title: Evaluation of the cardiovascular health study (CHS) instrument and the Vulnerable Elders Survey-13 (VES-13) in elderly cancer patients. Are we still missing the right screening tool?
abstract: BACKGROUND
  A geriatric screening tool would be valuable to identify elderly cancer patients who might benefit from a comprehensive geriatric assessment (CGA). This study evaluated the accuracy of the cardiovascular health study (CHS) instrument in predicting abnormality in CGA. The vulnerable elders' survey-13 (VES-13) was also evaluated.
  
  
  METHODS
  Patients aged ≥ 70 years with solid tumors underwent a CGA after being screened with the CHS and VES-13. Analyses were conducted for the overall population and according to the disease status (early or advanced) and type of early cancer (breast or gastrointestinal, GI).
  
  
  RESULTS
  Of 259 patients, 75% were impaired according to the CHS and 47% according to the VES-13. CGA impairment was reported in 171 patients (66%). In the overall population, overall accuracy, sensitivity and specificity of CHS in identifying CGA impairments were 74%, 87% and 49%, respectively. The corresponding figures for the VES-13 were 68%, 62% and 81%. Sensitivity and specificity of CHS in predicting CGA impairments in subgroups were early 81% and 55%, advanced 98% and 29%; early breast 78% and 69%, early GI 87.5% and 19%.
  
  
  CONCLUSIONS
  The CHS compared favourably with VES-13 for sensitivity. However, the great variability in specificity observed with the CHS within subgroups limits its applicability in the global population.
authors.affiliation: Sandro Pitigliani Medical Oncology Unit, Department of Oncology, Hospital of Prato, Istituto Toscano Tumori, Prato. Electronic address: lbiganzoli@usl4.toscana.it.
authors.forename: L
authors.initials: L
authors.lastname: Biganzoli
authors.affiliation: Clinical Trials Coordinating Center, AOU Careggi, Istituto Toscano Tumori, Florence.
authors.forename: L
authors.initials: L
authors.lastname: Boni
authors.affiliation: Sandro Pitigliani Medical Oncology Unit, Department of Oncology, Hospital of Prato, Istituto Toscano Tumori, Prato.
authors.forename: D
authors.initials: D
authors.lastname: Becheri
authors.affiliation: Sandro Pitigliani Medical Oncology Unit, Department of Oncology, Hospital of Prato, Istituto Toscano Tumori, Prato.
authors.forename: E
authors.initials: E
authors.lastname: Zafarana
authors.affiliation: Sandro Pitigliani Medical Oncology Unit, Department of Oncology, Hospital of Prato, Istituto Toscano Tumori, Prato.
authors.forename: C
authors.initials: C
authors.lastname: Biagioni
authors.affiliation: Sandro Pitigliani Medical Oncology Unit, Department of Oncology, Hospital of Prato, Istituto Toscano Tumori, Prato.
authors.forename: S
authors.initials: S
authors.lastname: Cappadona
authors.affiliation: Clinical Trials Coordinating Center, AOU Careggi, Istituto Toscano Tumori, Florence.
authors.forename: E
authors.initials: E
authors.lastname: Bianchini
authors.affiliation: Sandro Pitigliani Medical Oncology Unit, Department of Oncology, Hospital of Prato, Istituto Toscano Tumori, Prato.
authors.forename: C
authors.initials: C
authors.lastname: Oakman
authors.affiliation: Geriatric Medicine Unit, Hospital of Prato, Prato, Italy.
authors.forename: S U
authors.initials: SU
authors.lastname: Magnolfi
authors.affiliation: Sandro Pitigliani Medical Oncology Unit, Department of Oncology, Hospital of Prato, Istituto Toscano Tumori, Prato.
authors.forename: A
authors.initials: A
authors.lastname: Di Leo
authors.affiliation: Geriatric Medicine Unit, Hospital of Prato, Prato, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Mottino
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications*