Clinical global impression of change in physical frailty

Development of a measure based on clinical judgment

Stephanie Studenski*, Risa P. Hayes, Ruth Q. Leibowitz, Rita Bode, Laurie Lavery, Jeremy Walston, Pamela Duncan, Subashan Perera

*Corresponding author for this work

Research output: Contribution to journalReview article

178 Citations (Scopus)

Abstract

OBJECTIVES: To expand the ability to assess physical frailty by developing a Clinical Global Impression of Change in Physical Frailty (CGIC-PF) instrument. DESIGN: Qualitative and quantitative instrument development. SETTING: Academic centers. PARTICIPANTS: Six expert panel members, 46 clinicians, 24 patients, and 12 caregivers. MEASUREMENTS: Literature review and structured group processes with experts, clinicians, and consumers were used to generate an initial list of domains and indicators. Structured interviews with clinical experts in the area of frailty were used to establish relevance and feasibility of measurement of domains. Interrater reliability was assessed through a Web-based study. Geriatricians pilot tested the feasibility of the baseline CGIC-PF with 10 patients. RESULTS: The CGIC-PF includes six intrinsic domains (mobility, balance, strength, endurance, nutrition, and neuromotor performance) and seven consequences domains (medical complexity, healthcare utilization, appearance, self-perceived health, activities of daily living, emotional status, and social status). Each domain has two to four clinical indicators. Change is scored on a 7-point scale from markedly worse to markedly improved. Average interrater reliability of the CGIC-PF for the Web-based cases was 0.97. Geriatricians completed a baseline CGIC-PF on their own patients in 10 minutes or less. CONCLUSION: The CGIC-PF is a structured assessment of change in physical frailty with defined content and process. It has strong face validity, reliability, and feasibility for use in clinical research. It may be useful as one criterion of change and as an anchor for change in other measures.

Original languageEnglish
Pages (from-to)1560-1566
Number of pages7
JournalJournal of the American Geriatrics Society
Volume52
Issue number9
DOIs
Publication statusPublished - Sep 2004
Externally publishedYes

Keywords

  • Aging
  • Clinical global impression of change
  • Frailty
  • Measurement

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