Development, Validation, and Application of the Electronic Frailty Index: A Scoping Review

OBJECTIVE: The aim of this scoping review was to examine the scope and characteristics of the published literature related to the Electronic Frailty Index (eFI). DESIGN: Scoping review. SETTING AND PARTICIPANTS: Original studies related to the eFI in older adults. METHODS: Six databases were searched for articles published between March 2016 and August 2024: PubMed, Web of Science, Cochrane Library, Scopus, China National Knowledge Infrastructure (CNKI), and Wanfang Database. Data extracted included the publication year, country, sample size, data sources for developing an eFI, number of items included in the eFI, performance of the eFI, and application of the eFI. RESULTS: Of the 424 articles initially retrieved, this scoping review included 50 studies for analysis. Thirty-nine (78%) of these studies were conducted after the year 2019. Moreover, we identified 8 distinct eFIs. Twelve studies assessed the performance of eFIs, whereas 30 studies used them. The eFIs covered 4 key domains: diseases, functional information, laboratory tests and measures, and symptoms and signs. The most common outcome examined was mortality. Furthermore, the eFIs were applied for diverse purposes, including exploring the relationship between frailty and health outcomes. CONCLUSIONS AND IMPLICATIONS: This scoping review revealed that eFIs can be developed using various electronic health care data sources, and they have been extensively employed for various population-level purposes. The observed associations between the eFIs, existing frailty assessment tools, and health outcomes highlight their utility in evaluating the care needs of an aging population.