Mapping frailty concepts to SNOMED CT

Area of Science:

• Gerontology
• Health Informatics
• Clinical Assessment

Background:

• Frailty is an emergent geriatric syndrome characterized by decreased physiological reserve, increasing morbidity and mortality.
• It differs from normal aging by its rapid decline in function.
• The Comprehensive Geriatric Assessment (CGA) is the gold standard for frailty identification, with its electronic version (eCGA) used in electronic medical records (EMR).

Purpose of the Study:

• To evaluate the adequacy of SNOMED CT for representing frailty concepts.
• To identify defining characteristics of frailty commonly used in assessment tools.
• To determine if these characteristics are captured in existing tools and can be mapped to SNOMED CT.

Main Methods:

• A literature search identified frailty characteristics and assessment tools.
• Findings were compared to frailty components within the eCGA.
• A descriptive study design was used to manually map eCGA concepts to SNOMED CT terms via expert consensus.

Main Results:

• The eCGA encompasses all common frailty defining characteristics.
• Manual mapping of 133 unique eCGA questions to SNOMED CT resulted in 72% direct matches, 17% one-to-many matches, and 11% non-matches.
• Expert clinician mapping achieved an inter-rater reliability of 0.75 (kappa).

Conclusions:

• The mapping of eCGA elements to SNOMED CT provides a foundation for integrating frailty monitoring into chronic disease databases.
• This facilitates enhanced surveillance and management of frailty in older adults within primary care settings.