What are we trying to measure? Rethinking approaches to health outcome assessment for the older person with cancer

Abstract

The health burden of cancer within the older population is well recognized. For many of these patients, interventions and treatments will focus predominantly on improvements in health outcomes. There has been substantial interest in the development and application of health outcome assessments for use in cancer patients, yet in comparison, there has been less focus on the older person with cancer. This paper will review current perspectives on health outcome assessment in older people with cancer; the methodological challenges associated with this work and present recommendations for future work, including the potential application of a 'user-generated' approach to health outcome assessment in the older person with cancer.

Cancer survivorship and aging

“…Particular attention needs to be paid to the length, mode and frequency of assessments. Respondent fatigue, slower response time, literacy level, and font size of survey items and questionnaires are important issues that need to be addressed when conducting survey research with an older population 46,47. While mail questionnaires are more cost effective using face-to-face interviews or telephone interviews with the elderly results in more accurate and complete data and likely a higher response rate 48,49.…”

“…With few exceptions, most of the measures used in oncology have been developed and validated in young to middle aged adults 46. The extent to which existing measures are psychometrically valid and reliable in older populations remains unknown.…”

The added value of geriatric assessment in evaluating a patient's Health‐Related Quality‐of‐Life: A study in ≥70‐year‐old early‐stage invasive breast cancer patients

“…However, when older adults with cancer are asked about their expectations for treatment, most will focus on health‐related Quality‐of‐Life (HRQOL) as an important goal (Wedding, Pientka, & Höffken, 2007). Therefore, the field of geriatric oncology research is increasingly focused on maintaining a patient's Quality‐of‐Life (Fitzsimmons, 2004), especially when survival benefits become less achievable due to increased treatment‐related toxicity burdens and comorbidities inherent to ageing.…”