University of Wisconsin Hospital and Clinics, Madison, WI.
Alliance Statistics and Data Center, Mayo Clinic, Rochester, MN.
JCO Clin Cancer Inform. 2021 Apr;5:435-441. doi: 10.1200/CCI.20.00163.
This study determined whether an electronic version of the geriatric assessment is feasible in a multi-institutional, diverse setting.
Ten sites within the Alliance for Clinical Trials in Oncology participated. Patients who had active cancer or a history of cancer and were 65 years of age or older were eligible. The geriatric assessment was completed with an electronic data capture system that had been loaded onto iPads. Feasibility was defined a priori as completion in at least 70% of patients either with or without help. To enhance racial diversity, the original sample size was later changed and augmented by 50% with the intention of increasing enrollment of older minority patients.
A total of one hundred fifty-four patients were registered with a median age of 72 years (range, 65-91 years). Forty-three (28%) identified themselves as African American or Black. One hundred forty-one patients (92%) completed the electronic geriatric assessment. Feasibility was observed across all subgroups, regardless of race, education, performance status, comorbidities, and cognition; 124 patients (81%) completed the geriatric assessment without help. Reasons for not completing the geriatric assessment are as follows: clinic visit did not occur (n = 6), no iPad connection to the Internet (n = 3), patient declined (n = 2), prolonged hospitalization (n = 1), and patient died (n = 1). Reasons for needing help, as reported by study personnel, were as follows: the patient preferred that research personnel ask the questions (n = 9), vision problem (n = 3), lack of comfort with the iPad (n = 2), questions were not clear (n = 1), less proficient in English (n = 1), and challenge in pressing the green button to go to the next question (n = 1).
The electronic geriatric assessment is feasible in a multi-institutional setting that includes a notable proportion of African American or Black patients.
本研究旨在确定在多机构、多样化的环境中，电子版老年评估是否可行。
肿瘤临床研究联盟的 10 个站点参与了这项研究。符合条件的患者为患有活动性癌症或癌症病史且年龄在 65 岁或以上的患者。使用已加载到 iPad 上的电子数据采集系统完成老年评估。可行性的定义是，无论是否有帮助，至少有 70%的患者完成评估。为了增强种族多样性，原始样本量后来增加了 50%，旨在增加老年少数族裔患者的入组人数。
共登记了 154 名患者，中位年龄为 72 岁（范围 65-91 岁）。43 名（28%）患者自认为是非裔美国人或黑人。141 名（92%）患者完成了电子老年评估。无论种族、教育程度、表现状态、合并症和认知能力如何，所有亚组均观察到可行性；124 名（81%）患者在没有帮助的情况下完成了老年评估。未完成老年评估的原因如下：未进行门诊就诊（n=6）、无 iPad 连接到互联网（n=3）、患者拒绝（n=2）、住院时间延长（n=1）、以及患者死亡（n=1）。研究人员报告的需要帮助的原因如下：患者希望研究人员提问（n=9）、视力问题（n=3）、对 iPad 不舒适（n=2）、问题不清楚（n=1）、英语不熟练（n=1）以及点击绿色按钮进入下一个问题有困难（n=1）。
电子老年评估在包括相当比例的非裔美国或黑人患者的多机构环境中是可行的。
