Development, Reliability, and Validity of Comprehensive Frailty Assessment Tool for Older Adults with Cancer (FOAC) in China.

Purpose: With the accelerating ageing population, frailty has emerged as a critical concern among older cancer patients. The purpose of the study was to develop a valid and reliable Comprehensive Frailty Assessment Tool for Older Adults with Cancer (FOAC) in China.

Patients and methods: The FOAC was developed in 4 phases. Phase 1: Conceptualization and Item Generation:32 items were formulated from the literature. Phase 2: Content validation of the FOAC by modified Delphi method. Phase 3: Face validity index (FVI) was calculated by recording the views of two groups, including older adults with cancer and those with professional roles. Phase 4:Using CGA-determined frailty as the dependent variable, receiver operating characteristic (ROC) curve analysis was conducted using FOAC, FP, and aCGA frailty screening scales as independent variables and their area under the curve (AUC), sensitivity, specificity, cut-off value, predicted value, and accuracy were determined. Internal consistency reliability measurement was assessed with Cronbach's alpha.

Results: The FOAC has 30 items. Physiological dimension (11 items). Psychological & cognitive dimension (12 items). Social support (7 items). the results of this study demonstrated that the overall Cronbach's alpha coefficient of the scale was 0.869.

Conclusion: The FOAC is a valid and reliable frailty screening tool that significantly addresses the problems of existing frailty assessment tools, such as single dimension, low sensitivity, complex scoring, and insufficient clinical applicability. It contributes to guiding healthcare professionals in providing more accurate diagnosis, treatment, and cancer management for older adults.