title: Screening elderly cancer patients for disabilities: evaluation of study of osteoporotic fractures (SOF) index and comprehensive geriatric assessment (CGA).
abstract: BACKGROUND
  Comprehensive geriatric assessment (CGA) is a multidimensional tool aimed at detecting multiple age-related problems; the study of osteoporotic fractures (SOF) index is a 3-item instrument designed to measure frailty and pre-frailty status. The aim of this prospective cohort study was to evaluate the accuracy of the SOF index and CGA in predicting the disability status in elderly cancer patients.
  
  
  METHODS
  Patients aged ≥ 70 years with a confirmed diagnosis of a solid or hematologic tumor underwent both CGA and SOF assessment. The sensitivity and specificity of SOF in determining the presence of frailty were analyzed using the CGA as the reference standard. The diagnostic accuracy of SOF < 80% was considered not acceptable.
  
  
  RESULTS
  The study involved 400 patients aged ≥ 70 years (median age 77.2, range 70-97).The SOF and CGA classified, respectively, 33.2% and 31.8% of patients as fit, 67.8% and 68.2% as unfit. The SOF showed a sensibility and a specificity of 89.0 [95% confidence interval (CI) 84.7-92.5] and 81.1 (73.2-87.5) with an accuracy of 86.5 (82.8-89.7). The negative predictive value (NPV) was 103/133, i.e. 77.4% (95% CI 69.4-84.2).
  
  
  CONCLUSIONS
  As the SOF proved to reach the end-point of our study, we support its use as a means of screening elderly cancer patients in everyday clinical practice.
authors.affiliation: Department of Oncology, San Paolo Hospital, Milan; Department of Medicine, Surgery and Dentistry, University of Milan, Milan. Electronic address: andrea_luciani@email.it.
authors.forename: A
authors.initials: A
authors.lastname: Luciani
authors.affiliation: Department of Oncology, San Paolo Hospital, Milan; Department of Medicine, Surgery and Dentistry, University of Milan, Milan.
authors.forename: L
authors.initials: L
authors.lastname: Dottorini
authors.affiliation: Department of Oncology, San Paolo Hospital, Milan; Department of Medicine, Surgery and Dentistry, University of Milan, Milan.
authors.forename: N
authors.initials: N
authors.lastname: Battisti
authors.affiliation: Department of Oncology, San Paolo Hospital, Milan; Department of Medicine, Surgery and Dentistry, University of Milan, Milan.
authors.forename: C
authors.initials: C
authors.lastname: Bertuzzi
authors.affiliation: Department of Oncology, San Paolo Hospital, Milan; Department of Medicine, Surgery and Dentistry, University of Milan, Milan.
authors.forename: S
authors.initials: S
authors.lastname: Caldiera
authors.affiliation: Laboratory of Clinical Trial, Istituto di Ricerche Farmacologiche 'Mario Negri', Milan, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Floriani
authors.affiliation: Department of Oncology, San Paolo Hospital, Milan; Department of Medicine, Surgery and Dentistry, University of Milan, Milan.
authors.forename: S
authors.initials: S
authors.lastname: Zonato
authors.affiliation: Department of Oncology, San Paolo Hospital, Milan; Department of Medicine, Surgery and Dentistry, University of Milan, Milan.
authors.forename: D
authors.initials: D
authors.lastname: Ferrari
authors.affiliation: Department of Oncology, San Paolo Hospital, Milan; Department of Medicine, Surgery and Dentistry, University of Milan, Milan.
authors.forename: P
authors.initials: P
authors.lastname: Foa
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D006233:Persons with Disabilities; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000175:diagnosis*; D009752:Nutritional Status; D058866:Osteoporotic Fractures / Q000175:diagnosis*; D011446:Prospective Studies; D012720:Severity of Illness Index