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The inter‐ and intrarater reliability and feasibility of dietetic assessment of sarcopenia and frailty in potential liver transplant recipients: A mixed‐methods study
Author(s) -
Johnston Heidi E.,
de Crom Tosca,
Hargrave Cathy,
Adhyaru Pooja,
Woodward Aidan J.,
Pang Siong,
Ali Azmat,
Coombes Jeff S.,
Keating Shelley E.,
McLean Kate,
Mayr Hannah L.,
Macdonald Graeme A.,
Hickman Ingrid J.
Publication year - 2021
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.14185
Subject(s) - medicine , sarcopenia , intraclass correlation , reliability (semiconductor) , gerontology , physical therapy , psychometrics , clinical psychology , power (physics) , physics , quantum mechanics
Sarcopenia and frailty are associated with poorer outcomes in potential liver transplant (LT) recipients. We examined the reliability and feasibility of dietitians assessing sarcopenia and frailty. Seventy‐five adults referred for LT underwent assessments of muscle mass (abdominal CTs), physical function (handgrip strength; HGS, short physical performance battery; SPPB), and frailty (Liver Frailty Index; LFI). Inter‐ and intrarater reliability and agreement were assessed in subsets of patients using intraclass correlation coefficients (ICCs) and Bland‐Altman plots. CTs were analyzed by a dietitian and two independent experts, two dietitians assessed function and frailty. Feasibility assessed system, patient, and profession factors (staff survey). Inter‐ and intrarater reliability for CT‐defined low muscle were excellent (ICCs > 0.97). Reliability between dietitians was excellent for HGS (0.968, 95% CI, 0.928–0.986), SPPB (0.932, 95% CI, 0.798–0.973), and LFI (0.938, 95% CI 0.861–0.973). Bland‐Altman analysis indicated excellent agreement for HGS. All transplant clinicians valued sarcopenia and frailty in LT assessments and considered the dietitian appropriate to perform them. Seven saw no barriers to implementation into practice, while five queried test standardization, learning from repeat testing, and resource cost. Dietetic assessments of sarcopenia and frailty are reliable, feasible, and valued measures in the assessment of potential LT recipients.