Department of Medicine, University Health Network, Toronto, ON, Canada.
Department of Nursing, Princess Margaret Cancer Centre, Toronto, ON, Canada.
J Geriatr Oncol. 2023 Mar;14(2):101424. doi: 10.1016/j.jgo.2022.101424. Epub 2023 Jan 17.
Remote, online geriatric assessment (GA) is gaining attention in oncology. Most GA domains can be assessed remotely. However, there is limited evidence identifying reliable tools that can be used in lieu of objective measures of physical function, such as grip strength and physical performance during remote, online GA. In this prospective cohort study, we aimed to assess the performance of the SARC-F, a screening questionnaire for sarcopenia, in identifying low grip strength and the Short Physical Performance Battery (SPPB). Additionally, we assessed the satisfaction of clinical staff with using the SARC-F in the clinic.
Data were prospectively collected from older adults with cancer of any type and stage who underwent GA in the geriatric oncology clinic of a tertiary cancer centre. Following GA, patients were asked to complete the SARC-F tool. Spearman correlations were performed between objective measures of physical function, SARC-F domains, and SARC-F total score. Additionally, the sensitivity, specificity, positive predictive value, and negative predictive value were assessed to evaluate the performance of SARC-F to detect low grip strength and SPPB.
Eighty (n = 80) older adults (mean age: 80 years) with cancer completed the SARC-F. A positive SARC-F was found in 31.3% of the cohort. Moderate correlations were found between the SPPB per point and Assistance in walking (r = -0.69), as well as the SPPB per point and total SARC-F score (r = -0.66). SARC-F exhibited moderate sensitivity in identifying low grip strength using the Foundation for the National Institutes of Health (FNIH) criteria (sensitivity: 64.3%) or the Sarcopenia Definitions and Outcomes Consortium (SDOC) criteria (sensitivity: 40.4%). However, specificity was high (>75%) regardless of the criteria applied. Similarly, moderate sensitivity (52.2%), but excellent specificity (97.1%) was found for SPPB. When low grip strength per FNIH was combined with low SPPB, SARC-F demonstrated high sensitivity (80%) and specificity (75.7%).
SARC-F exhibited promising performance in identifying low grip strength per FNIH and low SPPB combined. To definitively assess the performance of the SARC-F in detecting low grip strength and SPPB, larger studies are warranted.
远程在线老年综合评估(GA)在肿瘤学领域越来越受到关注。大多数 GA 领域都可以远程评估。然而,目前还没有足够的证据来确定可以替代握力和远程在线 GA 期间体能表现等客观身体功能测量的可靠工具。在这项前瞻性队列研究中,我们旨在评估 SARC-F(肌少症筛查问卷)在识别握力下降和短体适能表现测试(SPPB)中的性能。此外,我们还评估了临床工作人员对在诊所使用 SARC-F 的满意度。
数据是从在三级癌症中心老年肿瘤学诊所接受 GA 的任何类型和阶段癌症老年患者前瞻性收集的。在 GA 后,患者被要求完成 SARC-F 工具。对物理功能的客观测量、SARC-F 各领域和 SARC-F 总分之间进行 Spearman 相关性分析。此外,评估了 SARC-F 检测握力下降和 SPPB 的灵敏度、特异性、阳性预测值和阴性预测值。
80 名(n=80)患有癌症的老年人完成了 SARC-F。该队列中有 31.3%的患者 SARC-F 呈阳性。SPPB 每增加 1 分与行走辅助(r=-0.69)以及 SPPB 每增加 1 分与总 SARC-F 评分(r=-0.66)之间存在中度相关性。SARC-F 显示出使用国立卫生研究院(NIH)标准(灵敏度:64.3%)或肌少症定义和结果联盟(SDOC)标准(灵敏度:40.4%)识别握力下降的中等灵敏度。然而,特异性(>75%)无论应用何种标准均较高。同样,SPPB 的灵敏度中等(52.2%),但特异性(97.1%)很高。当 NIH 标准下的握力下降与 SPPB 下降相结合时,SARC-F 显示出较高的灵敏度(80%)和特异性(75.7%)。
SARC-F 显示出在识别 NIH 标准下的握力下降和 SPPB 下降方面具有良好的性能。为了明确评估 SARC-F 在检测握力下降和 SPPB 方面的性能,需要进行更大规模的研究。