[The authors respond:]
In his comments on our article,1 Doug Duke usefully reminds us that the care of elderly people is complex and commonly requires a multidisciplinary approach. He cautions that, if we use tools to assign patients to a frailty category, “expediency might override fairness.” This is, of course, a concern. However, older people who are reasonably fit derive little additional benefit from complex, multidisciplinary care compared with usual care, whereas elderly people who are frail benefit greatly.2,3,4 A pragmatic, nonarbitrary way is thus needed to classify relative degrees of fitness and frailty. In addition to being useful for research purposes, the scale we described aims to meet this need.
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