Aging cancer patients receive risky under or overtreatment. Geriatric assessments are essential to inform the clinicians to make better decisions. But optimal screening tools, time, and expertise are not easily available. This study evaluates the screening tools that are used on old patients with cancer. It aims to identify optimal tools that can benefit geriatric cancer assessments.
The systematic reviews relied on 4 popular databases. A narrative synthesis was done on PubMed, Embase, MEDLINE, and CINAHL data. Studies with accurate diagnostics and validated screening tools were eligible for selection. Researchers conducted data analyses on 12 screening tool usage reports of 17 unique studies. Out of 12, only 1 was a randomized clinical trial with 11 being prospective cohort studies.
The time taken to use the screening tools was not available in all the studies. The most frequently assessed tools included 12 Geriatric-8 (G8) and VES-13, or vulnerable elders survey-13. The VES-13 scored well in specificity, while G8 had better sensitivity scores. The other screening tools, with two studies each, were the Physical Performance Test, abbreviated comprehensive geriatric assessment, and Groningen Frailty Index. The remaining tools were from only one evaluated study each.
G8 and VES-13 have strong evidence and are best for geriatric assessments. The sensitivity and specificity trade-offs have to get weighed to select a tool. Further studies with ease of use and resourcing factors are essential to improve or validate current screening tools.
Ref: https://jamanetwork.com/journals/jamaoncology/article-abstract/2774872
