Nathanael R. Fillmore
Topics / Electronic Frailty Index
Topic

Electronic Frailty Index

Fillmore has extensively validated and refined the Veterans Affairs Frailty Index (VA-FI) as a scalable tool for predicting mortality, hospitalization, and emergency department utilization in older adults with cancer. His research demonstrates that electronic frailty measurement provides superior prognostic accuracy compared to traditional genetic risk models or performance status alone across various malignancies, including multiple myeloma, acute myeloid leukemia, and non-small cell lung cancer. Additionally, he has established the construct validity of electronic indices against clinician-led assessments and updated the tool to maintain reliability during the transition to ICD-10 diagnostic coding.

U.S. Veterans and VA Data 12 Frailty 12 Retrospective Cohort Study 10 Overall Survival 9 Electronic Health Records 8 Real World Evidence 7 Patient Outcomes 6 Survival Analysis 6 Cox Proportional Hazards Model 6 Cancer Patients 6 Hospitalization Metrics 5 Geriatric Oncology 4

Publications (12)

2026

Association of Frailty With Transfusions, Hospitalizations, and Survival in Patients With Myelodysplastic Syndrome Initiating Hypomethylating Agents.

Anahid Hamparsumian†, Jennifer La†, Mayuri Dharne, Gary Gilbert, Mary T. Brophy, Nhan V. Do, Dae Hyun Kim, Jane A. Driver, Nathanael R. Fillmore‡, Clark DuMontier‡† Equal first authorship · ‡ Equal senior authorship

EJHaem7(4), e70352
U.S. Veterans and VA Data Retrospective Cohort Study Frailty Overall Survival Hospitalization Metrics
2026

Frailty and survival outcomes in veterans with invasive cutaneous melanoma: A Veterans Affairs Cancer Registry retrospective cohort study.

Linden B. Huhmann†, Jonathan C. Hwang†, Daniel Y. Kim, Kaelyn Nannini, Nhan V. Do, John M. Gaziano, Lee E. Wheless, Nathanael R. Fillmore‡, Rebecca I. Hartman‡† Equal first authorship · ‡ Equal senior authorship

Journal of the American Academy of Dermatology95(1), 240-243
U.S. Veterans and VA Data Retrospective Cohort Study Cancer-Associated Thrombosis Cutaneous Melanoma Overall Survival
2025

Potentially Inappropriate Medications, Frailty, and Outcomes in Patients With Cancer Managed in a National Health Care System.

Jennifer La, Tammy Hshieh, Anahid Hamparsumian, Robert Zwolinski, Jameson Wood, Mayuri Dharne, J. Michael Gaziano, Mary T. Brophy, Nhan V. Do, Nikhil C. Munshi, Jane A. Driver, Gregory A. Abel, Nathanael R. Fillmore‡, Clark DuMontier‡‡ Equal senior authorship

Journal of the National Comprehensive Cancer Network23(9), 363-370
U.S. Veterans and VA Data Retrospective Cohort Study Electronic Health Records Frailty Overall Survival
2023

Construct validity of the electronic Veterans Affairs Frailty Index against clinician frailty assessment.

Clark DuMontier†, Robert Hennis†, Cenk Yilidirim, Benjamin J. Seligman, Valencia Carolina Fonseca, Brooke L. Lubinski, Stephanie M. Sison, Mayuri Dharne, Dae Hyun Kim, Andrea Wershof Schwartz, Jane A. Driver, Nathanael R. Fillmore‡, Ariela R. Orkaby‡† Equal first authorship · ‡ Equal senior authorship

Journal of the American Geriatrics Society71(12), 3857-3864
U.S. Veterans and VA Data Electronic Health Records Frailty Electronic Frailty Index Construct Validity
2023

More intensive therapy as more effective treatment for frail patients with multiple myeloma [corrected].

Clark DuMontier†, Jennifer La†, John Bihn, June Corrigan, Cenk Yildirim, Mayuri Dharne, Hamza Hassan, Sarvari Yellapragada, Gregory A. Abel, J. Michael Gaziano, Nhan V. Do, Mary Brophy, Dae H. Kim, Nikhil C. Munshi, Nathanael R. Fillmore‡, Jane A. Driver‡† Equal first authorship · ‡ Equal senior authorship

Blood Advances7(20), 6275-6284
U.S. Veterans and VA Data Retrospective Cohort Study Multiple Myeloma Frailty Overall Survival
2021

Contemporary Analysis of Electronic Frailty Measurement in Older Adults with Multiple Myeloma Treated in the National US Veterans Affairs Healthcare System.

Clark DuMontier†, Nathanael R. Fillmore†, Cenk Yildirim, David Cheng, Jennifer La, Ariela R. Orkaby, Brian Charest, Diana Cirstea, Sarvari Yellapragada, John Michael Gaziano, Nhan Do, Mary T. Brophy, Dae H. Kim, Nikhil C. Munshi, Jane A. Driver† Equal first authorship

Cancers13(12)
U.S. Veterans and VA Data Retrospective Cohort Study Electronic Health Records Multiple Myeloma Frailty
2021

Updating and Validating the U.S. Veterans Affairs Frailty Index: Transitioning From ICD-9 to ICD-10.

David Cheng†, Clark DuMontier†, Cenk Yildirim, Brian Charest, Chelsea E. Hawley, Min Zhuo, Julie M. Paik, Enzo Yaksic, J. Michael Gaziano, Nhan Do, Mary Brophy, Kelly Cho, Dae H. Kim, Jane A. Driver, Nathanael R. Fillmore‡, Ariela R. Orkaby‡† Equal first authorship · ‡ Equal senior authorship

Journals of Gerontology: Series A76(7), 1318-1325
U.S. Veterans and VA Data Electronic Health Records Frailty Electronic Frailty Index ICD-10 Coding