An international Delphi consensus process to determine a common data element and core outcome set for frailty: FOCUS (The Frailty Outcomes Consensus Project)

Jeanette C Prorok; Paula R Williamson; Beverley Shea; Darryl Rolfson; Leocadio Rodriguez Mañas; Matteo Cesari; Perry Kim; John Muscedere

doi:10.1186/s12877-022-02993-w

An international Delphi consensus process to determine a common data element and core outcome set for frailty: FOCUS (The Frailty Outcomes Consensus Project)

BMC Geriatr. 2022 Apr 5;22(1):284. doi: 10.1186/s12877-022-02993-w.

Authors

Jeanette C Prorok¹, Paula R Williamson², Beverley Shea³, Darryl Rolfson⁴, Leocadio Rodriguez Mañas⁵, Matteo Cesari⁶, Perry Kim¹, John Muscedere^{7

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Affiliations

¹ Canadian Frailty Network, Kingston, ON, Canada.
² University of Liverpool, Liverpool, UK.
³ University of Ottawa, Ottawa, Canada.
⁴ University of Alberta, Edmonton, Canada.
⁵ Hospital Universitario de Getafe ES, Madrid, Spain.
⁶ University of Milan, Milan, Italy.
⁷ Canadian Frailty Network, Kingston, ON, Canada. john.muscedere@kingstonhsc.ca.
⁸ Queen's University, 99 University Avenue, Kingston, ON, K7L 3N6, Canada. john.muscedere@kingstonhsc.ca.
⁹ Kingston Health Sciences Center, 76 Stuart Street, Ontario, K7L 2V7, Kingston, Canada. john.muscedere@kingstonhsc.ca.

Abstract

Background: Despite increased recognition of frailty and its importance, high quality evidence to guide decision-making is lacking. There has been variation in reported data elements and outcomes which makes it challenging to interpret results across studies as well as to generalize research findings. The creation of a frailty core set, consisting of a minimum set of data elements and outcomes to be measured in all frailty studies, would allow for findings from research and translational studies to be collectively analyzed to better inform care and decision-making. To achieve this, the Frailty Outcomes Consensus Project was developed to reach consensus from the international frailty community on a set of common data elements and core outcomes for frailty.

Methods: An international steering committee developed the methodology and the consensus process to be followed. The committee formulated the initial list of data elements and outcomes. Participants from across the world were invited to take part in the Delphi consensus process. The Delphi consisted of three rounds. Following review of data after three rounds, a final ranking round of data elements and outcomes was conducted. A required retention rate of 80% between rounds was set a priori.

Results: One hundred and eighty-four panelists from 25 different countries participated in the first round of the Delphi consensus process. This included researchers, clinicians, administrators, older adults, and caregivers. The retention rate between rounds was achieved. Data elements and outcomes forming primary and secondary core sets were identified, within the domains of participant characteristics, physical performance, physical function, physical health, cognition and mental health, socioenvironmental circumstances, frailty measures, and other.

Conclusion: It is anticipated that implementation and uptake of the frailty core set will enable studies to be collectively analyzed to better inform care for persons living with frailty and ultimately improve their outcomes. Future work will focus on identification of measurement tools to be used in the application of the frailty core set.

Keywords: COMET; Common data elements; Core outcome set; Delphi; Frailty; OMERACT.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Common Data Elements*
Consensus
Delphi Technique
Frailty* / diagnosis
Frailty* / epidemiology
Frailty* / therapy
Humans
Outcome Assessment, Health Care / methods
Research Design
Treatment Outcome