{"doi":"10.1111/jgs.19138","title":"<scp>eFrailty</scp> : Making frailty assessment accessible to clinicians and researchers","abstract":"“Which frailty assessment tool should I use?” This is the most frequently asked question from clinicians and researchers who are aware of the concept of frailty but are unfamiliar with the dozens of definitions and tools available for assessment. Even when one chooses a specific tool, locating it on the web and following instructions for scoring and interpretation can be cumbersome at the point of care. As geriatricians, researchers, and educators who measure, study, and teach frailty, we felt the need to fill this gap by creating a “one-stop shop” for commonly used frailty assessment tools. We are excited to introduce the product of our efforts over the past two years—eFrailty.org (Figure 1). “Our main goal in creating eFrailty is to make frailty assessment accessible to clinicians and researchers, within and outside geriatrics and aging research.” To achieve this goal, we aimed to (1) summarize the features of commonly used, validated frailty assessment tools; (2) create web-based calculators to allow real-time scoring and interpretation at the point of care; and (3) help users choose the most appropriate tool for their clinical situation. First, we curated 15 commonly used and validated frailty assessment tools (Table 1) through team consensus, informed by the literature (original research articles reporting each tool)1 and our clinical experience. Since the deficit accumulation frailty index (FI) has been operationalized in various ways due to adaptations made depending on the clinical and research datasets used, we chose the version based on items routinely collected in a comprehensive geriatric assessment (CGA).2 For each assessment tool, we indicate the average time to administer each assessment tool, unique features, number of test items, and included domains. The site also features a crosswalk to allow comparison of scores across nine common frailty assessment tools.3 Second, we created web-based interactive calculators for scoring and interpreting each frailty tool within the website. For example, for the Fried physical phenotype, we applied sex- and height-specific cutpoints for slow gait, sex- and body mass index-specific cutpoints for weak grip strength, and kilocalorie cutpoints from selected items of the Minnesota Leisure Time Activity Questionnaire to determine low physical activity.4, 5 These cutpoints are automatically incorporated within the calculator such that, without a calculator, manually identifying these cutpoints and computing scores in clinical practice can be otherwise challenging and time-insensitive. Third, we developed an algorithm to guide the choice of frailty assessment in different clinical settings (Figure 2). We identified three clinical scenarios: screening or brief risk assessment (“does this patient have frailty or an elevated risk for adverse health outcomes?”), comprehensive assessment and care planning (“what interventions and supportive services does this patient need to reverse frailty or prevent adverse health outcomes?”), and risk assessment before stressful treatment (“what is this patient's risk for experiencing adverse outcomes after surgery or chemotherapy?”). For screening in primary care or acute care settings, a simple tool that can be completed within 3–5 min based on self-report with or without a brief physical performance test (e.g., chair stands) is appropriate. For comprehensive assessment and care planning, tools based on a CGA or similar multi-domain assessment, which often require cognitive tests and physical performance tests, are needed to identify modifiable causes of frailty and tailor interventions to prevent frailty progression and optimize health. For risk stratification before stressful treatment, such as surgery or chemotherapy, it is preferable to choose a tool validated in the patient population undergoing the treatment of interest. In each scenario, we recommend one main tool and several alternative tools which users can opt to choose from. Users should","journal":"Journal of the American Geriatrics Society","year":2024,"id":428938,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":11,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9519,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1189849,"name":"Megan Cheslock","orcid":"0000-0002-8894-8132","position":1,"is_corresponding":false},{"id":1034809,"name":"Stephanie Denise M. Sison","orcid":"0000-0003-3894-7219","position":2,"is_corresponding":false},{"id":341309,"name":"Ariela R. Orkaby","orcid":"0000-0002-4297-6306","position":3,"is_corresponding":false},{"id":339160,"name":"Andrea Wershof Schwartz","orcid":"0000-0002-2076-6068","position":4,"is_corresponding":false},{"id":270250,"name":"Dae Hyun Kim","orcid":"0000-0001-7290-6838","position":0,"is_corresponding":true}],"reference_count":7,"raw_metadata":null,"created_at":"2026-07-19T01:59:02.165535Z","pmid":"39134464","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}