Objective:

To explore the integration of continuous wearable monitoring with the Hospital Frailty Risk Score (HFRS) framework, emphasizing equity and bias in frailty assessment.

Approach:

• Integration of Wearables: Proposes augmenting HFRS with continuous data from wearable devices to enhance frailty assessment.
• Bias and Equity Considerations: Highlights the importance of bias auditing and governance to mitigate health disparities in the use of wearable data.
• Validation and Monitoring: Calls for rigorous validation of wearable metrics across diverse demographic groups and continuous monitoring for hidden risks.

Key Findings:

• Frailty risks affect adults across all age groups, with significant implications for hospital stays and mortality.
• Wearable devices can provide continuous data that may enhance early detection of frailty.
• Existing wearable algorithms for frailty assessment are limited and require further development and validation.

Interpretation:

The integration of wearables into frailty assessment must be approached with caution to avoid perpetuating existing health disparities.

Limitations:

• Device performance can vary significantly based on demographic factors, potentially leading to biased outcomes.
• Current wearable algorithms lack comprehensive validation across diverse populations.

Conclusion:

A phased approach is necessary for integrating wearables into clinical practice, with a focus on validation and equity.