Table 5 Examples of Frailty Instruments implemented with the Cardiac-centered Frailty Ontology

Frailty Insrument: Barthell Index

Incontinence finding (CCFOID:11271) of either kind = 0

Continence finding (CCFOID:11271) or absent qualified incontinence finding of both kinds = 2

Able to perform personal care activities finding (CCFOID:11244) for each of its children:

 unqualified or able = 2

 with difficulty = 1

 unable = 0

Ability to transfer location finding (CCFOID:1122)(any one) = 2

 Absent (CCFOID:42) qualified = 0

Able (CCFOID:412) qualified able to mobilize finding (CCFOID:112121) or no aid for walking finding (CCFOID:112472) = 3

Able with difficulty (CCFOID:411) qualified able to mobilize finding or walking aid use finding (any kind) = 2

wheelchair bound finding (CCFOID: 1121223) = 1

unable (CCFOID:413) qualified able to mobilize finding or bed-ridden finding (CCFOID:1121221) = 0

Able qualified able to walk upstairs finding (CCFOID:1124713) or able to walk downstairs finding (CCFOID:1124711) = 2

Unable qualified able to walk upstairs finding = 0

Barthell Index Scoring

Add up the score: 20 = no disability 0 = complete disability

Frailty Instrument: Katz – ADLs

Count the number of:

Each of the able qualified ability to perform personal care activities finding (bathing, dressing, toileting, feeding)(CCFOID:11244) = 1

 Unable qualified = 0

Any able qualified ability to transfer location finding (CCFOID:1122) = 1

 Unable qualified = 0

Both unqualified continence finding or absent qualified incontinence finding of either kind = 1

Unqualified Incontinence finding of either kind = 0

Katz - ADLs Scoring

Add up the score: 6 = high functioning 0 = low functioning

Frailty Instrument: SF-36

Average the following for General Health score:

Questions 1, 33, 34, 35, 36

First assessment covers 5 questions, 1 score.

unqualified or high frequency (CCFOID:441) qualified fit and well finding = 100

mid-frequency (CCFOID:442) qualified fit and well finding = 75

absent qualified generally unwell finding (CCFOID:1324) = 50

mid-frequency qualified generally unwell finding = 25

unqualified or high frequency qualified generally unwell finding = 0

Question 2

unqualified or high frequency qualified fit and well finding with sudden onset (CCFOID:433) qualification = 100

mid-frequency qualified fit and well finding with sudden onset qualification = 75

absent qualified generally unwell finding = 50

generally unwell finding:

mid-frequency qualified = 25

unqualified or high frequency = 0

Average the following for Pain score

Question 21

absent qualified alteration in comfort: pain finding (CCFOID:1111) = 100

mid-frequency qualified alteration in comfort: pain finding = 50

high frequency qualified alteration in comfort: pain finding = 0

Question 22

absent qualified alteration in comfort: pain finding, with able qualified able to carry out daily routine finding (CCFOID:11245) = 100

mid-frequency qualified alteration in comfort: pain finding, with able qualified able to carry out daily routine finding = 75

high-frequency qualified alteration in comfort: pain finding, with able qualified able to carry out daily routine finding = 50

mid-frequency qualified alteration in comfort: pain finding, with difficulty qualified able to carry out daily routine finding = 25

high-frequency qualified alteration in comfort: pain finding, with unable or with difficulty qualified able to carry out daily routine finding = 0

Average the following for Physical Functioning score:

Question 3

high frequency qualified enjoys vigorous exercise finding (CCFOID:11233) or able qualified ability to run finding (CCFOID:11213) = 100

mid-frequency qualified enjoys vigorous exercise finding = 50

gets no exercise finding or unable qualified ability to run finding or absent qualified enjoys vigorous exercise finding = 0

Question 4

high frequency qualified enjoys moderate exercise finding (CCFOID:11232) = 100

mid-frequency qualified enjoys moderate exercise finding = 50

gets no exercise finding or unable qualified ability to run finding or absent qualified enjoys moderate exercise finding = 0

Question 5

able qualified ability to perform general purpose physical activity finding (CCFOID:11243) or able qualified ability to perform shopping activities finding (CCFOID:112413) = 100

with difficulty qualified ability to perform general purpose physical activity finding or with difficulty qualified ability to perform shopping activities finding = 50

unable qualified ability to perform general purpose physical activity finding or unable qualified ability to perform shopping activities finding = 0

Question 6 & 7

This covers 2 question (scores twice) able qualified able to walk upstairs finding = 200

with difficulty qualified able to walk upstairs finding = 100

unable qualified able to walk upstairs finding = 0

Question 8

able qualified able to kneel finding (CCFOID:11211) = 100

with difficulty qualified able to kneel finding = 50

unable qualified able to kneel finding = 0

Questions 9–11

This covers 3 question (scores three times) able qualified able to walk finding (CCFOID:112471) = 300

with difficulty qualified able to walk finding = 200

unable qualified able to walk finding = 0

Question 12

able qualified ability to perform personal care activities finding = 100

with difficulty qualified ability to perform personal care activities finding = 50

unable qualified ability to perform personal care activities finding = 0

Average the following for Role Limitations due to Physical Health score:

Question 13–15

This covers 3 question (scores three times) absent qualified occupational maladjustment finding (CCFOID:1154) = 300

mid-frequency qualified occupational maladjustment finding = 150

high-frequency qualified occupational maladjustment finding = 0

Question 16

able qualified able to carry out daily routine finding = 100

with difficulty qualified able to carry out daily routine finding = 50

unable qualified able to carry out daily routine finding = 0

Average the following for Role Limitations due to Emotional Problems score

Question 17–19

This covers 3 question (scores three times) absent qualified occupational maladjustment finding and any psychological finding (CCFOID:113) = 300

mid-frequency qualified occupational maladjustment finding and any psychological finding = 150

high-frequency qualified occupational maladjustment finding and any psychological finding = 0

Average the following for Energy/Fatigue score

Questions 23, 27, 29, 31 (1 score)

able qualified able to sustain energy level finding (CCFOID:132221) or absent qualified lack of energy finding or absent qualified fatigue = 100

with difficulty qualified able to sustain energy level finding or mid-frequency qualified lack of energy finding or mid-frequency qualified fatigue = 50

unable qualified able to sustain energy level finding or high frequency qualified lack of energy finding or high frequency qualified fatigue = 0

Average the following for Emotional Well-Being score

Questions 24, 26

This covers 2 question (scores twice) high frequency qualified calm finding or absent qualified nervous finding or absent qualified anxiety diagnosis (CCFOID:21) = 200

mid-frequency qualified calm finding = 150

mid-frequency qualified nervous finding = 100

absent qualified calm finding = 50

high frequency qualified nervous finding or anxiety diagnosis = 0

Questions 25, 28, 30

This covers 3 question (scores three times) high frequency qualified happy finding or absent qualified sad finding (CCFOID:113334) or absent qualified depression diagnosis (CCFOID:22) = 300

mid-frequency qualified happy finding = 225

mid-frequency qualified sad finding = 150

absent qualified happy finding = 75

high frequency qualified sad finding or depression diagnosis = 0

Average the following for Social Functioning score

Question 32

able qualified ability to perform community living activities finding (CCFOID:11241) = 100

with difficulty qualified ability to perform community living activities finding = 50

unable qualified ability to perform community living activities finding = 0

Question 20

absent qualified impaired social interaction finding (CCFOID:11531) = 100

mid-frequency qualified impaired social interaction finding = 50

high frequency qualified impaired social interaction finding = 0

SF-36 Scoring

Scores are from 0 to 100 for each section, higher score = less frail/better health