Optimizing the G8 Screening Tool for Older Patients With Cancer: Diagnostic Performance and Validation of a Six-Item Version (original) (raw)
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Geriatric 8 Scale to Predict Functional Decline in Older Adults With Cancer: a Systematic Review
Background: to determine the operative characteristics of the Geriatric Scale 8 versus the Comprehensive Geriatric Assessment to detect older adult patients with cancer at risk of functional decline. Methods: we conducted a systematic search for studies in three major indexed databases: Medline (PubMed), Embase and Google Scholar. We selected studies from 2010-2020, considering criteria such as older adults with some type of cancer, in which the G8 scale has been applied and has been associated with functional decline. Results: we found 690 relevant titles. After reviewing the titles, abstracts, and full articles, we selected two articles that met the inclusion criteria. From these articles, we found a sensitivity of 81%, a specificity of 38%, a positive likelihood ratio of 1.21 and a negative likelihood ratio of 0.63. Conclusions: We conclude that the G8 scale has a good sensitivity for the detection of functional decline in older adults with cancer, however, the scale does not hav...
Annals of oncology : official journal of the European Society for Medical Oncology / ESMO, 2015
Screening tools are proposed to identify those older cancer patients in need of geriatric assessment (GA) and multidisciplinary approach. We aimed to update the International Society of Geriatric Oncology (SIOG) 2005 recommendations on the use of screening tools. SIOG composed a task group to review, interpret and discuss evidence on the use of screening tools in older cancer patients. A systematic review was carried out and discussed by an expert panel, leading to a consensus statement on their use. Forty-four studies reporting on the use of 17 different screening tools in older cancer patients were identified. The tools most studied in older cancer patients are G8, Flemish version of the Triage Risk Screening Tool (fTRST) and Vulnerable Elders Survey-13 (VES-13). Across all studies, the highest sensitivity was observed for: G8, fTRST, Oncogeriatric screen, Study of Osteoporotic Fractures, Eastern Cooperative Oncology Group-Performance Status, Senior Adult Oncology Program (SAOP) 2...
Journal of Geriatric Oncology, 2011
Vulnerable Elders Survey (VES-13) has been validated for screening older cancer patients for a Comprehensive Geriatric Assessment (CGA). To identify a widely acceptable approach that encourages oncologists to screen older cancer patients for a CGA, we examined the Eastern Cooperative Oncology Group Performance Status (ECOG-PS) and Karnofsky Index of Performance Status (KPS) scales' ability to identify abnormalities on a CGA and compared the performance of the two instruments with the VES-13.
Journal of Clinical Oncology, 2014
To update the International Society of Geriatric Oncology (SIOG) 2005 recommendations on geriatric assessment (GA) in older patients with cancer. Methods SIOG composed a panel with expertise in geriatric oncology to develop consensus statements after literature review of key evidence on the following topics: rationale for performing GA; findings from a GA performed in geriatric oncology patients; ability of GA to predict oncology treatment-related complications; association between GA findings and overall survival (OS); impact of GA findings on oncology treatment decisions; composition of a GA, including domains and tools; and methods for implementing GA in clinical care. Results GA can be valuable in oncology practice for following reasons: detection of impairment not identified in routine history or physical examination, ability to predict severe treatment-related toxicity, ability to predict OS in a variety of tumors and treatment settings, and ability to influence treatment choice and intensity. The panel recommended that the following domains be evaluated in a GA: functional status, comorbidity, cognition, mental health status, fatigue, social status and support, nutrition, and presence of geriatric syndromes. Although several combinations of tools and various models are available for implementation of GA in oncology practice, the expert panel could not endorse one over another. Conclusion There is mounting data regarding the utility of GA in oncology practice; however, additional research is needed to continue to strengthen the evidence base.
European Journal of Cancer, 2011
Background: Frailty is an important factor to be considered in the senior cancer patient (pt). The Comprehensive Geriatric Assessment (CGA) is considered to be the gold standard to evaluate frailty in this pt population but its routine use in clinical practice is difficult. Therefore, screening instruments are needed to identify cancer pts who can be treated according to standard guidelines or are in need for a full CGA with geriatric interventions. The G8 questionnaire is a short and simple screening tool and was compared with the CGA to distinguish fit from unfit pts. Materials and Methods: Eligible pts were evaluated by the G8 questionnaire [score range: 0 (poor score) to 17 (good score)] and a full CGA to discriminate fit from unfit pts. The CGA evaluated function, mobility, nutrition, co-morbidity, cognition, depression and social support. Pts were considered unfit (vulnerable or frail) if there was more than 1 deficit within the CGA. Cutoff point used for the G8 questionnaire was a G8 score 14 for unfit pts. ROC analysis was used to evaluate the overall performance of the G8 questionnaire compared to the CGA. Results: 135 cancer pts were recruited from two sites in Belgium. Median age was 77 years old (range 66−97 years). Most prevalent types of cancer were urological cancers (22%), head and neck cancers (21%), cancer of the digestive system (17%), breast cancer (16%) and lung cancer (13%). According to the CGA, 44% of patients were considered unfit. The G8 questionnaire screened 75% of the patients as unfit with a sensitivity of 92% (95% confidence interval [CI]: 82−97%), a specificity of 39% (95% CI: 28−51%), a positive predictive value of 55% (95% CI: 44−64%) and a negative predictive value of 85% (95% CI: 68−95%). 62% of the pts were correctly classified. The Area Under the ROC Curve (AUC) was 0.85 (Standard error 0.03; 95% CI: 0.78-0.90). Conclusions: Overall the G8 questionnaire had a good ability (AUC=0.85) to discriminate fit from unfit patients in our sample compared to the CGA. For a cutoff point G8 score 14 the sensitivity was very high, but unfortunately the specificity or the probability to correctly identify fit patients was poor.
