Validation of the virtual measurement of the Essential Frailty Toolset

Abstract

Funding AcknowledgementsType of funding sources: None.BackgroundThe Essential Frailty Toolset (EFT) is a valid measurement of frailty in people with heart valve disease. COVID-19 has prompted the transition to virtual health consultations and necessitates the validation of the virtual assessment of frailty.MethodsWe conducted a prospective observational cohort study to compare the measurement of EFT in person and virtual format within a maximum 2-week window of repeated measurement. The weighted Kappa tests was used to measure the agreement of EFT scores between assessments; we explored the effect of the sequence of measurement using the Cochran-Mantel-Haenszel statistic to test the general association between the timing of measurement and differences of EFT score.ResultsWe recruited a sample of 49 patients, with a mean age of 81 ± 7 years, including 29 men (59.2%); the primary valvular heart diseases were aortic stenosis (n=40, 81.6%), mitral regurgitation (n=2, 4.1%) and tricuspid regurgitation (n=7, 14.3%). The virtual measurement of frailty was conducted using a standardised protocol. The platform for virtual connection selected by patients was FaceTime (n=20, 40.8%) and Zoom (n=29, 59.2%); the median (IQR) number of days between the in-person and the virtual assessment was 5 (3,10). The weighted Kappa estimate was 0.69 (95% CI 0.55, 0.82), illustrating a strong agreement between the separate scores obtained. The test for the general association was non-significant (p=0.82), indicating a lack of evidence for detecting an association between EFT scores and chronological order of assessment.ConclusionThe EFT can be reliably measured virtual in older patients with valvular heart disease to inform clinical care.