title: Feasibility of computer-based self-administered cancer-specific geriatric assessment in older patients with gastrointestinal malignancy.
abstract: BACKGROUND
  The Cancer-Specific Geriatric Assessment (CSGA) is a primarily self-administered paper survey of validated measures.
  
  
  METHODS
  We developed and tested the feasibility of a computer-based CSGA in patients ≥70 years of age who were receiving treatment for gastrointestinal malignancies at the Dana-Farber Cancer Institute. From December 2009 to June 2011, patients were invited to complete the CSGA at baseline (start of new treatment) and follow-up (at the first of 4 months later or within 4 weeks of completing treatment). Feasibility endpoints were proportion of eligible patients consented, proportion completing CSGA at baseline and follow-up, time to complete CSGA, and proportion of physicians reporting CSGA results that led to a change in clinical decision-making.
  
  
  RESULTS
  Of the 49 eligible patients, 38 consented (76% were treatment naive). Median age was 77 years (range: 70-89 years), and 48% were diagnosed with colorectal cancer. Mean physician-rated Karnofsky Performance Status was 87.5 at baseline (SD 8.4) and 83.5 at follow-up (SD 8). At baseline, 92% used a touchscreen computer; 97% completed the CSGA (51% independently). At follow-up, all patients used a touchscreen computer; 71% completed the CSGA (41% independently). Mean time to completion was 23 minutes at baseline (SD 8.4) and 20 minutes at follow-up (SD 5.1). The CSGA added information to clinical assessment for 75% at baseline (n = 27) and 65% at follow-up (n = 17), but it did not alter immediate clinical decision-making.
  
  
  CONCLUSIONS
  The computer-based CSGA feasibility endpoints were met, although approximately half of patients required assistance. The CSGA added information to clinical assessment but did not affect clinical decision-making, possibly due to limited alternate treatment options in this subset of patients.
authors.affiliation: Dana-Farber Cancer Institute, Department of Medical Oncology, Gastrointestinal Oncology, 450 Brookline Avenue, Boston, MA 02215, USA. Nj_mccleary@dfci.harvard.edu
authors.forename: Nadine J
authors.initials: NJ
authors.lastname: McCleary
authors.forename: Devin
authors.initials: D
authors.lastname: Wigler
authors.forename: Donna
authors.initials: D
authors.lastname: Berry
authors.forename: Kaori
authors.initials: K
authors.lastname: Sato
authors.forename: Thomas
authors.initials: T
authors.lastname: Abrams
authors.forename: Jennifer
authors.initials: J
authors.lastname: Chan
authors.forename: Peter
authors.initials: P
authors.lastname: Enzinger
authors.forename: Kimmie
authors.initials: K
authors.lastname: Ng
authors.forename: Brian
authors.initials: B
authors.lastname: Wolpin
authors.forename: Deborah
authors.initials: D
authors.lastname: Schrag
authors.forename: Charles S
authors.initials: CS
authors.lastname: Fuchs
authors.forename: Arti
authors.initials: A
authors.lastname: Hurria
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Meyerhardt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003625:Data Collection; D003657:Decision Making; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D015577:Geriatric Assessment; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male