Related Experiment Video
Updated: Nov 14, 2025

Frailty Assessment in an Aging Mouse Model
Published on: September 23, 2025
A method for calculating the fragility index of continuous outcomes
Jon-Michael E Caldwell1, Keon Youssefzadeh1, Orr Limpisvasti1
1Cedars-Sinai Kerlan-Jobe Orthopedic Institute, Los Angeles, CA.
Objective:
Clinicians' overdependence on p-values to determine significance in clinical trials is common yet potentially misleading. The Fragility Index (FI) describes how robust a significant result is by determining the number of events the statistical significance hinges on. However, this concept cannot be applied to nondichotomous variables. We describe a method to calculate a Continuous Fragility Index (CFI) for continuous variables. We further provide a method to estimate CFI when original data is not available.
Study Design And Setting:
An iterative substitution algorithm is described to calculate CFI prospectively from data or retrospectively from summary statistics and its response to variations in the data is reported. We then apply this method to a previously published review as a proof-of-concept.
Results:
The CFI increases linearly with sample size, logarithmically with mean difference, and decreases exponentially with standard deviation. Forty-eight studies were included of which 30 had significant non-dichotomous outcomes. CFI and FI were uncorrelated and mean CFI was significantly higher than FI (9 vs. 2, P< 0.001).
Conclusion:
Our algorithm extends fragility to continuous outcomes, expanding the applications of the fragility concept. The fragility of outcomes within a single study may vary based on variable type and should be evaluated independently.
Related Concept Videos
Expected Frequencies in Goodness-of-Fit Tests
Friedman Two-way Analysis of Variance by Ranks
Determination of Expected Frequency
Fatigue
Parametric Survival Analysis: Weibull and Exponential Methods
Weibull Distribution
The Weibull distribution is a flexible model used in parametric survival analysis. It can handle both increasing and decreasing hazard rates, depending on its shape parameter...
Actuarial Approach
Consider the example of a high-risk surgical procedure with significant early-stage mortality. A two-year clinical study is conducted,...

