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老年评估领域作为老年癌症患者临床终点的预测因素:一项更新的系统评价方案

Geriatric assessment domains as predictors for clinical endpoints in older adults with cancer: Protocol for an updated systematic review.

作者信息

Sattar Schroder, Papadopoulos Efthymios, Haase Kristen R, Bradley Cara, Mariano Caroline, Tejero Isabel, Jin Rana, Puts Martine, Alibhai Shabbir M H

机构信息

College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.

School of Kinesiology, College of Human Sciences & Education, Louisiana State University, Baton Rouge, Louisiana, United States of America.

出版信息

PLoS One. 2025 Mar 25;20(3):e0319943. doi: 10.1371/journal.pone.0319943. eCollection 2025.


DOI:10.1371/journal.pone.0319943
PMID:40131960
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11936278/
Abstract

Geriatric assessments (GA) are increasingly used to inform treatment decision making and tailoring supportive care for older adults with cancer. Identifying which domains predict clinically relevant outcomes might be particularly useful for risk stratification in settings where a GA is not available and/or feasible. The objective of this updated systematic review is to evaluate individual GA domains as predictors for mortality and treatment-related outcomes. Eligible studies will be identified using a predefined search strategy developed in collaboration with an expert librarian in electronic databases (Medline, Cochrane, Embase, CINAHL) and comprise peer-reviewed papers published in any language from July 2017 and reporting on the prospective association between individual GA domains and mortality as well as surgical- or systemic treatment-related outcomes in older adults with cancer. All title/abstract screening, full-text screening, and data extraction will be performed independently by at least 2 authors. Information on cut-offs of GA domains will also be extracted to assess for variability across studies. A decision on performing a meta-analysis versus a narrative summary will be made based on predetermined criteria, which will include heterogeneity among studies and variability in GA tools and cutoff used for each individual domain, as well as level of risk of bias. If a meta-analysis is indicated, a random effects meta-analysis will be conducted using the Comprehensive Meta-Analysis software. The review will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. This protocol has been registered with PROSPERO (ID: CRD42024580404). This review seeks to investigate individual GA domains as predictors for patient- and treatment-related outcomes. Findings may inform efforts on optimizing GA for this population.

摘要

老年评估(GA)越来越多地用于为癌症老年患者的治疗决策提供信息并量身定制支持性护理。在无法进行和/或不可行GA的情况下,确定哪些领域可预测临床相关结果可能对风险分层特别有用。这项更新的系统评价的目的是评估各个GA领域作为死亡率和治疗相关结果的预测指标。将使用与电子数据库(Medline、Cochrane、Embase、CINAHL)的专家馆员合作制定的预定义搜索策略来识别符合条件的研究,这些研究包括2017年7月以来以任何语言发表的同行评审论文,报告各个GA领域与癌症老年患者的死亡率以及手术或全身治疗相关结果之间的前瞻性关联。所有标题/摘要筛选、全文筛选和数据提取将由至少两名作者独立进行。还将提取GA领域的临界值信息,以评估各研究之间的变异性。将根据预定标准决定进行荟萃分析还是叙述性总结,预定标准将包括研究之间的异质性、GA工具的变异性以及每个领域使用的临界值,以及偏倚风险水平。如果表明需要进行荟萃分析,将使用综合荟萃分析软件进行随机效应荟萃分析。本评价将按照系统评价和荟萃分析的首选报告项目(PRISMA)指南进行报告。本方案已在PROSPERO注册(ID:CRD42024580404)。本评价旨在研究各个GA领域作为患者和治疗相关结果的预测指标。研究结果可能为优化该人群的GA提供参考。

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本文引用的文献

[1]
The Cochrane risk of bias assessment tool 2 (RoB 2) versus the original RoB: A perspective on the pros and cons.

Health Sci Rep. 2024-6-3

[2]
A tool to assess risk of bias in non-randomized follow-up studies of exposure effects (ROBINS-E).

Environ Int. 2024-4

[3]
Defining an Abnormal Geriatric Assessment: Which Deficits Matter Most?

Cancers (Basel). 2023-12-9

[4]
Effectiveness of geriatric assessment and management in older cancer patients: a systematic review and meta-analysis.

J Natl Cancer Inst. 2023-12-6

[5]
Practical Assessment and Management of Vulnerabilities in Older Patients Receiving Systemic Cancer Therapy: ASCO Guideline Update.

J Clin Oncol. 2023-9-10

[6]
Impact of comprehensive geriatric assessment on the risk of adverse events in the older patients receiving anti-cancer therapy: a systematic review and meta-analysis.

Age Ageing. 2022-7-1

[7]
Geriatric assessment in the management of older patients with cancer - A systematic review (update).

J Geriatr Oncol. 2022-7

[8]
The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.

BMJ. 2021-3-29

[9]
Communication With Older Patients With Cancer Using Geriatric Assessment: A Cluster-Randomized Clinical Trial From the National Cancer Institute Community Oncology Research Program.

JAMA Oncol. 2020-2-1

[10]
Predictive value of each geriatric assessment domain for older patients with cancer: A systematic review.

J Geriatr Oncol. 2019-3-27

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