Translation and validation of the Thai clinical frailty scale and classification tree in older adults
Abstract Background The Clinical Frailty Scale (CFS) is widely used for frailty assessment, but has not yet been formally validated for use in Thai populations. This study evaluated the reliability and validity of the Thai versions of the CFS (CFS-Thai) and its Classification Tree (CFS-CT-Thai). Met...
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| Language: | English |
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BMC
2025-05-01
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| Series: | BMC Geriatrics |
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| Online Access: | https://doi.org/10.1186/s12877-025-06013-5 |
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| author | Panas Jesadaporn Siripong Teepaneeteerakul Nuttanun Wongsarikan Kochaphan Phirom Supannika Poonthananiwatkul Panita Limpawattana |
| author_facet | Panas Jesadaporn Siripong Teepaneeteerakul Nuttanun Wongsarikan Kochaphan Phirom Supannika Poonthananiwatkul Panita Limpawattana |
| author_sort | Panas Jesadaporn |
| collection | DOAJ |
| description | Abstract Background The Clinical Frailty Scale (CFS) is widely used for frailty assessment, but has not yet been formally validated for use in Thai populations. This study evaluated the reliability and validity of the Thai versions of the CFS (CFS-Thai) and its Classification Tree (CFS-CT-Thai). Methods In this cross-sectional study, 213 participants aged ≥ 65 years (127 outpatients and 86 inpatients) were enrolled from two tertiary care hospitals in Thailand. The CFS and CFS-CT were translated into Thai using standard procedures. Inter-rater reliability was evaluated in a subsample of 53 inpatients. Concurrent validity was examined using the Thai version of the FRAIL scale (T-FRAIL), the Eastern Cooperative Oncology Group Performance Status (ECOG PS), and the modified Thai Frailty Index (mTFI). Results The CFS-Thai showed strong inter-rater reliability (κ = 0.80, p < 0.001) and excellent agreement with the CFS-CT-Thai (κ = 0.94, p < 0.001). It demonstrated moderate correlation with T-FRAIL (ρ = 0.53) and strong correlation with ECOG PS (ρ = 0.76) and mTFI (ρ = 0.73). Using mTFI as the reference standard, the CFS-Thai showed high sensitivity (92.7%) and lower specificity (55.0%) at cut-off ≥ 4 (AUC = 0.74, 95% CI: 0.62–0.86), while cut-off ≥ 5 improved specificity (79.3%) and retained high sensitivity (93.5%) (AUC = 0.86, 95% CI: 0.81–0.92). ECOG PS ≥ 2 provided balanced diagnostic performance (sensitivity 83.9%, specificity 93.3%, AUC = 0.89, 95% CI: 0.82–0.95). Conclusions The CFS-Thai and CFS-CT-Thai are reliable and valid instruments for frailty assessment in Thai older adults. Their diagnostic accuracy supports integration into clinical practice, especially in settings with limited geriatric expertise. Further studies should examine their implementation across diverse populations and their predictive value for clinical outcomes. |
| format | Article |
| id | doaj-art-7cf205439c064972ae30495ca71ebaeb |
| institution | OA Journals |
| issn | 1471-2318 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
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| series | BMC Geriatrics |
| spelling | doaj-art-7cf205439c064972ae30495ca71ebaeb2025-08-20T01:51:41ZengBMCBMC Geriatrics1471-23182025-05-0125111110.1186/s12877-025-06013-5Translation and validation of the Thai clinical frailty scale and classification tree in older adultsPanas Jesadaporn0Siripong Teepaneeteerakul1Nuttanun Wongsarikan2Kochaphan Phirom3Supannika Poonthananiwatkul4Panita Limpawattana5Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Chiang Mai UniversityDivision of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Chiang Mai UniversityResearch Unit of Medicine, Department of Internal Medicine, Faculty of Medicine, Chiang Mai UniversityResearch Institute for Health Sciences, Chiang Mai UniversityQuality Center, Bangkok Hospital PhuketDivision of Geriatric Medicine, Department of Medicine, Faculty of Medicine, Khon Kaen UniversityAbstract Background The Clinical Frailty Scale (CFS) is widely used for frailty assessment, but has not yet been formally validated for use in Thai populations. This study evaluated the reliability and validity of the Thai versions of the CFS (CFS-Thai) and its Classification Tree (CFS-CT-Thai). Methods In this cross-sectional study, 213 participants aged ≥ 65 years (127 outpatients and 86 inpatients) were enrolled from two tertiary care hospitals in Thailand. The CFS and CFS-CT were translated into Thai using standard procedures. Inter-rater reliability was evaluated in a subsample of 53 inpatients. Concurrent validity was examined using the Thai version of the FRAIL scale (T-FRAIL), the Eastern Cooperative Oncology Group Performance Status (ECOG PS), and the modified Thai Frailty Index (mTFI). Results The CFS-Thai showed strong inter-rater reliability (κ = 0.80, p < 0.001) and excellent agreement with the CFS-CT-Thai (κ = 0.94, p < 0.001). It demonstrated moderate correlation with T-FRAIL (ρ = 0.53) and strong correlation with ECOG PS (ρ = 0.76) and mTFI (ρ = 0.73). Using mTFI as the reference standard, the CFS-Thai showed high sensitivity (92.7%) and lower specificity (55.0%) at cut-off ≥ 4 (AUC = 0.74, 95% CI: 0.62–0.86), while cut-off ≥ 5 improved specificity (79.3%) and retained high sensitivity (93.5%) (AUC = 0.86, 95% CI: 0.81–0.92). ECOG PS ≥ 2 provided balanced diagnostic performance (sensitivity 83.9%, specificity 93.3%, AUC = 0.89, 95% CI: 0.82–0.95). Conclusions The CFS-Thai and CFS-CT-Thai are reliable and valid instruments for frailty assessment in Thai older adults. Their diagnostic accuracy supports integration into clinical practice, especially in settings with limited geriatric expertise. Further studies should examine their implementation across diverse populations and their predictive value for clinical outcomes.https://doi.org/10.1186/s12877-025-06013-5FrailtyGeriatric assessmentValidation studyReproducibility of resultsThailand |
| spellingShingle | Panas Jesadaporn Siripong Teepaneeteerakul Nuttanun Wongsarikan Kochaphan Phirom Supannika Poonthananiwatkul Panita Limpawattana Translation and validation of the Thai clinical frailty scale and classification tree in older adults BMC Geriatrics Frailty Geriatric assessment Validation study Reproducibility of results Thailand |
| title | Translation and validation of the Thai clinical frailty scale and classification tree in older adults |
| title_full | Translation and validation of the Thai clinical frailty scale and classification tree in older adults |
| title_fullStr | Translation and validation of the Thai clinical frailty scale and classification tree in older adults |
| title_full_unstemmed | Translation and validation of the Thai clinical frailty scale and classification tree in older adults |
| title_short | Translation and validation of the Thai clinical frailty scale and classification tree in older adults |
| title_sort | translation and validation of the thai clinical frailty scale and classification tree in older adults |
| topic | Frailty Geriatric assessment Validation study Reproducibility of results Thailand |
| url | https://doi.org/10.1186/s12877-025-06013-5 |
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