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        "titulo" => "Simplificaci&#243;n de la escala de Barthel para el cribado de fragilidad y dependencia severa en pacientes pluripatol&#243;gicos"
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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Proposed practical approach for assessing functional independence &#40;Barthel index<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>90 points&#41; and severe functional dependence &#40;Barthel index<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>60 points&#41;&#44; using the Barthel index simplified to 3 measures&#44; in polypathological patients&#44; for subsequent frailty screening&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Background</span><p id="par0005" class="elsevierStylePara elsevierViewall">Frailty is one of the main geriatric syndromes&#44; and its prevalence in the elderly population is high&#46;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">1&#44;2</span></a> When chronic diseases and comorbidities coexist&#44; the prevalence of frailty increases significantly&#59; in polypathological patients &#40;PPPs&#41;&#44; the rate of frailty reaches 60&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">3</span></a> Frailty is an independent prognostic marker of mortality and poor health results in the short&#44; medium and long term&#46; Frailty is currently considered a pre-disability state with unstable homeostatic equilibrium and a risk of developing new disabilities from an incipient condition of functional limitation&#46; However&#44; the most important aspect is that frailty can be detected and treated&#44; thereby preventing the onset of disability by acting on the frailty&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">4&#8211;6</span></a> The social and healthcare approach to frailty is therefore one of the pillars of healthcare systems in caring for elderly populations&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">6</span></a> The Barthel index &#40;BI&#41; has been proposed as a method for screening for frailty&#44; with scores<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>90 indicating dependence&#46; If patients score 90 or more points&#44; specific performance tests can be conducted to diagnose frailty&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">6</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Functional impairment for basic activities of daily life &#40;BADL&#41; and disability are highly prevalent in PPPs&#46; In various multicenter studies&#44; most PPPs presented dependence&#44; which was severe in more than 30&#37; &#40;BI<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>60 points&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">7&#44;8</span></a> Identifying severe dependence is important when assessing and structuring healthcare interventions directed at PPPs&#44; because these interventions will vary in type and intensity depending on the patient&#39;s disability threshold&#46; Detecting PPPs with severe dependence will help establish specific support systems that mitigate the progressive cascade of disability and its consequent deleterious effects&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Implementing the BI to assess functionality for BADL before proceeding to specific performance tests for diagnosing frailty increases the clinical time needed to conduct the assessment&#46; Therefore&#44; simplifying the prior screening as much as possible using the BI will facilitate the screening and reduce the time needed to implement it&#44; thereby assisting clinicians in the diagnostic approach for frailty&#46; For the screening of severe dependence and the subsequent healthcare programming&#44; it would be useful to have a summarized version of the index that can help healthcare practitioners detect severe dependence&#46; However&#44; there is currently insufficient evidence to recommend a BADL assessment using a summarized version of the BI&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">We therefore established the study objectives of exploring the sensitivity&#44; specificity and positive predictive &#40;PPV&#41; and negative predictive values &#40;NPV&#41; of the 10 measures of the BI compared with the total score and assessing whether an abbreviated version of 1 or 2 measures could be used to screen for frailty and severe dependence&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">We conducted a cross-sectional study employing data from the inclusion of a consecutive multicenter sample of 1632 PPPs recruited in 37 Spanish hospitals &#40;17 tertiary hospitals&#44; 7 secondary hospitals and 12 regional hospitals&#41; over the course of 17<span class="elsevierStyleHsp" style=""></span>months for the PROFUND project&#46; The project was conducted within the Polypathological Patient and Advanced Age Workgroup of the Spanish Society of Internal Medicine&#46; Seventy-five percent of the patients were recruited during the hospital discharge&#44; 17&#46;5&#37; were recruited in outpatient clinics&#44; and 7&#46;5&#37; were recruited from home hospitalizations&#46; The project collected various