
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Liming Yang
- School of Computer Science, Peking University, Beijing 100871, China
| | - Zhuming Shi
- School of Electronics Engineering and Computer Science, Peking University, Beijing 100871, China
| | - Jiaqi Yu
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Huaxin Si
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Yaru Jin
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Yanhui Bian
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Yanyan Li
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Lili Ji
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Xiaoxia Qiao
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Wenyu Wang
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Hongpeng Liu
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China
| | - Ming Zhang
- School of Computer Science, Peking University, Beijing 100871, China
| | - Cuili Wang
- School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China.
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Li S, Fan W, Zhu B, Ma C, Tan X, Gu Y. Frailty Risk Prediction Model among Older Adults: A Chinese Nation-Wide Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148410. [PMID: 35886260 PMCID: PMC9322778 DOI: 10.3390/ijerph19148410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 07/01/2022] [Accepted: 07/03/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Numerous studies have been performed on frailty, but rarely do studies explore the integrated impact of socio-demographic, behavioural and social support factors on frailty. This study aims to establish a comprehensive frailty risk prediction model including multiple risk factors. METHODS The 2018 wave of the Chinese Longevity and Health Longitudinal Survey was used. Univariate and multivariate logistic regressions were performed to identify the relationship between frailty and multiple risk factors and establish the frailty risk prediction model. A nomogram was utilized to illustrate the prediction model. The area under the receiver operating characteristic curve (AUC), Hosmer-Lemeshow test and calibration curve were used to appraise the prediction model. RESULTS Variables from socio-demographic, social support and behavioural dimensions were included in the final frailty risk prediction model. Risk factors include older age, working as professionals and technicians before 60 years old, poor economic condition and poor oral hygiene. Protective factors include eating rice as a staple food, regular exercise, having a spouse as the first person to share thoughts with, doing physical examination once a year and not needing a caregiver when ill. The AUC (0.881), Hosmer-Lemeshow test (p = 0.618), and calibration curve showed that the risk prediction model was valid. CONCLUSION Risk factors from socio-demographic, behavioural and social support dimensions had a comprehensive effect on frailty, further supporting that a comprehensive and individualized intervention is necessary to prevent frailty.
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Affiliation(s)
- Siying Li
- School of Public Health, Wuhan University, Wuhan 430071, China; (S.L.); (W.F.); (B.Z.); (C.M.)
| | - Wenye Fan
- School of Public Health, Wuhan University, Wuhan 430071, China; (S.L.); (W.F.); (B.Z.); (C.M.)
| | - Boya Zhu
- School of Public Health, Wuhan University, Wuhan 430071, China; (S.L.); (W.F.); (B.Z.); (C.M.)
| | - Chao Ma
- School of Public Health, Wuhan University, Wuhan 430071, China; (S.L.); (W.F.); (B.Z.); (C.M.)
| | - Xiaodong Tan
- School of Public Health, Wuhan University, Wuhan 430071, China; (S.L.); (W.F.); (B.Z.); (C.M.)
- Correspondence: (X.T.); (Y.G.)
| | - Yaohua Gu
- School of Nursing, Wuhan University, Wuhan 430071, China
- Correspondence: (X.T.); (Y.G.)
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