Citation
Duchesneau, Emilie D.; Shmuel, Shahar; Faurot, Keturah R.; Park, Jihye; Musty, Allison; Pate, Virginia; Yang, Yang Claire; Kinlaw, Alan C.; Sturmer, Til; & Funk, Michele Jonsson, et al. (2023). Translation of a Claims-Based Frailty Index from the International Classification of Diseases, Ninth Revision, Clinical Modification to the Tenth Revision. American Journal of Epidemiology, 192(12), 2085-2093. PMCID: PMC Journal - In ProcessAbstract
The Faurot frailty index (FFI) is a validated algorithm that uses enrollment and International Classification of Diseases, 9th Edition, Clinical Modification (ICD-9-CM)-based billing information from Medicare claims data as a frailty proxy. In October 2015, the US healthcare system transitioned from ICD-9-CM to ICD-10-CM. Applying the Centers for Medicare and Medicaid Services General Equivalence Mappings, we translated diagnosis-based frailty indicator codes from ICD-9-CM to ICD-10-CM, followed by manual review. We used interrupted time series analysis of Medicare data to assess comparability of the pre- and post-transition FFI. In cohorts of beneficiaries enrolled in January 2015-2017 with 8-month frailty lookback periods, we estimated associations between the FFI and 1-year risk of geriatric-relevant outcomes (mortality, hospitalization, skilled nursing facility [SNF] admission). Updated indicators had similar prevalence compared to pre-transition definitions. The median and interquartile range for predicted probability of frailty were similar before and after the ICD transition (pre-transition: 0.034 [0.02-0.07]; post-transition: 0.038 [0.02-0.09]). The updated FFI was associated with increased risks of mortality, hospitalization, and SNF admission, similar to findings from the ICD-9-CM era. Studies of medical interventions in older adults using administrative claims should use validated indices, like the FFI, to mitigate confounding or assess effect measure modification by frailty.URL
https://doi.org/10.1093/aje/kwad151Reference Type
Journal ArticleYear Published
2023Journal Title
American Journal of EpidemiologyAuthor(s)
Duchesneau, Emilie D.Shmuel, Shahar
Faurot, Keturah R.
Park, Jihye
Musty, Allison
Pate, Virginia
Yang, Yang Claire
Kinlaw, Alan C.
Sturmer, Til
Funk, Michele Jonsson
Lund, Jennifer L.