demographic&#44; clinical&#44; laboratory&#44; functional&#44; psychometric and healthcare parameters from all included patients&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The BI was determined for all included patients by the project researchers&#44; considering scores &#60;90 points as dependence and scores &#60;60 points as severe dependence&#46; These 2 values were considered the gold standard for the presence or absence of dependence and severe dependence&#44; respectively&#46; For each of the 10 measures in the index&#44; we calculated the correlation using the kappa index&#44; sensitivity&#44; specificity&#44; PPV and NPV compared with the previously mentioned gold standard&#46; We then analyzed whether the diagnostic validity indices improved through the use of all possible combinations of 2 measures&#46; We employed the SPSS statistical package version 20&#46;0 for the calculations&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0035" class="elsevierStylePara elsevierViewall">The study included 1632 PPPs &#40;mean age&#44; 77&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#46;8<span class="elsevierStyleHsp" style=""></span>years&#59; 53&#37; men&#41;&#46; The patients&#8217; main clinical and functional characteristics are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRefs" href="#tbl0010">Tables 2 and 3</a> show the correlation and diagnostic validity indices for each of the 10 measures and for the combinations of 2 measures with higher indices&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">With respect to performing the BI with a score of 90 or more points&#44; the measures with the highest NPV were &#8220;feeding&#8221; and &#8220;grooming&#8221; &#40;96&#46;6&#37; for both&#41;&#59; the combination of the 2 measures did not increase the NPV &#40;99&#37;&#41;&#46; The measures with the highest PPV were &#8220;walking&#8221; and &#8220;going up and down stairs autonomously&#8221; &#40;81&#37; and 92&#37;&#44; respectively&#41;&#59; the combination of the 2 measures resulted in an increased PPV compared with the maximum obtained in the individually considered measures &#40;increasing it to 95&#37;&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">With respect to performing the BI with a score of 60 or more points&#44; the measures with the highest NPV were also &#8220;feeding&#8221; and &#8220;grooming&#8221; &#40;87&#37; for both&#41;&#59; the combination of the 2 measures did not increase the NPV &#40;81&#37;&#41;&#46; The measures with the highest PPV were &#8220;walking&#8221; and &#8220;going up and down stairs autonomously&#8221; &#40;92&#46;2&#37; and 95&#46;5&#37;&#44; respectively&#41;&#59; the combination of the 2 measures resulted in an increased PPV compared with the maximum obtained in the individually considered measures &#40;increasing it to 99&#46;5&#37;&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">After obtaining these results&#44; we proposed a simplified sequence for the functional stratification and approach to frailty screening for PPPs &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0060" class="elsevierStylePara elsevierViewall">The recruited cohort&#39;s clinical characteristics are those of populations of PPPs in hospital settings&#58; advanced age&#44; significant comorbidity burden&#44; symptomatic and functional repercussion and polypharmacy&#46;<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">8&#44;9</span></a> It is notable that approximately 60&#37; of these patients had moderate dependence&#44; and approximately 30&#37; showed severe dependence for BADL&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">When assessing functional independence for BADL&#44; the measures that achieved the highest NPV were &#8220;feeding&#8221; and &#8220;grooming&#8221;&#44; both when obtaining a BI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>90 points and when obtaining a BI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>60 points&#46; However&#44; the combination of being independent for both measures did not significantly increase the NPV of either of the 2 measures taken individually&#46; Therefore&#44; either of the 2 measures can be employed for screening dependence in PPPs&#46; Thus&#44; we have a high degree of certainty that patients with some degree of dependence in &#8220;feeding&#8221; or &#8220;grooming&#8221; would not score 60 or more points on the full BI&#46; For the study algorithm&#44; we opted for the &#8220;feeding&#8221; measure rather than &#8220;grooming&#8221; due to the former&#39;s smaller confidence interval between the outliers&#46; In fact&#44; the ability to feed oneself is one of the basic executive functions that is maintained up to the most advanced stages of dependence&#44; with the other BADL being lost before it&#44; as has been found in other studies&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">10</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">Independence for performing the measures &#8220;walking&#8221; and &#8220;going up and down stairs&#8221; achieved a high PPV&#44; both for obtaining a BI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>90 points and