Frailty

The Discovery Data Service helps to identify potentially frail patients using a frailty algorithm.

The frailty algorithm results can be provided via the NHS111 Frailty API or displayed in the Frailty Checker.

If the specified patient has an observation for severe or moderate frailty, the algorithm returns a value of true; observations for mild frailty return a value of false. If a patient is not found in the Discovery Data Service, the algorithm returns a value of not found.

The frailty algorithm results are then described, via the API or in the Frailty Checker, as follows:

  • Potentially frail - Patient has Moderate or Severe frailty codes
  • Not frail - Patient has Mild or No frailty codes
  • Not found - Patient not found

The frailty algorithm uses the following frailty codes:

Concept ID Original code Original term Frailty category
713634000 38Ql. FI - Frailty Index > 0.36 (Severe)
>0.24 and <=0.36 (Moderate)
>0.13 and <=0.24 (Mild)
713636003 Frailty Index score > 0.36 (Severe)
>0.24 and <=0.36 (Moderate)
>0.13 and <=0.24 (Mild)
445414007 38DW. CSHA frailty scale >=7 (Severe)
>=6 and <7 (Moderate)
>=5 and <6 (Mild)
925861000000102 2Jd2. Severe frailty Severe
2010301000006105 EMISNQQF7 QFrailty category - severe frailty Severe
2010341000006107   QFrailty category - severe frailty (estimate) Severe
1839051000006106 EMISNQON5 On frailty register Moderate
925831000000107 2Jd1. Moderate frailty Moderate
248279007 2Jd.. Frailty [RFC] Moderate
908431000006104 HNG0500 Frail elderly people [RFC] Moderate
910301000006104 HNGNQRF75 Frail person [RFC] Moderate
909011000006109 HNG0632 Frail elderly people Moderate
2010291000006109 EMISNQQF6 QFrailty category - moderate frailty Moderate
2010331000006102   QFrailty category -moderate frailty (estimate) Moderate
925791000000100 2Jd0.> Mild frailty Mild
2010281000006106   QFrailty category - mild frailty Mild
2010321000006100   QFrailty category - mild frailty (estimate) Mild

The frailty algorithm then calculates frailty categories using the following logic:

Severe frailty

Patients with observations where any of the following are true:

  • Concept ID is 925861000000102 (Severe frailty)
  • Concept ID is 2010301000006105 (QFrailty category - severe frailty)
  • Concept ID is 2010341000006107 (QFrailty category - severe frailty (estimate))
  • Concept ID is 713634000 (FI - Frailty Index) or 713636003 (Frailty Index score) with a value > 0.36
  • Concept ID is 445414007 (CSHA frailty scale) with a value >= 7

Moderate frailty

Patients with observations where any of the following are true:

  • Concept ID is 925831000000107 (Moderate frailty)
  • Concept ID is 1839051000006106 (On frailty register)
  • Concept ID is 910301000006104 ([RFC] Frail person)
  • Concept ID is 248279007 (Frailty)
  • Concept ID is 908431000006104 ([RFC] Frail elderly people)
  • Concept ID is 909011000006109 ([RFC] Frail elderly people)
  • Concept ID is 2010291000006109 (QFrailty category - moderate frailty)
  • Concept ID is 2010331000006102 (QFrailty category - moderate frailty (estimate))
  • Concept ID is 713634000 (FI - Frailty Index) or 713636003 (Frailty Index score) with a value > 0.24 and <= 0.36
  • Concept ID de is 445414007 (CSHA frailty scale) with a value >= 6 and < 7

Mild frailty

Patients with observations where any of the following are true:

  • Concept ID is 925791000000100 (Mild frailty)
  • Concept ID is 2010281000006106 (QFrailty category - mild frailty)
  • Concept ID is 2010321000006100 (QFrailty category - mild frailty (estimate))
  • Concept ID is 713634000 (FI - Frailty Index) or 713636003 (Frailty Index score) with a value > 0.13 and <= 0.24
  • Concept ID is 445414007 (CSHA frailty scale) with a value >= 5 and < 6

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