Table 5.

Step 4. Cut-points, frailty criterion evaluation

					% (n) who were delisted/died
Model	Cut-point	Sensitivity	Specificity	% frail	Not frail	Frail	AUC (95% CI)	NRI vs SPPB (95% CI)	NRI vs FFP (95% CI)
LT-FS-Base: most clinically scalable (frailty measures + routinely available labs)
	23.5	0.54	0.76	27.5	6.9 (17)	21.3 (20)	0.65 (0.56, 0.73)	0.16 (−0.02,0.33) p = 0.08	0.11 (−0.08,0.30) p = 0.25
LT-FS-Body Composition: Model 1 plus body composition: low ASMI
	23.9	0.65	0.71	32.8	5.7 (13)	21.4 (24)	0.68 (0.60, 0.76)*, **	0.22 (0.02, 0.41) p = 0.03	0.20 (−0.02,0.42) p = 0.08
LT-FS-Biomarker: Model 2 plus research-based novel biomarkers
	28.2	0.78	0.70	35.4	3.6 (8)	24.0 (29)	0.74 (0.67, 0.81)***	0.34 (0.12, 0.56) p = 0.005	0.34 (0.12,0.56) p = 0.008
					% (n) who were delisted/died
Model	Cut point	Sensitivity	Specificity	% frail	Not frail	Frail	AUC (95% CI)
SPPB	<=9	0.51	0.63	38.6	8.6 (18)	14.4 (19)	0.57 (0.49, 0.66)
FFP	>=3	0.39	0.72	29.4	8.7 (19)	13.2 (12)	0.55 (0.46, 0.64)

SPPB = Short Physical Performance Battery; FFP = Fried Frailty Phenotype; AUC = area under the curve; NRI = Net Reclassification Index Binary cut-points for each model to define “frailty” were determined using ROC analyses. Youden, Distance to Perfect, and Balance criteria were used to define frailty cut-points. Based on cut-points, this Table demonstrates sensitivity, specificity, as well as the % frail by each criterion, % of frail and not frail that were delisted before transplant or died before or within 1 year after transplant and the area under the curve (AUC) of frailty models.

^*:p-value for AUC comparison with SPPB = 0.07;

^**:p-value for AUC comparison with FFP = 0.04;

^***:p-value for AUC comparison with SPPB and FFP <= 0.003.