for obtaining a BI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>60 points&#46; Additionally&#44; the combination of being independent for both measures increased the PPV to 95&#37; and 99&#46;6&#37; for obtaining a BI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>90 and a BI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>60 points&#44; respectively&#46; This combination of measures could be employed for functional independence&#44; such that a PPP capable of walking and going up and down stairs alone could be considered independent for performing BADL and would be candidate for frailty screening&#44; as has been proposed in various consensus documents&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">6&#44;11</span></a> Based on our results&#44; functional independence and severe dependence could be determined with high reliability and time efficiency using this combination of 3 measures&#46; Thus&#44; in the recruited sample&#44; 474 patients &#40;31&#37;&#41; were independent for walking and going up and down stairs and had a BI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>90 points &#40;true positives&#41;&#46; Furthermore&#44; 316 patients &#40;21&#37;&#41; had some degree of dependence for feeding and had a BI<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>60 points &#40;true negatives&#41;&#46; Therefore&#44; more than 50&#37; of the PPPs could be spared the implementation of the full BI&#46; Other authors have performed simplifications of the BI to 3&#8211;5 measures but only in the setting of acute cerebrovascular disease and the assessment of its sequelae&#44; comparing its utility with specific stroke scales&#59; there is therefore no approach for patients with multimorbidity and polypathology&#46;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">12&#8211;14</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">The results of the present study lack validation and should therefore be validated in future studies using an independent patient cohort to confirm this studies&#8217; reliability and external validity&#46; Another possible limitation is the sample&#39;s high representation of hospitalized patients&#44; enrolled at discharge&#44; which could create uncertainty as to its validity in stable outpatients&#46; The study&#39;s main strength&#44; however&#44; is that it was implemented using a broad multicenter sample with a wide geographical dispersion&#44; which will likely maintain its validity in subsequent patient samples&#46; The study&#39;s main clinical utility lies in facilitating and shortening the time needed to conduct screening for frailty and severe dependence in a high percentage of PPPs&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">In conclusion&#44; the ability to feed oneself only achieved a high NPV in detecting severe dependence for BADL&#44; while the ability to walk and go up and down stairs achieved a high PPV for the screening of functional independence&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Funding</span><p id="par0085" class="elsevierStylePara elsevierViewall">The study was funded by the <span class="elsevierStyleGrantSponsor" id="gs1">Institute of Health Carlos <span class="elsevierStyleSmallCaps">III</span></span> &#40;ISCIII&#44; <span class="elsevierStyleGrantNumber" refid="gs1">FIS 07&#47;0047</span>&#41;&#44; <span class="elsevierStyleGrantSponsor" id="gs2">Ministry of Health and Consumer Affairs&#44; Spain</span>&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Authorship</span><p id="par0090" class="elsevierStylePara elsevierViewall">Concept and design of the manuscript&#58; M&#225;ximo Bernabeu-Wittel&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Data collection&#58; M&#225;ximo Bernabeu-Wittel&#44; Jes&#250;s D&#237;ez-Manglano&#44; Dolores Nieto Mart&#237;n&#44; Nieves Ram&#237;rez-Duque and Manuel Ollero-Baturone&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Data analysis and interpretation&#58; M&#225;ximo Bernabeu-Wittel&#44; Jes&#250;s D&#237;ez-Manglano and Dolores Nieto Mart&#237;n&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Drafting&#44; review and approval of the submitted manuscript&#46; M&#225;ximo Bernabeu-Wittel&#44; Jes&#250;s D&#237;ez-Manglano&#44; Dolores Nieto Mart&#237;n&#44; Nieves Ram&#237;rez-Duque and Manuel Ollero-Baturone&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To analyze the sensitivity&#44; specificity and positive predictive &#40;PPV&#41; and negative predictive &#40;NPV&#41; values of each measure of the Barthel index &#40;BI&#41; compared with the full questionnaire for polypathological patients &#40;PPPs&#41;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Multicentre cross-sectional study&#46; We considered 2 cut-off points for the BI &#40;&#8805;90 points for screening frailty and &#60;60 points for diagnosing severe dependence&#41;&#46; For each measure and combination of 2 measures&#44; we calculated the sensitivity&#44; specificity&#44; PPV and NPV with respect to the full BI&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The mean BI of the 1632 included PPPs &#40;mean age&#44; 77&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#46;8<span