Adaptation of the comprehensive rheumatologic assessment of frailty (CRAF) as a multidimensional frailty screening tool in patients with rheumatoid arthritis in Vietnam

Abstract

Abstract Background In recent times, there has been acknowledgment of the prevalence of frailty and pre-frailty among individuals with rheumatoid arthritis (RA). Comprehensive Rheumatologic Assessment of Frailty (CRAF) stands out as a dependable tool grounded in synthesis and clinical judgment. Despite this, a validated Vietnamese rendition of the CRAF is currently unavailable. This study seeks to assess the reliability and validity of the CRAF in a patient with RA in Vietnam. Methods A cross-sectional investigation was carried out with 402 patients diagnosed with rheumatoid arthritis, encompassing both inpatients and outpatients at the Centre for Rheumatology at Bach Mai Hospital in Hanoi, Vietnam. CRAF was employed to gauge the extent of frailty. To establish convergent validity, the scores from the CRAF were correlated with those from the Fried phenotype. Discriminant validity was ascertained through the utilization of receiver operating characteristic (ROC) curve analysis. Additionally, a multivariate logistic regression model was applied to evaluate the individual determinants’ relative impact on the CRAF. Results In testing for convergent validity, a significant correlation was found between CRAF and Fried phenotype (p < 0.001). The discriminatory power of CRAF was higher than those of the Fried phenotype (difference between areas under the ROC curves = 0.947 (95% CI: 0.927–0.967). Variables associated with frailty at the multivariate analysis were comorbitidy, medication intake, BMI, DAS28-CRP, and age (all at p < 0.01). Conclusion CRAF exhibited strong validity and accurate discrimination. Incorporating frailty assessment into regular rheumatological practices could signify a significant advancement in the care of rheumatoid arthritis.

Keywords

• Frailty
• Rheumatoid arthritis
• Validation study