Frailty and Bone Disease

Frailty classifications will be externally validated against outcomes including overall survival, progression-free survival, and early mortality. The simplified International Myeloma Working Group frailty scale will use age, Charlson Comorbidity Index, and ECOG performance status to classify patients as frail or non-frail. Skeletal-related events will be derived from healthcare systems data using ICD-10 and OPCS-4 codes in HES and radiotherapy data. Hospital admission and comorbidity data will be used to derive and externally validate several frailty tools. BLISS will examine myeloma bone disease as an important endpoint that has been difficult to assess in randomised controlled trials.