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