class="elsevierStyleHsp" style=""></span>years&#59; 53&#37; men&#41; was 69<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>31 &#40;&#60;90 for 58&#46;7&#37; and &#60;60 for 31&#46;4&#37; of the patients&#41;&#46; The &#8220;feeding&#8221; measure achieved the highest NPV&#44; for a BI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>60 and &#8805;90 points &#40;87&#37; and 99&#46;6&#37;&#44; respectively&#41;&#46; The &#8220;walking&#8221; and &#8220;going up and down stairs&#8221; measures achieved the highest PPV&#44; for a BI<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>60 and &#8805;90 &#40;99&#46;2&#37;&#47;99&#46;5&#37; and 81&#37;&#47;92&#37;&#41;&#44; respectively&#46; The combination of the 2 measures increased the PPV to 95&#37; and 99&#46;6&#37;&#44; respectively&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">PPPs in hospital settings have a high rate of functional impairment&#46; The measure for feeding achieved the highest NPV and can therefore be employed for diagnosing severe dependence&#46; The combination of the measures for walking and going up and down stairs achieved the highest PPV and can therefore be employed to propose frailty screening for PPPs&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objectives"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
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      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Analizar la sensibilidad &#40;S&#41;&#44; la especificidad &#40;E&#41; y los valores predictivos positivo &#40;VPP&#41; y negativo &#40;VPN&#41; de cada dimensi&#243;n del &#237;ndice de Barthel &#40;IB&#41; con respecto al cuestionario completo en pacientes pluripatol&#243;gicos &#40;PPP&#41;&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio transversal multic&#233;ntrico&#46; Se consideraron dos puntos de corte del IB &#40;&#8805;<span class="elsevierStyleHsp" style=""></span>90 puntos para el cribado de fragilidad y &#60;<span class="elsevierStyleHsp" style=""></span>60 puntos para el diagn&#243;stico de dependencia severa&#41;&#46; Para cada dimensi&#243;n y combinaciones de dos dimensiones se calcularon la S&#44; la E&#44; el VPP y el VPN con respecto al IB completo&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">El IB medio de los 1&#46;632 PPP incluidos &#40;edad media de 77&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#44;8<span class="elsevierStyleHsp" style=""></span>a&#241;os&#44; 53&#37; varones&#41; fue 69<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>31 &#40;&#60;<span class="elsevierStyleHsp" style=""></span>90 en el 58&#44;7&#37; y &#60;<span class="elsevierStyleHsp" style=""></span>60 en el 31&#44;4&#37; de pacientes&#41;&#46; La dimensi&#243;n &#171;alimentaci&#243;n&#187; obtuvo los mayores VPN para tener un IB<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>60 y &#8805;<span class="elsevierStyleHsp" style=""></span>90 puntos &#40;87&#37; y 99&#44;6&#37;&#44; respectivamente&#41;&#46; Las dimensiones &#171;deambular&#187; y &#171;subir y bajar escaleras&#187; obtuvieron el mayor VPP para tener un IB<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>60 y &#8805;<span class="elsevierStyleHsp" style=""></span>90 &#40;99&#44;2&#47;99&#44;5&#37; y 81&#47;92&#37;&#41;&#44; respectivamente&#59; la combinaci&#243;n de ambas preguntas aument&#243; el VPP al 95 y al 99&#44;6&#37;&#44; respectivamente&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Los PPP de &#225;mbito hospitalario presentan con elevada frecuencia deterioro funcional&#46; La dimensi&#243;n referente a alimentarse obtuvo el mayor VPN&#44; por lo que se puede utilizar para el diagn&#243;stico de dependencia severa&#44; mientras que la combinaci&#243;n de deambular y subir y bajar escaleras obtuvo el mayor VPP&#44; pudiendo utilizarse para plantear el cribado de fragilidad de los PPP&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Objetivos"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:2 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0035">Please cite this article as&#58; Bernabeu-Wittel M&#44; D&#237;ez-Manglano J&#44; Nieto-Mart&#237;n D&#44; Ram&#237;rez-Duque N&#44; Ollero-Baturone M&#46; Simplificaci&#243;n de la escala de Barthel para el cribado de fragilidad y dependencia severa en pacientes pluripatol&#243;gicos&#46; Rev Clin Esp&#46; 2019&#59;219&#58;433&#8211;439&#46;</p>"
      ]
      1 => array:3 [
        "etiqueta" => "&#9674;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0040">The rest of the PROFUND Project researchers are related in the <a class="elsevierStyleCrossRef" href="#sec0035">Appendix</a>&#46;</p>"
        "identificador" => "fn0005"
      ]
    ]
    "apendice" => array:1 [
      0 => array:1 [
        "seccion" => array:1 [
          0 => array:4 [
