Currently accepted at: JMIR Formative Research
Date Submitted: Dec 30, 2025
Date Accepted: Oct 6, 2026
This paper has been accepted and is currently in production.
It will appear shortly on 10.2196/90593
The final accepted version (not copyedited yet) is in this tab.
Toward Web-based Implementation of Comprehensive Geriatric Assessment of Frailty: Development and Formative Evaluation of the eFI-CGA Web Application
ABSTRACT
Background:
Population aging has led to a rising prevalence and impact of frailty. Timely identification and management of health changes in health in older adults are critical to maintaining functional independence and improving the quality of life. Doing so can mitigate pressures on health and social care. To support this mission, we developed the eFI-CGA Web Application, which digitally translates the reference-standard Comprehensive Geriatric Assessment (CGA) and automates deficit-accumulation Frailty Index (FI) scoring for online use in research and clinical practice.
Objective:
This paper reports its development, deployment, and initial evaluation of the eFI-CGA web application.
Methods:
Development of the eFI-CGA web application was guided by both fidelity to CGA and by clinical end-user requirements. Deployment leveraged standardized web technologies on the Microsoft Azure platform using the ASP.NET Core framework. The application employed a hybrid WebForms and Model–View–Controller (MVC) architecture implemented in C# and JavaScript. System evaluation comprised functional and performance testing of front-end and back-end components, as well as their integrations. Testing was conducted using standard datasets consisting of systematically designed cases (n = 32) and mock patient cases (n = 46).
Results:
The released web application (efi-cga.ca) was fully interoperable across all common web browsers of modern operating systems. The web application prioritized usability, accessibility, efficiency, and integration into clinical workflows. Key features included secure authentication, personalized user spaces, and interactive data entry, search, retrieval, storage, analysis, and visualization functions. Initial evaluation confirmed complete adherence to design specifications, including 100% accuracy in itemized CGA and eFI-CGA score automations. Users can save, either centrally or locally, the assessment data including input and coded values for generating frailty scores and keeping additional notes in support of care planning.
Conclusions:
The eFI-CGA web application provides an accessible and practical digital approach to evidence-based frailty assessment, supporting frailty-centered interventions and care planning across diverse care settings. Large-scale, real-world validations are warranted to further enhance its performance and utility.
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Copyright
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