Screening tools for multidimensional health problems warranting a geriatric assessment in older cancer patients: an update on SIOG recommendations
A partir d'une revue de la littérature (44 études identifiées portant sur 17 outils différents), cette étude met à jour les recommandations de la Société internationale d'oncologie gériatrique en matière d'outils permettant de détecter, chez des patients âgés atteints de cancer, le besoin d'une évaluation gériatrique standardisée et d'une approche multidisciplinaire
Background : Screening tools are proposed to identify those older cancer patients in need of geriatric assessment (GA) and multidisciplinary approach. We aimed to update the International Society of Geriatric Oncology (SIOG) 2005 recommendations on the use of screening tools.
Materials and methods : SIOG composed a task group to review, interpret and discuss evidence on the use of screening tools in older cancer patients. A systematic review was performed and discussed by an expert panel, leading to a consensus statement on their use.
Results : Forty-four studies reporting on the use of 17 different screening tools in older cancer patients were identified. The tools most studied in older cancer patients are G8, fTRST and VES-13. . Across all studies, the highest sensitivity was observed for: G8, fTRST, OGS, SOF, ECOG-PS, SAOP2 and Gerhematolim. In 11 direct comparisons for detecting problems on a full GA, the G8 was more or equally sensitive than other instruments in all six comparisons, whereas results were mixed for the VES-13 in seven comparisons. In addition different tools have demonstrated associations with outcome measures, including G8 and VES-13.
Conclusions : Screening tools do not replace GA but are recommended in a busy practice in order to identify those patients in need of full GA. If abnormal, screening should be followed by GA and guided multidisciplinary interventions. Several tools are available with different performance for various parameters (including sensitivity for addressing the need for further GA). Further research should focus on the ability of screening tools to build clinical pathways and to predict different outcome parameters.
Annals of Oncology , article en libre accès, 2014