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Diagnostic Accuracy of Frailty Measurement Tools on Frailty Assessment in
Cancer Patients: A Diagnostic Meta-analysis

1
D. Apriadi and H. Huang 1

College of Nursing/School of Nursing, Taipei Medical University, Chinese Taipei
1

Background: The questionnaire-based method is commonly used for a rapid assessment of
individuals with frailty. However, the appropriate scale for identifying frail cases in the cancer
population remains unclear.

Objective: This meta-analysis was to investigate the diagnostic accuracy of three
questionnaire-based tools (i.e., Groningen Frailty Indicator (GFI), Tilburg Frailty Indicator (TFI), and
Vulnerable Elders Survey-13 (VES-13) for screening frailty in the cancer population.

Methods: Five electronic databases, including the Cumulative Index to Nursing and Allied Health
Literature, Embase, Google Scholar, PubMed, and ProQuest, were searched from their inception until
January 20, 2024. Study quality, encompassing risks of bias and applicability, was evaluated using a
Oral Presentation Abstracts
QUADAS-2 tool. A bivariate meta-analysis with random-effects model was adopted to calculate the
pooled sensitivity and specificity of the frailty assessment tools and subgroup and meta-regression
analysis were performed to explain the sources of observed heterogeneity among studies.

Results: Fifteen studies, examining the diagnostic accuracy of the TFI (n=1), GFI (n = 4), and VES-13
(n = 12) for assessing frailty, were included. The pooled sensitivity and specificity of GFI were 67% and
81%, and the VES-13 was 65% and 81%, respectively. Significant moderators of a percentage of male,
and high prevalence of frailty may effect the estimation of the sensitivity or specificity of the frailty
assessment tools.

Conclusion: The GFI and VES-13 were shown have high specificity in identifying frailty, yet both had low
sensitivity. These findings suggest the need for increased awareness and understanding of the health
context or risk factors among cancer patients. Raising awareness of the importance of more regular
check-ups and increased attention to early detection of frailty symptoms is crucial. Since available
frailty screening methods have insufficient discriminative power to make better judgements for
further assessment.

Keywords: cancer, frailty, frailty assessment, frailty measurement tools, meta-analysis

_____________________________________________________________________________________________________
Correspondence: Hui-Chuan Huang, College of Nursing/School of Nursing, Taipei Medical University,
Chinese Taipei
E-mail: huichuan@tmu.edu.tw

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