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Oral Health Assessment by Lay Personnel for Older Adults
Published on: February 2, 2020
Identifying an accurate pre-screening tool in geriatric oncology
Eliane Kellen1, Paul Bulens, Laura Deckx
1Leuven Centre of Cancer Prevention, University Hospitals-Leuven, Belgium. eliane.kellen@uz.kuleuven.ac.be
Critical Reviews in Oncology/Hematology
|January 12, 2010
Summary
Comprehensive geriatric assessment (CGA) is recommended for older cancer patients. This study found that while physical and disability questions are useful, existing pre-screening tools like aCGA, VES-13, and GFI miss too many vulnerable individuals.
Area of Science:
- Geriatric Oncology
- Clinical Geriatrics
- Cancer Care Research
Background:
- Comprehensive Geriatric Assessment (CGA) is crucial for elderly cancer patients (over 70).
- Several pre-screening tools, including abbreviated CGA (aCGA), Vulnerable Elders Survey (VES-13), and Groningen Frailty Index (GFI), have been proposed to identify patients needing full CGA.
- Accurate pre-screening is essential to efficiently allocate resources and ensure appropriate care for vulnerable older adults with cancer.
Purpose of the Study:
- To evaluate the efficiency and accuracy of three pre-screening instruments (aCGA, VES-13, GFI) in identifying elderly cancer patients who would benefit from a full Comprehensive Geriatric Assessment.
- To determine the most effective tool for detecting vulnerability in this population.
Main Methods:
- A study involving 113 elderly cancer patients was conducted.
- Patients underwent assessment using the aCGA, VES-13, GFI, and the full CGA.
- Sensitivity and specificity of the aCGA, VES-13, and GFI were calculated against the full CGA as the gold standard. The aCGA's sub-components were also analyzed for predictive value.
Main Results:
- A significant majority of participants (68.14%) were identified as at risk of vulnerability, exhibiting two or more impairments or cognitive deficits.
- The physical and disability components of the screening instruments showed utility.
- However, the VES-13 and GFI, and other components of the aCGA, were found to miss a substantial number of patients who would benefit from full CGA.
Conclusions:
- Current pre-screening instruments, including VES-13 and GFI, are not sufficiently sensitive for identifying all elderly cancer patients who require Comprehensive Geriatric Assessment.
- The physical and disability domains are valuable but insufficient on their own.
- Further refinement or development of pre-screening tools is needed to accurately capture the full spectrum of vulnerability in older cancer patients.
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