            "apendice" => "<p id="par0110" class="elsevierStylePara elsevierViewall">Lucy Abella-V&#225;zquez&#44; Hospital Nuestra Sra&#46; de la Candelaria&#44; Tenerife&#46;</p> <p id="par0115" class="elsevierStylePara elsevierViewall">Mariano Aguayo-Canela&#44; Hospital Virgen Macarena&#44; Seville&#46;</p> <p id="par0120" class="elsevierStylePara elsevierViewall">M&#243;nica Albert-Coll&#44; Hospital de Manacor&#44; Mallorca&#46;</p> <p id="par0125" class="elsevierStylePara elsevierViewall">Antonio Alem&#225;n&#44; Hospital Morales Meseguer&#44; Murcia&#46;</p> <p id="par0130" class="elsevierStylePara elsevierViewall">Jordi Aligu&#233;&#44; Hospital de Manresa&#44; Barcelona&#46;</p> <p id="par0135" class="elsevierStylePara elsevierViewall">Jos&#233; Barb&#233; Gil-Ortega&#44; Hospital Vall d&#8217;Hebr&#243;n&#44; Barcelona&#46;</p> <p id="par0140" class="elsevierStylePara elsevierViewall">Bosco Bar&#243;n-Franco&#44; Hospital Juan Ram&#243;n Jim&#233;nez&#44; Huelva&#46;</p> <p id="par0145" class="elsevierStylePara elsevierViewall">M&#225;ximo Bernabeu-Wittel&#44; Hospital Virgen del Roc&#237;o&#44; Seville&#46;</p> <p id="par0150" class="elsevierStylePara elsevierViewall">Cristina de la Calle-Cabrera&#44; University Hospital&#44; Salamanca&#46;</p> <p id="par0155" class="elsevierStylePara elsevierViewall">Manuel Cassani-Garza&#44; Hospital Virgen del Roc&#237;o&#44; Seville&#46;</p> <p id="par0160" class="elsevierStylePara elsevierViewall">Manuela Castillo-Blasco&#44; Hospital Dr&#46; Moliner&#44; Valencia&#46;</p> <p id="par0165" class="elsevierStylePara elsevierViewall">Felipe D&#237;ez&#44; Hospital de Torrec&#225;rdenas&#44; Almer&#237;a&#46;</p> <p id="par0170" class="elsevierStylePara elsevierViewall">Jes&#250;s D&#237;ez-Manglano&#44; Hospital Royo Villanova&#44; Zaragoza&#46;</p> <p id="par0175" class="elsevierStylePara elsevierViewall">Alberto Escalera-Zalvide&#44; Hospital Juan Ram&#243;n Jim&#233;nez&#44; Huelva&#46;</p> <p id="par0180" class="elsevierStylePara elsevierViewall">Luis Feliu-Mazaria&#44; General Hospital of Palma&#44; Mallorca&#46;</p> <p id="par0185" class="elsevierStylePara elsevierViewall">Manuel Francisco Fern&#225;ndez-Miera&#44; Hospital Marqu&#233;s de Valdecilla&#44; Santander&#46;</p> <p id="par0190" class="elsevierStylePara elsevierViewall">Antonio Fern&#225;ndez-Moyano&#44; Hospital San Juan de Dios del Aljarafe&#44; Seville&#46;</p> <p id="par0195" class="elsevierStylePara elsevierViewall">Francesc Formiga&#44; Hospital de Bellvitge&#44; Barcelona&#46;</p> <p id="par0200" class="elsevierStylePara elsevierViewall">Jordy Forteza-Rey&#44; Hospital Son Dureta&#44; Mallorca&#46;</p> <p id="par0205" class="elsevierStylePara elsevierViewall">Aurelio Fuertes-Mart&#237;n&#44; University Hospital&#44; Salamanca&#46;</p> <p id="par0210" class="elsevierStylePara elsevierViewall">Javier Galindo-Oca&#241;a&#44; Hospital Virgen del Roc&#237;o&#44; Seville&#46;</p> <p id="par0215" class="elsevierStylePara elsevierViewall">Pilar Giner&#44; Hospital San Cecilio&#44; Granada&#46;</p> <p id="par0220" class="elsevierStylePara elsevierViewall">Montserrat Godoy&#44; Hospital de la Serran&#237;a&#44; Malaga&#46;</p> <p id="par0225" class="elsevierStylePara elsevierViewall">Sandra G&#243;mez-Lesmes&#44; University Hospital&#44; Salamanca&#46;</p> <p id="par0230" class="elsevierStylePara elsevierViewall">Hern&#225;n Llorente-Cancho&#44; University Hospital&#44; Salamanca&#46;</p> <p id="par0235" class="elsevierStylePara elsevierViewall">Carolina Luque-Amado&#44; Hospital de la Serran&#237;a&#44; Malaga&#46;</p> <p id="par0240" class="elsevierStylePara elsevierViewall">Jos&#233; Manuel Mach&#237;n-L&#225;zaro&#44; Hospital de Guadalajara&#46;</p> <p id="par0245" class="elsevierStylePara elsevierViewall">Mar&#237;a Maiz-Jim&#233;nez&#44; Hospital de la Serran&#237;a&#44; Malaga&#46;</p> <p id="par0250" class="elsevierStylePara elsevierViewall">Francisco Mart&#237;nez&#44; Hospital Virgen Macarena&#44; Seville&#46;</p> <p id="par0255" class="elsevierStylePara elsevierViewall">Tom&#225;s Mart&#237;nez&#44; Hospital Juan Ram&#243;n Jim&#233;nez&#44; Huelva&#46;</p> <p id="par0260" class="elsevierStylePara elsevierViewall">Francisco Martos&#44; Hospital de Benalm&#225;dena&#44; Malaga&#46;</p> <p id="par0265" class="elsevierStylePara elsevierViewall">Beatriz Massa&#44; Hospital de Villajoyosa&#44; Alicante&#46;</p> <p id="par0270" class="elsevierStylePara elsevierViewall">Jes&#250;s Medina&#44; Hospital 12 de Octubre&#44; Madrid&#46;</p> <p id="par0275" class="elsevierStylePara elsevierViewall">Francisco Medrano-Gonz&#225;lez&#44; Hospital de Albacete&#46;</p> <p id="par0280" class="elsevierStylePara elsevierViewall">Manuel Montero P&#233;rez-Barquero&#44; Hospital Reina Sof&#237;a&#44; C&#243;rdoba&#46;</p> <p id="par0285" class="elsevierStylePara elsevierViewall">Antonia Mora-Rufete&#44; General Hospital of Elche&#46;</p> <p id="par0290" class="elsevierStylePara elsevierViewall">Clotilde Morales&#44; Hospital de Manresa&#44; Barcelona&#46;</p> <p id="par0295" class="elsevierStylePara elsevierViewall">Lourdes Moreno-Gavi&#241;o&#44; Hospital Virgen del Roc&#237;o&#44; Seville&#46;</p> <p id="par0300" class="elsevierStylePara elsevierViewall">Alberto Muela-Molinero&#44; Hospital de Le&#243;n&#46;</p> <p id="par0305" class="elsevierStylePara elsevierViewall">Jos&#233; Murcia-Zaragoza&#44; General Hospital of Alicante&#46;</p> <p id="par0310" class="elsevierStylePara elsevierViewall">M&#46; Dolores Nieto-Mart&#237;n&#44; Hospital Virgen del Roc&#237;o&#44; Seville&#46;</p> <p