The final set of results consisted of twelve web-based frailty assessment applications, all of which were developed over the past five years (2015 – 2020). The majority of the web applications were provided by the USA (50% and UK or European countries (42%), with a focus on frailty grading and outcome prediction for specific patient groups (58%). The basic information for each of the applications is summarized below and described in Table 1.
Released in 2015, the Edmonton Frail Scale consists of 11 assessment items. It provides a simple way to assess frailty in older adults and can be completed in 5 minutes on average.
Also released in 2015, the Myeloma Frailty Score Calculator aids in the prognosis of elderly myeloma patients. It assesses 31 items, which can be saved in a PDF document along with the calculated score.
In the following year, the Johns Hopkins Frailty Assessment Calculator was released to assess the five-item frailty phenotype . A free trial is limited to 5 calculations; unlimited calculations and guidebook and database access can be obtained with an annual subscription.
The Geriatric 8 (G8) Health Status Screening Tool was recently updated in 2017, for used to identify older cancer patients who may benefit from a CGA. Free accounts can download a PDF assessment; a subscription leads to unlimited downloads and the ability to add notes to the PDF.
The Liver Frailty Index was also released in 2017 to assess physical frailty in patients with chronic liver disease and/or cirrhosis. It assesses three performance-based items: grip strength, chair stands, and balance, with detailed instructions including diagrams for use.
Also released in 2017, the QFrailty Risk Calculator assesses older adults’ risk of developing frailty involving over 40 items of 10 health domains. The software estimates the frailty degrees (e.g “mild” or “severe”), and the two-year hospitalization and death risks.
The Frailty Risk Calculator was released in 2018 and estimates the probability of hospitalization or death within the next year.
Also released in 2018, the Senior Health Calculator uses the CGA items to produce a FI. Fifty items on medical history, functional status, performance tests, and nutritional status are assessed, and FI calculation can be based only on the first two domains. The input data, FI, and summary may be saved or printed as PDF.
The Modified Frailty Index was recently updated in 2019 and assesses the morbidity and mortality risks in older general surgery patients. Free accounts can download a PDF of the assessment; a subscription leads to unlimited downloads and adding notes to the PDF.
The Frailty Index Calculator, a simple calculator developed in 2020, allows users to enter the number of health deficits present in a patient and the total number of deficits measured, and gets an FI score using the formula FI = No. deficits present / No. deficits measured. Users need to have the input numbers ready somewhere else first.
The Myelodysplastic syndromes (MDS) Specific Frailty Index was released in 2020 and evaluates frailty in patients with myelodysplastic syndrome. Seventeen items are included to calculate a frailty scale ratio, composite score, and estimated survival outcome. Users may manually copy/paste the input and output to the local computer.
The Cumulative Illness Rating Scale-Geriatric (CIRS-G) is a brief assessment that quantifies the disease burden in older adults. The Assessment uses 14 multiple-choice items to produce a frailty score. With a free account, users can copy assessment inputs and results to the local computer.
Eight feature categories could be applied to scoring these web applications (i.e., assigning a 0 through 3 to each category), making 24 the highest possible sum-up score that a web application could receive (Table 2). Figure 2 shows the sum-up scores of these web applications. The two categories that scored with high values among the applications were User Interface and Cost (2.67/3 and 2.75/3, respectively), whereas the other categories had a mean score of 1.5 or lower (Figure 2). The category with the lowest score was Data Saving, with only 4 assessments not scoring a 0, as most of the web applications permitted no or very primitive data saving.