Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
Department of Medicine, University Health Network, Toronto, Canada.
J Geriatr Oncol. 2023 Sep;14(7):101553. doi: 10.1016/j.jgo.2023.101553. Epub 2023 Jun 26.
The Geriatric 8 (G8) is a brief cancer-specific tool which screens for patients who require a comprehensive geriatric assessment (CGA). The G8 test assesses patients on eight domains such as mobility, polypharmacy, age, and self-rated health. However, the current G8 requires a healthcare professional (nurse or physician) present to conduct the test, which limits its usefulness. The Self-G8 questionnaire (S-G8) is an adaptation of the original G8 test, assessing all the same domains, with questions modified to be appropriate for patients to self-complete. Our objective was to evaluate the performance of S-G8 compared to the G8 and CGA.
The initial S-G8 was designed by our team through review of the literature and questionnaire design principles, and was optimized through feedback from patients over the age of 70. The questionnaire subsequently underwent further refinement after undergoing pilot testing (N = 14). The diagnostic accuracy of the final iteration of the S-G8 was evaluated along with the standard G8 in a prospective cohort study (N = 52) in an academic geriatric oncology clinic at the Princess Margaret Cancer Centre, Toronto, Canada. Psychometric characteristics were evaluated including internal consistency, sensitivity, and specificity compared to the G8 and to the CGA.
There was strong correlation between the G8 and S-G8 scores, with a Spearman correlation co-efficient of 0.76 (p < 0.001). Internal consistency was acceptable at 0.60. The frequency of abnormality (<14 score) for the G8 and S-G8 was 82.7% and 61.5%, respectively. The mean score for the original G8 and S-G8 was 11.9 and 13.5, respectively. The cut-off of 14 for the S-G8 yielded the best combination of sensitivity of 0.70 ± 0.07 and specificity of 0.78 ± 0.14 when compared to the G8. When compared to two or more abnormal domains on the CGA, the S-G8 performed at least as well as the G8 with a sensitivity of 0.77, specificity of 0.85, and a Youden's index of 0.62.
The S-G8 questionnaire appears to be an acceptable alternative to the original G8 in identifying older adults with cancer who will benefit from a CGA. Large scale testing is warranted.
老年 8 项（G8）是一种简短的癌症专用工具，用于筛查需要全面老年评估（CGA）的患者。G8 测试评估患者的八个领域，如移动性、多药治疗、年龄和自我报告的健康状况。然而，目前的 G8 需要医疗保健专业人员（护士或医生）在场进行测试，这限制了它的实用性。自我 G8 问卷（S-G8）是原始 G8 测试的改编版，评估所有相同的领域，问题经过修改，以便患者能够自行完成。我们的目标是评估 S-G8 与 G8 和 CGA 的性能。
最初的 S-G8 是由我们的团队通过文献回顾和问卷设计原则设计的，并通过 70 岁以上患者的反馈进行了优化。该问卷随后在试点测试（N=14）后进一步改进。在加拿大多伦多玛格丽特公主癌症中心的学术老年肿瘤学诊所进行了一项前瞻性队列研究（N=52），评估了最终迭代的 S-G8 与标准 G8 的诊断准确性。评估了心理测量特性，包括与 G8 和 CGA 相比的内部一致性、敏感性和特异性。
G8 和 S-G8 评分之间存在很强的相关性，Spearman 相关系数为 0.76（p<0.001）。内部一致性可接受，为 0.60。G8 和 S-G8 的异常频率（<14 分）分别为 82.7%和 61.5%。原始 G8 和 S-G8 的平均分数分别为 11.9 和 13.5。与 G8 相比，S-G8 的 14 分截止值可获得最佳的敏感性（0.70±0.07）和特异性（0.78±0.14）组合。与 CGA 上两个或更多异常域相比，S-G8 的敏感性为 0.77，特异性为 0.85，Youden 指数为 0.62，与 G8 至少一样好。
S-G8 问卷似乎是识别需要 CGA 的老年癌症患者的一种可接受的 G8 替代方法。需要进行大规模测试。
