- Design
- Prospective observational diagnostic accuracy study
- Population
- 200 patients aged ≥70 referred for coronary angiography
- Primary outcome
- Accuracy of eyeballing vs Fried frailty test
- Effect
- Sensitivity 93.9%, NPV 98.5%, specificity 80.8%, PPV 49.2%; AUC 0.87
This Israeli prospective study, published 17 September in the Journal of the American Geriatrics Society, assessed 200 patients aged 70 and over before coronary angiography. Two cardiologists, blinded to each other, rated frailty by the formal Fried test and by "eyeballing" on a Fried-like scale.
Frailty prevalence by Fried was 16.5%. Eyeballing had a sensitivity of 93.9% and negative predictive value of 98.5%, specificity of 80.8% and positive predictive value of 49.2% (AUC 0.87). Specificity was lower in women and inpatients. Frailty on the Fried test was associated with higher six-month mortality and readmission.
A quick clinical impression is good at spotting who is not frail. When the eyeball says frail, half the time it is wrong, and a structured measure should confirm before it changes a procedural decision.
- A clinician's impression that an older patient is not frail is usually right.
- When frailty is suspected by eye, confirm with a structured tool such as the Fried test.
- Clinical impression over-called frailty more often in women and inpatients.
- Frailty on formal testing predicted six-month death and readmission after angiography.
Why it matters
Supports a two-step approach that saves time without letting impressions decide access to procedures.
The statistics, in plain English
A positive predictive value of 49.2% means that about half of patients judged frail by eye were not frail on formal testing.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for geriatrics, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free