Predicting Frailty and Geriatric Interventions in Older Cancer Patients: Performance of Two Screening Tools for Seven Frailty Definitions—ELCAPA Cohort
Screening tools have been developed to identify patients warranting a complete geriatric assessment (GA). However, GA lacks standardization and does not capture important aspects of geriatric oncology practice. We measured and compared the diagnostic performance of screening tools G8 and modified G8...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-01-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/1/244 |
| _version_ | 1797499339228053504 |
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| author | Claudia Martinez-Tapia Marie Laurent Elena Paillaud Philippe Caillet Emilie Ferrat Jean-Léon Lagrange Jean-Paul Rwabihama Mylène Allain Anne Chahwakilian Pascaline Boudou-Rouquette Sylvie Bastuji-Garin Etienne Audureau |
| author_facet | Claudia Martinez-Tapia Marie Laurent Elena Paillaud Philippe Caillet Emilie Ferrat Jean-Léon Lagrange Jean-Paul Rwabihama Mylène Allain Anne Chahwakilian Pascaline Boudou-Rouquette Sylvie Bastuji-Garin Etienne Audureau |
| author_sort | Claudia Martinez-Tapia |
| collection | DOAJ |
| description | Screening tools have been developed to identify patients warranting a complete geriatric assessment (GA). However, GA lacks standardization and does not capture important aspects of geriatric oncology practice. We measured and compared the diagnostic performance of screening tools G8 and modified G8 according to multiple clinically relevant reference standards. We included 1136 cancer patients ≥ 70 years old referred for GA (ELCAPA cohort; median age, 80 years; males, 52%; main locations: digestive (36.3%), breast (16%), and urinary tract (14.8%); metastases, 43.5%). Area under the receiver operating characteristic curve (AUROC) estimates were compared between both tools against: (1) the detection of ≥1 or (2) ≥2 GA impairments, (3) the prescription of ≥1 geriatric intervention and the identification of an unfit profile according to (4) a latent class typology, expert-based classifications from (5) Balducci, (6) the International Society of Geriatric Oncology task force (SIOG), or using (7) a GA frailty index according to the Rockwood accumulation of deficits principle. AUROC values were ≥0.80 for both tools under all tested definitions. They were statistically significantly higher for the modified G8 for six reference standards: ≥1 GA impairment (0.93 vs. 0.89), ≥2 GA impairments (0.90 vs. 0.87), ≥1 geriatric intervention (0.85 vs. 0.81), unfit according to Balducci (0.86 vs. 0.80) and SIOG classifications (0.88 vs. 0.83), and according to the GA frailty index (0.86 vs. 0.84). Our findings demonstrate the robustness of both screening tools against different reference standards, with evidence of better diagnostic performance of the modified G8. |
| first_indexed | 2024-03-10T03:46:00Z |
| format | Article |
| id | doaj.art-05d9bdc0ccb4465cb60842f26d1719d5 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T03:46:00Z |
| publishDate | 2022-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-05d9bdc0ccb4465cb60842f26d1719d52023-11-23T11:18:23ZengMDPI AGCancers2072-66942022-01-0114124410.3390/cancers14010244Predicting Frailty and Geriatric Interventions in Older Cancer Patients: Performance of Two Screening Tools for Seven Frailty Definitions—ELCAPA CohortClaudia Martinez-Tapia0Marie Laurent1Elena Paillaud2Philippe Caillet3Emilie Ferrat4Jean-Léon Lagrange5Jean-Paul Rwabihama6Mylène Allain7Anne Chahwakilian8Pascaline Boudou-Rouquette9Sylvie Bastuji-Garin10Etienne Audureau11Université Paris Est Créteil (UPEC), INSERM, IMRB, F-94010 Creteil, FranceUniversité Paris Est Créteil (UPEC), INSERM, IMRB, F-94010 Creteil, FranceUniversité Paris Est Créteil (UPEC), INSERM, IMRB, F-94010 Creteil, FranceUniversité Paris Est Créteil (UPEC), INSERM, IMRB, F-94010 Creteil, FranceUniversité Paris Est Créteil (UPEC), INSERM, IMRB, F-94010 Creteil, FranceDepartment of Medical Oncology, AP-HP, Hôpital