id="par0315" class="elsevierStylePara elsevierViewall">Ignacio Novo Valeiro&#44; University Hospital&#44; Salamanca&#46;</p> <p id="par0320" class="elsevierStylePara elsevierViewall">Manuel Ollero-Baturone&#44; Hospital Virgen del Roc&#237;o&#44; Seville&#46;</p> <p id="par0325" class="elsevierStylePara elsevierViewall">Blanca Pinilla&#44; Hospital Gregorio Mara&#241;&#243;n&#44; Madrid&#46;</p> <p id="par0330" class="elsevierStylePara elsevierViewall">Nieves Ram&#237;rez-Duque&#44; Hospital Virgen del Roc&#237;o&#44; Seville&#46;</p> <p id="par0335" class="elsevierStylePara elsevierViewall">Carmen Ramos-Cantos&#44; Hospital de la Axarqu&#237;a&#44; Malaga&#46;</p> <p id="par0340" class="elsevierStylePara elsevierViewall">Manuel Rinc&#243;n-G&#243;mez&#44; Hospital Virgen del Roc&#237;o&#44; Seville&#46;</p> <p id="par0345" class="elsevierStylePara elsevierViewall">M&#46; Luisa Rodr&#237;guez-Benedito&#44; General Hospital of Requena&#44; Valencia&#46;</p> <p id="par0350" class="elsevierStylePara elsevierViewall">Virginia Rodr&#237;guez-Mart&#237;nez&#44; Hospital de Torrec&#225;rdenas&#44; Almer&#237;a&#46;</p> <p id="par0355" class="elsevierStylePara elsevierViewall">Manuel Romero-Jim&#233;nez&#44; Hospital Infanta Elena&#44; Huelva&#46;</p> <p id="par0360" class="elsevierStylePara elsevierViewall">Sixto Ruiz&#44; Hospital de Inca&#44; Mallorca&#46;</p> <p id="par0365" class="elsevierStylePara elsevierViewall">Alberto Ruiz-Cantero&#44; Hospital de la Serran&#237;a&#44; Malaga&#46;</p> <p id="par0370" class="elsevierStylePara elsevierViewall">Emilio Sacanella&#44; Hospital Cl&#237;nic&#44; Barcelona&#46;</p> <p id="par0375" class="elsevierStylePara elsevierViewall">Mar&#237;a S&#225;nchez-Ledesma&#44; University Hospital&#44; Salamanca&#46;</p> <p id="par0380" class="elsevierStylePara elsevierViewall">Antonio Sanjos&#233;-Laporte&#44; Hospital Vall d&#8217;Hebr&#243;n&#44; Barcelona&#46;</p> <p id="par0385" class="elsevierStylePara elsevierViewall">Carlos Sanrom&#225;n&#44; Hospital de la Axarqu&#237;a&#44; Malaga&#46;</p> <p id="par0390" class="elsevierStylePara elsevierViewall">M&#46; &#193;ngeles Soria-L&#243;pez&#44; Cl&#237;nica Virgen de la Vega&#44; Murcia&#46;</p> <p id="par0395" class="elsevierStylePara elsevierViewall">Alicia Tejera-Concepci&#243;n&#44; Hospital Nuestra Sra&#46; de la Candelaria&#44; Tenerife&#46;</p> <p id="par0400" class="elsevierStylePara elsevierViewall">Pedro Tenllado-Doblas&#44; Hospital Dr&#46; Moliner&#44; Valencia&#46;</p> <p id="par0405" class="elsevierStylePara elsevierViewall">Guillermo Ternavasio&#44; University Hospital&#44; Salamanca&#46;</p> <p id="par0410" class="elsevierStylePara elsevierViewall">Eulalia Villegas-Bruguera&#44; Hospital Dos de Maig&#44; Barcelona&#46;</p>"
            "etiqueta" => "Appendix"
            "titulo" => "Project PROFUND Researchers"
            "identificador" => "sec0035"
          ]
        ]
      ]
    ]
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        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Proposed practical approach for assessing functional independence &#40;Barthel index<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>90 points&#41; and severe functional dependence &#40;Barthel index<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>60 points&#41;&#44; using the Barthel index simplified to 3 measures&#44; in polypathological patients&#44; for subsequent frailty screening&#46;</p>"
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      1 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
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          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; IQR&#44; interquartile range&#59; mMRC&#44; modified Medical Research Council&#59; NYHA&#44; New York Heart Association&#59; SD&#44; standard deviation&#46;</p>"
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                  \t\t\t\t"><span class="elsevierStyleBold">Number of categories&#47;patient</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;8&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Patients with &#8805;3 categories</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">808 &#40;49&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Category A &#40;heart disease&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1264 &#40;77&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Category C &#40;lung disease&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">744 &#40;45&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Category E &#40;neurological disease&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">624 &#40;38&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Category B &#40;chronic&#47;autoimmune kidney disease&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">526 &#40;32&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Category G &#40;active neoplasia&#47;chronic anemia&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">418 &#40;25&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Category F &#40;peripheral artery disease&#47;diabetes with neuropathy&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">411 &#40;25&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Category H &#40;degenerative osteoarticular disease&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">271 &#40;16&#46;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Category D &#40;liver disease&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">112 &#40;6&#46;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Number of other comorbidities per patient</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;5 &#40;2&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Cardiovascular</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;25 &#40;1&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Endocrine metabolic</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;17 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Neuropsychiatric</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;46 &#40;0&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Gastrointestinal</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;3 &#40;0&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Other more common comorbidities</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Hypertension</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1170 &#40;71&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Arrhythmias</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">603 &#40;36&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Atrial fibrillation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">575 &#40;35&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Other arrhythmias&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28 &#40;1&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Diabetes without visceral involvement</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">478 &#40;29&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Dyslipidemia</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">473 &#40;29&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Anxiety and depressive disorders</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">179 &#40;11&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Benign prostatic hyperplasia</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">170 &#40;10&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Osteoporosis</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">114 &#40;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Charlson index&#47;age-adjusted Charlson index</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#91;2&#93;&#47;6&#46;3 &#91;2&#46;4&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Patients with baseline dyspnea NYHA<span class="elsevierStyleSmallCaps">III</span>-<span class="elsevierStyleSmallCaps">IV</span>&#47;<span class="elsevierStyleSmallCaps">III</span>-<span class="elsevierStyleSmallCaps">IV</span> of the mMRC</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">777 &#40;47&#46;6&#37;&#41;&#47;855 &#40;52&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Patients with active neoplasia in the enrolment&#47;metastatic disease</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">188 &#40;11&#46;2&#37;&#41;&#47;70 &#40;37&#46;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Hospitalizations in the past 12 months&#47;3 months</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;9 &#40;1&#46;2&#41;&#47;1 &#40;0&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Baseline Barthel Index</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">69 &#40;31&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Patients with baseline Barthel index</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">90</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">958 &#40;58&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Patients with baseline Barthel index</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">60</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">512 &#40;31&#46;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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              "identificador" => "tblfn0005"
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Considering the measure dichotomously &#40;independence vs&#46; any degree of dependence in performing this measure&#41;&#46;</p> <p class="elsevierStyleNotepara" id="npar0010">Multicenter sample of 1632 polypathological patients&#46; The maximum PPV and NPV obtained in the individual questions are in <span class="elsevierStyleBold">bold</span>&#59; the maximum PPV and NPV obtained with the combinations of 2 measures are in <span class="elsevierStyleItalic"><span class="elsevierStyleBold">bold and italics</span></span>&#46; The 95&#37; confidence interval is shown in parentheses&#46;</p> <p class="elsevierStyleNotepara" id="npar0015">Abbreviations&#58; S&#44; sensitivity&#59; SP&#44; specificity&#59; PPV&#44; positive predictive value&#59; NPF&#44; negative predictive value&#46;</p>"
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              "identificador" => "tblfn0010"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Considering the measure dichotomously &#40;independence vs&#46; any degree of dependence in performing this measure&#41;&#46;</p> <p class="elsevierStyleNotepara" id="npar0025">Multicenter sample of 1632 polypathological patients&#46; The maximum PPV and NPV obtained in the individual questions are in <span class="elsevierStyleBold">bold</span>&#59; the maximum PPV and NPV obtained with the combinations of 2 measures are in <span class="elsevierStyleItalic"><span class="elsevierStyleBold">bold and italics</span></span>&#46; The 95&#37; confidence interval is shown in parentheses&#46;</p> <p class="elsevierStyleNotepara" id="npar0030">Abbreviations&#58; S&#44; sensitivity&#59; SP&#44; specificity&#59; PPV&#44; positive predictive value&#59; NPF&#44; negative predictive value&#46;</p>"
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          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Correlation results &#40;kappa index&#41;&#44; sensitivity&#44; specificity&#44; positive predictive value and negative predictive value of each measure of the Barthel index and its optimal combinations for the diagnosis of a Barthel index<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>60 points and its use in screening severe dependence&#46;</p>"
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        0 => array:2 [
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                    0 => array:2 [
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                      "autores" => array:1 [
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                          "etal" => false
                          "autores" => array:1 [
                            0 => "Q&#46;L&#46; Xue"
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                    0 => array:2 [
                      "doi" => "10.1016/j.cger.2010.08.009"
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                        "volumen" => "27"
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                        "paginaFinal" => "15"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21093718"
                            "web" => "Medline"
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                          "etal" => false
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                            0 => "F&#46; Wou"
                            1 => "S&#46; Conroy"
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                    0 => array:1 [
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                      "titulo" => "Sarcopenia en pacientes pluripatol&#243;gicos&#46; Caracter&#237;sticas cl&#237;nicas y factores associados"
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                        0 => array:2 [
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                            2 => "J&#46; Lanseros"
                            3 => "R&#46; Fern&#225;ndez-Ojeda"
                            4 => "J&#46; D&#237;ez-Manglano"
                            5 => "F&#46; Salgado"
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                      "LibroEditado" => array:2 [
                        "titulo" => "XXVII Congreso Nacional de Medicina Interna&#46; EA-056&#44; Zaragoza"
                        "serieFecha" => "Noviembre de 2016"
                      ]
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              "etiqueta" => "4"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Searching for an operational definition of frailty&#58; a Delphi method based consensus statement&#46; The Frailty Operative Definition-Consensus Conference Project"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Rodr&#237;guez-Ma&#241;as"
                            1 => "C&#46; F&#233;art"
                            2 => "G&#46; Mann"
                            3 => "J&#46; Vi&#241;a"
                            4 => "S&#46; Chatterji"
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                    0 => array:2 [
                      "doi" => "10.1093/gerona/gls119"
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                        "fecha" => "2013"
                        "volumen" => "68"
                        "paginaInicial" => "62"
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                          "etal" => true
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                            0 => "J&#46;E&#46; Morley"
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                            2 => "G&#46; Abellan van Kan"
                            3 => "S&#46;D&#46; Anker"
                            4 => "J&#46;M&#46; Bauer"
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                      "titulo" => "Functional decline over one-year follow up in a multicenter cohort of polypathological patients&#58; a new approach to functional prognostication"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            1 => "M&#46; Ollero-Baturone"
                            2 => "A&#46; Ruiz-Cantero"
                            3 => "L&#46; Moreno-Gavi&#241;o"
                            4 => "B&#46; Bar&#243;n-Franco"
                            5 => "A&#46; Fuertes"
                          ]
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