Geriatric oncology screening tools for CGA-based interventions: results from a phase II study of geriatric assessment and management for older adults with cancer. Issue 6 (November 2018)

• Record Type: Journal Article
• Authors: Yokom, Daniel W.; Alibhai, Shabbir M.H.; Sattar, Schroder; Krzyzanowska, Monika K.; Puts, Martine T.E.
• Is Part Of: Journal of geriatric oncology. Volume 9:Issue 6(2018)
• Page Start: 683
• Page End: 686
• Publication Date: 2018-11
• Subjects: Screening tools -- CGA -- Geriatric assessment -- G8 -- VES-13 -- Frailty phenotype; Geriatric oncology -- Periodicals; Neoplasms -- Periodicals; Aged -- Periodicals; Geriatric oncology; Electronic journals; Periodicals; 618.976994005
• DOI: 10.1016/j.jgo.2018.03.001
• Languages: English
• ISSNs: 1879-4068

Abstract

Abstract: Introduction: Screening tools in geriatric oncology have traditionally been studied for their ability to identify patients who have abnormal domains on a comprehensive geriatric assessment (CGA). However, an alternative outcome of identifying patients who would receive CGA-based interventions could improve selection of patients whose management will be altered by a CGA. The objective of this study was to assess the performance of three geriatric oncology screening tools for their ability to predict for CGA-based interventions. Materials and Methods: G8, Vulnerable Elders Survey (VES-13) and a modified frailty phenotype (mFP) screening tools were collected prospectively for patients enrolled in a phase II trial of geriatric evaluation and management. Interventions were defined as a new clinical diagnosis, change in management of a comorbidity, or referral to an allied health professional. Performance characteristics were calculated for each screening tool based on the outcomes of ≥2 abnormal CGA-domains and ≥1 CGA-based interventions. Results: Discordance between the outcomes was seen in 31.9% of patients. Using the outcome of ≥2 abnormal CGA-domains, the G8 was most sensitive at 0.73 while VES-13 and mFP were both 1.0 specific. Using the outcome of CGA-based interventions the most sensitive tool was still the G8 at 0.64 and the most specific was the mFP at 0.80. Discussion: All screening tests' performance characteristics for the G8, VES-13 and mFP were lower for the outcome of CGA-based interventions than for the traditional outcome of abnormal CGA-domains. Significant discordance between the outcomes highlights the difficulty with trying to predict which patients will truly benefit from a CGA.