Comprehensive Geriatric Assessment in the Older Adult with Cancer: A Review
European Urology Focus, 2017
Context: The number of older adults with cancer is expected to increase rapidly in the upcoming decades. Aging is heterogeneous and chronological age is often not reflective of biological age. A comprehensive geriatric assessment (CGA) is an in-depth assessment of multiple domains of health that results in better assessment of a patient's overall health and fitness and allows directed intervention to improve patient outcomes. Objective: To review the value of CGA for older adults with cancer, CGA composition and tools that can be utilized, and the feasibility of including CGA in oncologic practice. Evidence acquisition: The currently available evidence on CGA for older adults with cancer was reviewed. Evidence synthesis: A CGA can highlight unidentified health problems and identify patients at higher risk of mortality, functional decline, surgical complications, chemotherapy intolerance, and chemotherapy toxicity. It has been shown that CGA is feasible in the oncology clinic, but geriatric screening tools may be useful to specifically identify patients who would benefit from a full CGA. Conclusions: CGA is feasible and can identify patients at higher risk of adverse events such as mortality, functional decline, surgical complications, and chemotherapy toxicity. Clinicians should consider incorporating CGA when assessing and caring for older adults with cancer. Patient summary: In this report, we review the benefits of a comprehensive geriatric assessment (CGA), a detailed in-depth assessment that identifies health problems not typically identified during routine assessments, for older adults with cancer. We describe the different domains of the CGA and suggest tools to utilize, as well as ways to incorporate CGA into the cancer care setting.
BMC Geriatrics
Background Pre-treatment evaluation for sarcopenia is recommended in cancer patients. New screening tests that are less time-consuming and can identify patients who will potentially benefit from geriatric assessment are being developed; the G8 geriatric screening test is one such example. We aimed to investigate whether the G8 screening test can detect probable sarcopenia and is valid and reliable compared to a comprehensive geriatric assessment (CGA) in Turkish older adults with solid cancers. Methods We included solid cancer patients referred to a single center. Probable sarcopenia and abnormal CGA were defined as low handgrip strength. Cut-offs for handgrip strength in the Turkish population have been previously determined to be 32 kg for males and 22 kg for females and impairment in at least one of the CGA tests, respectively. The CGA tests comprised KATZ Basic Activities of Daily Living Scale Lawton–Brody Instrumental Activities of Daily Living Scale, Mini-Mental-State Examinat...
Use of comprehensive geriatric assessment in older cancer patients
Critical Reviews in Oncology/Hematology, 2005
Background: As more and more cancers occur in elderly people, oncologists are increasingly confronted with the necessity of integrating geriatric parameters in the treatment of their patients. Methods: The International Society of Geriatric Oncology (SIOG) created a task force to review the evidence on the use of a comprehensive geriatric assessment (CGA) in cancer patients. A systematic review of the evidence was conducted. Results: Several biological and clinical correlates of aging have been identified. Their relative weight and clinical usefulness is still poorly defined. There is strong evidence that a CGA detects many problems missed by a regular assessment in general geriatric and in cancer patients. There is also strong evidence that a CGA improves function and reduces hospitalization in the elderly. There is heterogeneous evidence that it improves survival and that it is cost-effective. There is corroborative evidence from a few studies conducted in cancer patients. Screening tools exist and were successfully used in settings such as the emergency room, but globally were poorly tested. The article contains recommendations for the use of CGA in research and clinical care for older cancer patients. Conclusions: A CGA, with or without screening, and with follow-up, should be used in older cancer patients, in order to detect unaddressed problems, improve their functional status, and possibly their survival. The task force cannot recommend any specific tool or approach above others at this point and general geriatric experience should be used.
Comprehensive geriatric assessment test in elderly cancer patients
Sudan Medical Monitor, 2015
Background: Cancer is the first cause of the death among the people with 65-75 years age, and about 60% of cancers are diagnosed at age over 70. In this study, the impact of comprehensive geriatric assessments (CGAs) on the quality and the length of life in disabled elderly cancer patients were evaluated. Patients and Methods: In an interventional study, 70 patients with cancer were randomly divided into two treatment and control groups. The patients were evaluated during a 6-month study using CGA test. Results: The patient's mean age was 4.2 ± 67.1 years. It was shown that CGA intervention had no impact on physical activity tests, including instrumental activities of daily living and activities of daily living, but a significant improvement was shown in patient's psychological status using geriatric depression test. Conclusions: The results of the current study showed that CGA interventions have a positive effect on the quality of the life of the elderly cancer patients.