The tele-liver frailty index (TeLeFI): development of a novel frailty tool in patients with cirrhosis via telemedicine

Wang, Melinda; Shui, Amy; Barry, Fawzy; Verna, Elizabeth C.; Kent, Dorothea; Yao, Frederick; Seetharaman, Srilakshmi; Berry, Kacey; Grubbs, Rachel K.; George, Geena; Huang, Chiung‐Yu; Duarte‐Rojo, Andrés; Lai, Jennifer C.

doi:10.1016/j.ajt.2023.04.012

Cited by 7 publications

(5 citation statements)

References 48 publications

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“…As a novel evaluation method, a virtual telemedicine-enabled frailty assessment tool for patients with advanced LC was recently developed. The tele-liver frailty index (TeLeFi), consisting of validated functional capacity surveys and virtually-assessed chair stands, was able to accurately identify frailty in liver transplant patients via telemedicine when compared to ambulatory frailty testing [139] and may be used on a large scale as a screening tool to diagnose frailty or to perform follow-up to identify those in greatest need of additional interventions for maintaining functional independence. In this context, the HepatoConect system also incorporates telemedicine-enabled frailty assessment tools and further evaluation methods based on the patient's performance status.…”

Section: Nutrition Evaluation Methods From An Rhms (Hepatoconect Syst...mentioning

confidence: 99%

Smart Solutions for Diet-Related Disease Management: Connected Care, Remote Health Monitoring Systems, and Integrated Insights for Advanced Evaluation

Coman,

Ianculescu,

Paraschiv

et al. 2024

Applied Sciences

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The prevalence of diet-related diseases underscores the imperative for innovative management approaches. The deployment of smart solutions signifies a paradigmatic evolution, capitalising on advanced technologies to enhance precision and efficacy. This paper aims to present and explore smart solutions for the management of diet-related diseases, focusing on leveraging advanced technologies, such as connected care, the Internet of Medical Things (IoMT), and remote health monitoring systems (RHMS), to address the rising prevalence of diet-related diseases. This transformative approach is exemplified in case studies focusing on tailored RHMS capabilities. This paper aims to showcase the potential of three RHMS in introducing a novel evaluation method and their customisation for proactive management of conditions influenced by dietary habits. The RO-SmartAgeing System uniquely addresses age-related aspects, providing an integrated approach that considers the long-term impact of dietary choices on ageing, marking an advanced perspective in healthcare. The NeuroPredict Platform, leveraging complex neuroinformatics, enhances the understanding of connections between brain health, nutrition, and overall well-being, contributing novel insights to healthcare assessments. Focused on liver health monitoring, the HepatoConect system delivers real-time data for personalized dietary recommendations, offering a distinctive approach to disease management. By integrating cutting-edge technologies, these smart solutions transcend traditional healthcare boundaries.

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Section: Nutrition Evaluation Methods From An Rhms (Hepatoconect Syst...mentioning

confidence: 99%

Smart Solutions for Diet-Related Disease Management: Connected Care, Remote Health Monitoring Systems, and Integrated Insights for Advanced Evaluation

Coman,

Ianculescu,

Paraschiv

et al. 2024

Applied Sciences

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“…More recently, the Tele-Liver Frailty Index was developed to accurately measure frailty virtually, leveraging validated surveys (Duke Activity Status Index and SARC-F screen) and an optional remote physical assessment (ie, chair stands via videoconference call). [13] Similarly, a telemedicine version of the 6MWT was recently developed and tested in a pilot study, demonstrating a robust correlation with the standard inperson 6MWT. [14] This remote assessment of aerobic capacity, coined the Tele-6MWT, utilizes a personal activity tracker and builds on past evidence, showing that daily step counts acquired by personal activity trackers correlate with frailty and predict worse clinical outcomes.…”

Section: Remote Frailty Assessmentsmentioning

confidence: 99%

Deciphering an expanding array of clinical and research frailty measures

Thuluvath,

Verna

2024

Clinical Liver Disease

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“…A novel tool called the tele-liver frailty index (TeLefI) has been proposed for frailty assessment and follow-up in cirrhotic patients[ 176 ]. It utilizes telemedicine to virtually measure frailty in liver transplant candidates with cirrhosis.…”

Section: Future Approaches In Frailty Managementmentioning

confidence: 99%

“…It utilizes telemedicine to virtually measure frailty in liver transplant candidates with cirrhosis. Wang et al [ 176 ] introduced this tool by comparing frailty assessment using in-person LFI and then by TelefI assessment tool[ 176 ]. The telemedicine-based TeLefI tool has been statistically validated in predicting LFI > 4.4, indicating that it can effectively identify patients who require more frequent follow-up or in-person assessment[ 176 ].…”

Section: Future Approaches In Frailty Managementmentioning

confidence: 99%

“…Wang et al [ 176 ] introduced this tool by comparing frailty assessment using in-person LFI and then by TelefI assessment tool[ 176 ]. The telemedicine-based TeLefI tool has been statistically validated in predicting LFI > 4.4, indicating that it can effectively identify patients who require more frequent follow-up or in-person assessment[ 176 ]. This tool has the potential to revolutionize frailty assessment and follow-up in cirrhotic patients, especially those who live in remote or underserved areas.…”

Section: Future Approaches In Frailty Managementmentioning

confidence: 99%

See 1 more Smart Citation

Frailty in end-stage liver disease: Understanding pathophysiology, tools for assessment, and strategies for management

Elsheikh,

Sabagh,

Mohamed

et al. 2023

World J Gastroenterol

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Frailty and sarcopenia are frequently observed in patients with end-stage liver disease. Frailty is a complex condition that arises from deteriorations across various physiological systems, including the musculoskeletal, cardiovascular, and immune systems, resulting in a reduced ability of the body to withstand stressors. This condition is associated with declined resilience and increased vulnerability to negative outcomes, including disability, hospitalization, and mortality. In cirrhotic patients, frailty is influenced by multiple factors, such as hyperammonemia, hormonal imbalance, malnutrition, ascites, hepatic encephalopathy, and alcohol intake. Assessing frailty is crucial in predicting morbidity and mortality in cirrhotic patients. It can aid in making critical decisions regarding patients’ eligibility for critical care and transplantation. This, in turn, can guide the development of an individualized treatment plan for each patient with cirrhosis, with a focus on prioritizing exercise, proper nutrition, and appropriate treatment of hepatic complications as the primary lines of treatment. In this review, we aim to explore the topic of frailty in liver diseases, with a particular emphasis on pathophysiology, clinical assessment, and discuss strategies for preventing frailty through effective treatment of hepatic complications. Furthermore, we explore novel assessment and management strategies that have emerged in recent years, including the use of wearable technology and telemedicine.

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The tele-liver frailty index (TeLeFI): development of a novel frailty tool in patients with cirrhosis via telemedicine

Cited by 7 publications

References 48 publications

Smart Solutions for Diet-Related Disease Management: Connected Care, Remote Health Monitoring Systems, and Integrated Insights for Advanced Evaluation

Smart Solutions for Diet-Related Disease Management: Connected Care, Remote Health Monitoring Systems, and Integrated Insights for Advanced Evaluation

Deciphering an expanding array of clinical and research frailty measures

Frailty in end-stage liver disease: Understanding pathophysiology, tools for assessment, and strategies for management

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