TY - JOUR
T1 - Determination of an adequate screening tool for identification of vulnerable elderly head and neck cancer patients treated with radio(chemo)therapy
AU - Pottel, Lies
AU - Boterberg, Tom
AU - Pottel, Hans
AU - Goethals, Laurence
AU - Van Den Noortgate, Nele
AU - Duprez, Fréderic
AU - De Neve, Wilfried
AU - Rottey, Sylvie
AU - Geldhof, Kurt
AU - Van Eygen, Koen
AU - Kargar-Samani, Khalil
AU - Ghekiere, Véronique
AU - Cornelis, Frank
AU - Mohile, Supriya
AU - Debruyne, Philip R.
PY - 2012/1
Y1 - 2012/1
N2 - Objectives: We evaluated two proposed screening tools, the Vulnerable Elders Survey-13 (VES-13) and the G8, to identify patients who could benefit from a comprehensive geriatric assessment (CGA). Materials and Methods: All consecutive patients aged ≥ 65. years with primary head and neck cancer were assessed with VES-13, G8 and CGA. Receiver operating characteristics (ROC)-analysis was used to determine diagnostic performance of both screening instruments. Results: Fifty-one patients were recruited, of which 39.2%, 66.7% and 68.6%, were defined vulnerable when evaluated with VES-13, G8 and CGA, respectively. The area under the ROC-curves (AUC ± SE) of VES-13 (0.889 ± 0.045) and G8 (0.909 ± 0.040) did not significantly differ (P=0.7083). A sensitivity and specificity of respectively 57.1% and 100% for VES-13 (cut-off ≥ 3) and 85.7% and 75.0% for G8 (cut-off ≤ 14) was obtained. The combined score "VES-13. +. (maximum-G8)" (AUC. =0.971 ± 0.019) showed a superior AUC to G8 (P=0.0242) and VES-13 (P=0.0237). The most optimal cut-off score of 5 for the combined test resulted in a sensitivity of 91.4% and a specificity of 93.8%. Positive and negative predictive values were 100% and 51.6%, 88.2% and 70.6%, and 97.0% and 83.3% for the VES-13, G8 and combined test respectively. Conclusion: Both tools were found to have good diagnostic performance. However, at the proposed cut-off scores, our data suggest the G8 as the most optimal screening tool. Moreover, the combined tool could represent an interesting alternative.
AB - Objectives: We evaluated two proposed screening tools, the Vulnerable Elders Survey-13 (VES-13) and the G8, to identify patients who could benefit from a comprehensive geriatric assessment (CGA). Materials and Methods: All consecutive patients aged ≥ 65. years with primary head and neck cancer were assessed with VES-13, G8 and CGA. Receiver operating characteristics (ROC)-analysis was used to determine diagnostic performance of both screening instruments. Results: Fifty-one patients were recruited, of which 39.2%, 66.7% and 68.6%, were defined vulnerable when evaluated with VES-13, G8 and CGA, respectively. The area under the ROC-curves (AUC ± SE) of VES-13 (0.889 ± 0.045) and G8 (0.909 ± 0.040) did not significantly differ (P=0.7083). A sensitivity and specificity of respectively 57.1% and 100% for VES-13 (cut-off ≥ 3) and 85.7% and 75.0% for G8 (cut-off ≤ 14) was obtained. The combined score "VES-13. +. (maximum-G8)" (AUC. =0.971 ± 0.019) showed a superior AUC to G8 (P=0.0242) and VES-13 (P=0.0237). The most optimal cut-off score of 5 for the combined test resulted in a sensitivity of 91.4% and a specificity of 93.8%. Positive and negative predictive values were 100% and 51.6%, 88.2% and 70.6%, and 97.0% and 83.3% for the VES-13, G8 and combined test respectively. Conclusion: Both tools were found to have good diagnostic performance. However, at the proposed cut-off scores, our data suggest the G8 as the most optimal screening tool. Moreover, the combined tool could represent an interesting alternative.
KW - Comprehensive geriatric assessment
KW - Elderly
KW - G8
KW - Head and neck cancer
KW - Radiotherapy
KW - Screening instrument
KW - Vulnerable
KW - Vulnerable Elders Survey-13
UR - http://www.scopus.com/inward/record.url?scp=84856336278&partnerID=8YFLogxK
U2 - 10.1016/j.jgo.2011.11.006
DO - 10.1016/j.jgo.2011.11.006
M3 - Article
AN - SCOPUS:84856336278
SN - 1879-4068
VL - 3
SP - 24
EP - 32
JO - Journal of Geriatric Oncology
JF - Journal of Geriatric Oncology
IS - 1
ER -