Moving Towards Common Data Elements and Core Outcome Measures in Frailty Research.

With aging populations around the world, frailty is becoming more prevalent increasing the need for health systems and social systems to deliver optimal evidence based care. However, in spite of the growing number of frailty publications, high-quality evidence for decision making is often lacking. Inadequate descriptions of the populations enrolled including frailty severity and frailty conceptualization, lack of use of validated frailty assessment tools, utilization of different frailty instruments between studies, and variation in reported outcomes impairs the ability to interpret, generalize and implement the research findings. The utilization of common data elements (CDEs) and core outcome measures (COMs) in clinical trials is increasingly being adopted to address such concerns. To catalyze the development and use of CDEs and COMs for future frailty studies, the Canadian Frailty Network (www.cfn-nce.ca; CFN), a not-for-profit pan-Canadian nationally-funded research network, convened an international group of experts to examine the issue and plan the path forward. The meeting was structured to allow for an examination of current frailty evidence, ability to learn from other COMs and CDEs initiatives, discussions about specific considerations for frailty COMs and CDEs and finally the identification of the necessary steps for a COMs and CDEs consensus initiative going forward. It was agreed at the onset of the meeting that a statement based on the meeting would be published and herein we report the statement.

Ductal carcinoma of the parotid gland.

A case of ductal carcinoma of the parotid gland is described. The medical literature contains only 13 previous reports on this kind of adenocarcinoma of the parotid gland. The tumour is characterized by its histologic resemblance to ductal carcinomas of the breast and prostate. The course of previously described cases suggests that this tumour has a highly aggressive biological behaviour.

Inflamed adenolymphoma with cholesterol granuloma.

Twelve cases of adenolymphoma with inflammation are described. Pre-operatively, three of these patients presented clinical signs of inflammation in the parotid gland. In ten cases purulent exudate could be aspirated from the tumour. Rupture of the cyst may cause an aseptic inflammation in the surrounding tissue. It is concluded that adult patients with clinical or cytological signs of inflammation in the parotid gland must be supervised until the gland is normal in order not to miss an underlying tumour.

Chondrosarcoma of the larynx.

Chondrosarcoma of the larynx is a rare neoplasm. The characteristic features of this tumor are described, and a case in a 69-year-old woman is reported. This case demonstrates the difficulties of histological classification. On the first biopsy specimen a benign chondroma was diagnosed. However, the microscopical features of the excised tumor were those of a chondrosarcoma. It is generally accepted that radiotherapy is of no value; surgical treatment by laryngectomy is advised. Some authors recommend a conservative attitude towards these tumors, which are of low malignancy, the growth slow and the risk of local or distant metastases slight.