He Sharon, Shepherd Heather L, Agar Meera, Shaw Joanne
Psycho-Oncology Co-operative Research Group (PoCoG), School of Psychology, The University of Sydney, Sydney, NSW, 2006, Australia.
Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.
BMC Geriatr. 2024 Dec 18;24(1):1001. doi: 10.1186/s12877-024-05607-9.
This umbrella review aimed to summarise and synthesize the evidence on the outcomes reported and used to assess the value and or efficacy of geriatric assessments (GAs) for older adults with cancer.
Six electronic databases, PsycINFO, MEDLINE, Embase, CINAHL, Cochrane Library and Web of Science databases, were searched to identify systematic reviews with or without meta-analyses that described the value or outcomes of GAs for older adults with cancer.
Twenty-six systematic reviews were included, of which six included a meta-analysis of the data. Thirteen associations and or outcomes were identified. Overall geriatric impairments predicted or were associated with majority of identified outcomes. However, the type of domains associated with outcomes differed within and across reviews. Only treatment toxicity was statistically significantly lower for patients allocated to the GA intervention group compared to standard care. Systematic reviews without meta-analyses demonstrated a positive impact of GA with management on treatment completion, communication and care planning and patient satisfaction with care.
There is evidence demonstrating the predictive value of GAs for older adults with cancer. GAs seems to be beneficial for older adults with cancer across some outcomes, with strong evidence demonstrating the impact of GA with management for treatment toxicity. However, there is mixed or limited evidence demonstrating the effect of GA in other treatment modalities, and on quality of life and economic outcomes.
本伞状综述旨在总结和综合关于已报告结果的证据，并用于评估老年癌症患者的老年评估（GA）的价值和/或疗效。
检索了六个电子数据库，即心理学文摘数据库（PsycINFO）、医学文献数据库（MEDLINE）、荷兰医学文摘数据库（Embase）、护理学与健康领域数据库（CINAHL）、考克兰图书馆和科学引文索引数据库（Web of Science），以识别描述老年癌症患者GA价值或结果的系统评价，无论是否包含荟萃分析。
纳入了26项系统评价，其中六项包含数据的荟萃分析。确定了13种关联和/或结果。总体而言，老年损伤预测或与大多数已识别结果相关。然而，与结果相关的领域类型在不同综述之间以及同一综述内部存在差异。与标准护理相比，分配到GA干预组的患者的治疗毒性在统计学上显著更低。未进行荟萃分析的系统评价表明，GA结合管理对治疗完成、沟通和护理计划以及患者对护理的满意度有积极影响。
有证据表明GA对老年癌症患者具有预测价值。GA似乎在某些结果方面对老年癌症患者有益，有强有力的证据表明GA结合管理对治疗毒性有影响。然而，关于GA在其他治疗方式以及对生活质量和经济结果方面的影响，证据参差不齐或有限。
