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脆弱老年人调查(VES 13)的阴性预测值(NPV)作为老年癌症患者的初筛试验的重要性。

The importance of negative predictive value (NPV) of vulnerable elderly survey (VES 13) as a pre-screening test in older patients with cancer.

机构信息

Department of Oncology, San Giacomo Hospital, Novi Ligure, Italy,

出版信息

Med Oncol. 2013 Dec;30(4):708. doi: 10.1007/s12032-013-0708-3. Epub 2013 Aug 31.

Abstract

The importance of prognostic value of the comprehensive geriatric assessment (CGA) is well known in geriatric oncology, but there is no consensus on the use of alternative abbreviated screening methods for the evaluation of older patient disabilities. The participants in this study underwent vulnerable elderly survey 13 (VES 13) at first entry in Oncology Department and were later assessed by a geriatrician according to CGA. A score >3 for VES 13 identified patients as vulnerable. Aim of this study was to evaluate the specificity, sensibility, positive predictive value (PPV), and negative predictive value (NPV) of VES 13 versus cumulative illness rating scale (CIRS), activities of daily living (ADL), instrumental activities of daily living (IADL), and short portable mental status questionnaire (SPMSQ). Hundred and seventeen patients (mean age 78.8 years) entered the study. The NPV of VES was 74.6% for CIRS, 90.1% for IADL, 93.0% for ADL, and 100% for SPMSQ. As for PPV, the VES 13 showed no accuracy. We can conclude that VES 13 demonstrated sufficient accuracy as a screening test in identifying elderly "fit" patients in order to spare the more time-consuming CGA.

摘要

全面老年评估(CGA)的预后价值在老年肿瘤学中是众所周知的,但对于评估老年患者残疾的替代简短筛查方法的使用尚未达成共识。本研究的参与者在肿瘤科首次就诊时接受了脆弱性老年人调查 13(VES 13),随后由老年病医生根据 CGA 进行评估。VES 13 得分为>3 分将患者识别为脆弱。本研究的目的是评估 VES 13 与累积疾病评分量表(CIRS)、日常生活活动(ADL)、工具性日常生活活动(IADL)和简短便携精神状态问卷(SPMSQ)相比的特异性、敏感性、阳性预测值(PPV)和阴性预测值(NPV)。117 名患者(平均年龄 78.8 岁)入组本研究。VES 的 NPV 分别为 CIRS 的 74.6%、IADL 的 90.1%、ADL 的 93.0%和 SPMSQ 的 100%。至于 PPV,VES 13 没有准确性。我们可以得出结论,VES 13 作为一种筛选测试,可以在识别老年“健康”患者方面具有足够的准确性,从而节省更耗时的 CGA。

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