A Questionnaire Study to Assess the Value of the Vulnerable Elders Survey, G8, and Predictors of Toxicity as Screening Tools for Frailty and Toxicity in Geriatric Cancer Patients

Abstract

Background: The aim of this study was to identify an appropriate screening instrument for the identification of frail elderly patients in a tertiary cancer center. In order to improve cancer care for older patients, the use of a geriatric assessment (GA) has been proposed to identify frail patients or those who are at a higher risk for chemotherapy-related toxicities. In busy clinical routine, an appropriate screening instrument could be used to spare time- and resource-consuming application of GA. Patients and Methods: We administered the Vulnerable Elders Survey (VES-13), G8 questionnaire, and Predictors of Toxicity (POT) as well as a GA at the first visit of 84 consecutive patients at a single Comprehensive Cancer Center. Analysis for patients' characteristics as well as sensitivity, specificity, and positive and negative predictive value (npv) was conducted. Results: The median age of the patients was 73 years (range 63-93 years), 61.9% were male, most (63%) suffered from gastrointestinal tumors, 39.3% had a multiple cancer diagnosis, and 53.6% had metastasis. 30 (35.7%) individuals were classified as ‘frail' by the GA. Sensitivity of G8 was 38.3%, and the npv was 63.8%. Sensitivity for VES-13 was 57.1%, and npv was 76.3%. Sensitivity of POT was 72.7%, and the npv was 80.6%. Conclusion: For the first time, the VES-13, G8, and POT are compared in a sample of older German patients. The POT seems to be a sufficient screening tool to identify frail patients in a tertiary referral cancer center and helps to save time and resources compared with a complete GA.

Frailty status but not age predicts complications in elderly cancer patients: a follow-up study

“…Furthermore, frailty predicted perioperative complications and inferior survival [19,20]. Other studies performing CGA in groups of patients with a variety of cancer diagnoses had another distribution of frailty with either a higher rate of fit patients [42,45] or a lower number of frail patients [46]. However, those studies included patients with a wider variety of cancer diagnoses as well as younger patients than in our study.…”

Frailty screening in dermato‐oncology practice: a modified Delphi study and a systematic review of the literature

“…Content-related domains of each frailty screening tool (FST) as identified by the systematic literature search Frailty screening in dermato-oncology extensively studied tool with appropriate measurement properties when compared to a full GA. [10][11][12][13]19,48,[50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65] In the few articles studying the recently developed mG8, sensitivity (89-92%) and specificity (36-79%) for geriatric impairments detected by GA appear higher than the original G8. 20,61 However, the mG8 is currently only available in a limited number of languages.…”

Geriatric Assessment in Oncology: G8 Screening Tool Validation and Reliability Study

“…To include CGA in routine care, which is a standard of care in oncology practice, older adults diagnosed with cancer must be screened to check whether full CGA is required or not. [18,19] Given the time and resource barriers related to CGA, the use of geriatric screening tool become prominent; [5,20,21] multiple screening tools, such as abbreviated Comprehensive Geriatric Assessment, [22] Cancer-Specific Geriatric Assessment instrument, [23] Vulnerable Elderly Survey-13, [24] Fried Frailty Criteria, [5,21] and Geriatrics 8 (G8). [25] Although the choice of the tool depends on clinical resources, G8 was recommended by SIOG with its highest sensitivity.…”

“…Scale concludes as not frail (scored 0-4), and frail as apparently vulnerable (scored 5-6), mildly frail (scored 7-8), moderate frailty (scored 9-10), and severe frailty (scored >11). [24] In this study, the Edmonton Frail Scale was used to assess the sensitivity and specificity of the G8 screening tool.…”