Validation of a French screening tool to identify older patients needing a Comprehensive Geriatric Assessment in the management of their cancer

2008 ◽  
Vol 68 ◽  
pp. S30
Author(s):  
S. Valéro ◽  
V. Migeot ◽  
G. Bouche ◽  
N. Raban ◽  
B. Roullet ◽  
...  
2021 ◽  
Author(s):  
Cagatay Cavusoglu ◽  
Gozde Tahtaci ◽  
Rana Tuna Dogrul ◽  
Ibrahim Ileri ◽  
Funda Yildirim ◽  
...  

Abstract Background: Pre-treatment evaluation for sarcopenia is recommended in cancer patients. We aimed to investigate whether the G8 screening test can detect probable sarcopenia and is valid and reliable compared to 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 and impairment in at least one of the CGA tests, respectively. Receiver operating characteristic curve analyses evaluated the test’s predictive ability. Intra-rater and inter-rater reliabilities were assessed.Results: The median age of the 76 patients included was 72 (65–91) years. There was a moderate correlation between handgrip strength and the G8 test total score. The sensitivity and specificity of the G8 test to detect probable sarcopenia alone were 50% and 92%, respectively (area under the curve [AUC]: 0.747; p<0.001); to determine abnormal CGA plus probable sarcopenia were 93.33% and 86.89%, respectively (AUC: 0.939; p<0.001), and to detect abnormal CGA alone were 79.63% and 95.45%, respectively (AUC: 0.893; p<0.001). The G8 test results agreed with those of CGA (κ=0.638; p<0.001). Both inter- and intra-rater assessments of G8 scores revealed a strong agreement (Interclass correlation coefficient (ICC)=0.979, p<0.001 and ρ=0.994, p<0.001, respectively). Conclusions: The Turkish version of the G8 test is a good screening tool to detect probable sarcopenia alone and in conjunction with abnormal CGA in older patients with solid malignancies. The G8 screening tool may be useful in detecting probable sarcopenia in Turkish older adults with solid cancers.


Author(s):  
Merle Weßel

AbstractDespite being a collection of holistic assessment tools, the comprehensive geriatric assessment primarily focuses on the social category of age during the assessment and disregards for example gender. This article critically reviews the standardized testing process of the comprehensive geriatric assessment in regard to diversity-sensitivity. I show that the focus on age as social category during the assessment process might potentially hinder positive outcomes for people with diverse backgrounds of older patients in relation to other social categories, such as race, gender or socio-economic background and their influence on the health of the patient as well as the assessment and its outcomes. I suggest that the feminist perspective of intersectionality with its multicategorical approach can enhance the diversity-sensitivity of the comprehensive geriatric assessment, and thus improve the treatment of older patients and their quality of life. By suggesting an intersectional-based approach, this article contributes to debates about justice and diversity in medical philosophy and advocates for the normative value of diversity in geriatric medicine.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24010-e24010
Author(s):  
Rocio Grajales ◽  
Alicia Gutierrez Mata ◽  
José Enrique Martínez Hernández ◽  
Alejandro Zavala-Calderon

e24010 Background: G8 is a geriatric screening tool designed to identify elderly cancer patients who benefit from a comprehensive geriatric assessment (CGA). Despite the increase in the incidence of cancer in the geriatric patients, there is absence of trials targeting this population. Decisions are often made based on their age and ECOG/Karnofsky scales, which does not reflect the actual role of an elderly patient. It is necessary to identify patients who require a CGA for an accurate evaluation and optimal oncological management. The routine implementation of the G8 geriatric screening tool in the oncology consultation consumes little time and is useful for timely referral of vulnerable patients to specialized care, in order to generate a positive impact on oncological therapy decision-making, improving their outcomes. Our main objective was to determine, using the geriatric screening tool G8, the percentage of patients aged >65 years with breast cancer, which require a CGA. Methods: The G8 questionnaire was applied to patients >65 yo with a diagnosis of breast cancer from December 2019 to May 2020. The baseline characteristics were prospectively collected and included clinical and demographic characteristics. The prognostic value of the functional status of the ECOG was evaluated and compared with that obtained from the G8. The difference between groups was assessed using Pearson's chi square with Yates correction. Additional scores were calculated using the Kaplan-Meier method and compared between groups using the log rank test. The hazard ratio with a 95% confidence interval was estimated using a Cox proportional hazards analysis, considering an abnormal G8 score as an exposure variable. Spearman correlation was made between age and the G8 score obtained. SPSS v22 software (IBM, USA) was used for all analyzes. Results: From December 2019 to May 2020, 357 patients were recruited. The mean age was 73.57 years (SD+7.02 y). The most frequent clinical stage was IIA (27.7%), followed by I (21.8%). 74.2% had an ECOG 1. Regarding treatment, 317 patients (88.8%) were on hormone therapy. The percentage of patients requiring a CGA was 44.3% (n = 158), of which only 55.1% (n = 87) were performed. We found no significant association between the requirement of CGA and clinical stage (p = 0.27) or treatment received (p = 0.345); but according to the ECOG, we obtained statistical significance p < 0.0001. Spearman correlation was performed between age and the G8 score, a correlation of 0.422 was obtained with p < 0.0001.The most affected domains of G8 were polypharmacy (51%) and ingestion (28.3%). Disease-free survival analysis was performed, without finding differences between vulnerable-frail and healthy patients. Conclusions: The G8 is a tool that allows to discern which patients require a CGA, in order to carry out interventions to improve comprehensive cancer treatment, so it should be implemented routinely in the oncology consultation.


2020 ◽  
Vol 95 (6) ◽  
pp. 1231-1252 ◽  
Author(s):  
Mandeep Singh ◽  
John A. Spertus ◽  
Shahyar M. Gharacholou ◽  
Rakesh C. Arora ◽  
Robert J. Widmer ◽  
...  

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Andreas W. Schoenenberger ◽  
Ian Russi ◽  
Benjamin Berte ◽  
Vanessa Weberndörfer ◽  
Renate Schoenenberger-Berzins ◽  
...  

2007 ◽  
Vol 25 (14) ◽  
pp. 1824-1831 ◽  
Author(s):  
Martine Extermann ◽  
Arti Hurria

Purpose During the last decade, oncologists and geriatricians have begun to work together to integrate the principles of geriatrics into oncology care. The increasing use of a comprehensive geriatric assessment (CGA) is one example of this effort. A CGA includes an evaluation of an older individual's functional status, comorbid medical conditions, cognition, nutritional status, psychological state, and social support; and a review of the patient's medications. This article discusses recent advances on the use of a CGA in older patients with cancer. Methods In this article, we provide an update on the studies that address the domains of a geriatric assessment applied to the oncology patient, review the results of the first studies evaluating the use of a CGA in developing interventions to improve the care of older adults with cancer, and discuss future research directions. Results The evidence from recent studies demonstrates that a CGA can predict morbidity and mortality in older patients with cancer. Accumulating data show the benefits of incorporating a CGA in the evaluation of older patients with cancer. Prospective trials evaluating the utility of a CGA to guide interventions to improve the quality of cancer care in older adults are justified. Conclusion Growing evidence demonstrates that the variables examined in a CGA can predict morbidity and mortality in older patients with cancer, and uncover problems relevant to cancer care that would otherwise go unrecognized.


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