Analysis and development of an electronic frailty index (eFI) for Finnish healthcare to identify at-risk individuals at early stages

In the era of population aging, identifying effective strategies to promote healthy aging is a key priority.

The degree of frailty is a critical determinant of healthy aging and a predictor of various adverse outcomes, such as mortality, disability and high healthcare utilization. Frailty is nevertheless reversible if identified at an early stage, but methods to assess frailty in routine healthcare practice are limited and middle-aged and younger adults are completely overlooked.

This project aims to analyze and create an electronic frailty index (eFI), a tool for Finnish healthcare to facilitate early identification of vulnerable at-risk individuals. The eFI can also facilitate planning proactive care pathways, guide decision-making and preoperative screening. The eFI allows tracking of health and functioning not only at an individual level but also in populations across different geographical and social areas.

Artificial intelligence will be an integral part of the analytical work. We will devise machine learning algorithms to

• select the eFI items exhibiting the highest predictive accuracy and generalizability, and
• identify eFI items in unstructured data, i.e., free-text clinical notes.

The latter approach enables broad application of the eFI to different electronic health record (EHR) systems in an unprecedented way as several aspects of frailty are commonly documented in free-text clinical notes instead of structured, quantitative records.

By combining structured and unstructured EHR data, the Finnish eFI provides as a pioneering tool to assess frailty also in younger adults, thus creating conditions for early management of frailty.

Project group

Principal Investigator Juulia Jylhävä (Senior Research Fellow, Tampere University, TAU); co-PI Mikaela von Bonsdorff (Associate professor, University of Jyväskylä, JYU)

Laura Kananen, Postdoctoral Research Fellow, PhD (TAU)
Jake Lin, Postdoctoral Research Fellow, PhD (TAU)
Maija Satamo, Researcher, MSc (TAU)
Jani Raitanen, Researcher/Statistician, MSc (TAU)
Pekka Abrahamsson, Professor, PhD (JUY)
Antti Kariluoto, Researcher (JUY)
Anna Tirkkonen, Doctoral Researcher, MSc (JUY)
Markus Haapanen, Physician and Postdoctoral researcher, MD, PhD (University of Helsinki and Folkhälsan Research Center, Helsinki)
Timo Erkkilä, CEO, PhD (Veracell Oy)