Clinical Research and Clinical Epidemiology Unit, Institut Bergonié, Regional Comprehensive Cancer Centre, Bordeaux; INSERM CIC-EC7, ISPED, Bordeaux University, Bordeaux.
SFR Public Health, Bordeaux University, Bordeaux; Department of Clinical Gerontology, Bordeaux University Hospital, Bordeaux.
Ann Oncol. 2012 Aug;23(8):2166-2172. doi: 10.1093/annonc/mdr587. Epub 2012 Jan 16.
Development of a geriatric screening tool is necessary to identify elderly cancer patients who would benefit from comprehensive geriatric assessment (CGA). We develop and evaluate the G-8 screening tool against various reference tests.
Analyses were based on 364 cancer patients aged>70 years scheduled to receive first-line chemotherapy included in a multicenter prospective study. The G-8 consists of seven items from the Mini Nutritional Assessment (MNA) questionnaire and age. Our primary reference test is based on a set of seven CGA scales: Activities Daily Living (ADL), Instrumental ADL, MNA, Mini-Mental State Exam, Geriatric Depression Scale, Cumulative Illness Rating Scale-Geriatrics, and Timed Get Up and Go. We considered the presence of at least one questionnaire with an impaired score as an abnormal reference exam. Additional reference exams are also discussed.
The prevalence of being at risk varied from 60% to 94% according to the various definitions of the reference test. When considering the primary reference test, a cut-off value of 14 for the G-8 tool provided a good sensitivity estimate (85%) without deteriorating the specificity excessively (65%).
The G-8 shows good screening properties for identifying elderly cancer patients who could benefit from CGA.
为了识别需要接受全面老年评估(CGA)的老年癌症患者,开发一种老年筛选工具是必要的。我们开发并评估了 G-8 筛选工具,以针对各种参考测试进行评估。
分析基于纳入一项多中心前瞻性研究的 364 名年龄>70 岁、计划接受一线化疗的癌症患者。G-8 由 Mini Nutritional Assessment(MNA)问卷和年龄的 7 个项目组成。我们的主要参考测试基于一套 7 个 CGA 量表:日常生活活动(ADL)、工具性日常生活活动(IADL)、MNA、简易精神状态检查、老年抑郁量表、累积疾病评分量表-老年和定时起立行走。我们认为至少有一个问卷的评分受损为异常参考检查。还讨论了其他参考检查。
根据参考测试的各种定义,风险存在的患病率从 60%到 94%不等。当考虑主要参考测试时,G-8 工具的截断值为 14 可提供良好的敏感性估计(85%),而特异性不会过度恶化(65%)。
G-8 对识别可能受益于 CGA 的老年癌症患者具有良好的筛选性能。