Henri-Mondor, F-94010 Creteil, FranceUniversité Paris Est Créteil (UPEC), INSERM, IMRB, F-94010 Creteil, FranceUniversité Paris Est Créteil (UPEC), INSERM, IMRB, F-94010 Creteil, FranceOncogeriatrics, Geriatric Department, AP-HP, Hôpital Broca, F-75013 Paris, FranceDepartment of Medical Oncology, AP-HP, Hôpital Cochin, F-75014 Paris, FranceUniversité Paris Est Créteil (UPEC), INSERM, IMRB, F-94010 Creteil, FranceUniversité Paris Est Créteil (UPEC), INSERM, IMRB, F-94010 Creteil, FranceScreening tools have been developed to identify patients warranting a complete geriatric assessment (GA). However, GA lacks standardization and does not capture important aspects of geriatric oncology practice. We measured and compared the diagnostic performance of screening tools G8 and modified G8 according to multiple clinically relevant reference standards. We included 1136 cancer patients ≥ 70 years old referred for GA (ELCAPA cohort; median age, 80 years; males, 52%; main locations: digestive (36.3%), breast (16%), and urinary tract (14.8%); metastases, 43.5%). Area under the receiver operating characteristic curve (AUROC) estimates were compared between both tools against: (1) the detection of ≥1 or (2) ≥2 GA impairments, (3) the prescription of ≥1 geriatric intervention and the identification of an unfit profile according to (4) a latent class typology, expert-based classifications from (5) Balducci, (6) the International Society of Geriatric Oncology task force (SIOG), or using (7) a GA frailty index according to the Rockwood accumulation of deficits principle. AUROC values were ≥0.80 for both tools under all tested definitions. They were statistically significantly higher for the modified G8 for six reference standards: ≥1 GA impairment (0.93 vs. 0.89), ≥2 GA impairments (0.90 vs. 0.87), ≥1 geriatric intervention (0.85 vs. 0.81), unfit according to Balducci (0.86 vs. 0.80) and SIOG classifications (0.88 vs. 0.83), and according to the GA frailty index (0.86 vs. 0.84). Our findings demonstrate the robustness of both screening tools against different reference standards, with evidence of better diagnostic performance of the modified G8.https://www.mdpi.com/2072-6694/14/1/244geriatric assessmentreference standardfrailtysurveys and questionnairessensitivity and specificity |
| spellingShingle | Claudia Martinez-Tapia Marie Laurent Elena Paillaud Philippe Caillet Emilie Ferrat Jean-Léon Lagrange Jean-Paul Rwabihama Mylène Allain Anne Chahwakilian Pascaline Boudou-Rouquette Sylvie Bastuji-Garin Etienne Audureau Predicting Frailty and Geriatric Interventions in Older Cancer Patients: Performance of Two Screening Tools for Seven Frailty Definitions—ELCAPA Cohort Cancers geriatric assessment reference standard frailty surveys and questionnaires sensitivity and specificity |
| title | Predicting Frailty and Geriatric Interventions in Older Cancer Patients: Performance of Two Screening Tools for Seven Frailty Definitions—ELCAPA Cohort |
| title_full | Predicting Frailty and Geriatric Interventions in Older Cancer Patients: Performance of Two Screening Tools for Seven Frailty Definitions—ELCAPA Cohort |
| title_fullStr | Predicting Frailty and Geriatric Interventions in Older Cancer Patients: Performance of Two Screening Tools for Seven Frailty Definitions—ELCAPA Cohort |
| title_full_unstemmed | Predicting Frailty and Geriatric Interventions in Older Cancer Patients: Performance of Two Screening Tools for Seven Frailty Definitions—ELCAPA Cohort |
| title_short | Predicting Frailty and Geriatric Interventions in Older Cancer Patients: Performance of Two Screening Tools for Seven Frailty Definitions—ELCAPA Cohort |
| title_sort | predicting frailty and geriatric interventions in older cancer patients performance of two screening tools for seven frailty definitions elcapa cohort |
| topic | geriatric assessment reference standard frailty surveys and questionnaires sensitivity and specificity |
| url | https://www.mdpi.com/2072-6694/14/1/244 |
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