title: Diagnostic Test of a Scoring System for Frailty Syndrome in the Elderly According to Cardiovascular Health Study, Study of Osteoporotic Fracture and Comprehensive Geriatric Assessment Based Frailty Index Compared with Frailty Index 40 Items.
abstract: OBJECTIVE
  to get a recommendation on the best frailty syndrome diagnostic tools, that will be able to be practiced on a daily setting in Indonesia.
  
  
  METHODS
  this is a cross-sectional study with diagnostic test approach, conducted to patients in the Geriatric Outpatient Clinic of Cipto Mangunkusumo National Referral Hospital on May-June 2013. Each subject underwent a frailty evaluation using CHS, SOF, FI-CGA and FI-40 scoring systems. Then, we calculate the sensitivity, specificity, PPV, NPV, LR+ and LR- of each scoring system compared to FI-40.
  
  
  RESULTS
  the proportion of frail, pre-frail and fit according to FI-40 are 25.3%, 71% and 3.7% respectively. In terms of differentiation frail to non-frail, CHS had 41.2% sensitivity, 95% specificity, PPV 73.7%, NPV 82.7%, LR+ 8.41 and LR- 0.62. SOF scoring system had 17.6% sensitivity, 99.5% specificity, PPV 92.3%, NPV 78.1%, LR+ 35.2 and LR- 0.83. Furthermore FI-CGA had 8.8% sensitivity, 100% specificity, PPV 100%, NPV 76.4%, LR+ and LR- 0.91.
  
  
  CONCLUSIONS
  There is no better scoring system that could be implemented to screen for frailty syndrome other than FI-40 items. However, other scoring systems could be used as a good diagnostic tool for the syndrome.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine Universitas Indonesia-Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
authors.forename: Euphemia
authors.initials: E
authors.lastname: Seto
authors.forename: Siti
authors.initials: S
authors.lastname: Setiati
authors.forename: Purwita W
authors.initials: PW
authors.lastname: Laksmi
authors.forename: Tirza Z
authors.initials: TZ
authors.lastname: Tamin
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000175:diagnosis; D003430:Cross-Sectional Studies; D005080:Exercise Test; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D018737:Hand Strength; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000175:diagnosis; D011237:Predictive Value of Tests; D016138:Walking