Shah SP, et al. - A prospective examination was carried out in older adult trauma patients in the Emergency Department (ED), to compare the utility of the picture-based Clinical Frailty Scale (CFS9), clinical assessments, and ultrasound muscle measurements against the reference FRAIL scale. Optimal diagnostic thresholds were derived and performance metrics for each comparison were calculated using sensitivity, specificity, predictive values, and area under receiver operating characteristic curves (AUROC). Frailty screening in the ED requires rapid, validated tools. In ruling out frailty, excellent negative predictive value was shown by the CFS9. In trauma patients who could not offer a history, ultrasound of combined biceps and quadriceps had modest concordance as an alternative.