title: The SAKK cancer-specific geriatric assessment (C-SGA): a pilot study of a brief tool for clinical decision-making in older cancer patients.
abstract: BACKGROUND
  Recommendations from international task forces on geriatric assessment emphasize the need for research including validation of cancer-specific geriatric assessment (C-SGA) tools in oncological settings. This study was to evaluate the feasibility of the SAKK Cancer-Specific Geriatric Assessment (C-SGA) in clinical practice.
  
  
  METHODS
  A cross sectional study of cancer patients ≥65 years old (N = 51) with pathologically confirmed cancer presenting for initiation of chemotherapy treatment (07/01/2009-03/31/2011) at two oncology departments in Swiss canton hospitals: Kantonsspital Graubünden (KSGR N = 25), Kantonsspital St. Gallen (KSSG N = 26). Data was collected using three instruments, the SAKK C-SGA plus physician and patient evaluation forms. The SAKK C-SGA includes six measures covering five geriatric assessment domains (comorbidity, function, psychosocial, nutrition, cognition) using a mix of medical record abstraction (MRA) and patient interview. Five individual domains and one overall SAKK C-SGA score were calculated and dichotomized as below/above literature-based cut-offs. The SAKK C-SGA was evaluated by: patient and physician estimated time to complete, ease of completing, and difficult or unanswered questions.
  
  
  RESULTS
  Time to complete the patient questionnaire was considered acceptable by almost all (≥96%) patients and physicians. Patients reported slightly shorter times to complete the questionnaire than physicians (17.33 ± 7.34 vs. 20.59 ± 6.53 minutes, p = 0.02). Both groups rated the patient questionnaire as easy/fairly easy to complete (91% vs. 84% respectively, p = 0.14) with few difficult or unanswered questions. The MRA took on average 8.32 ± 4.72 minutes to complete. Physicians (100%) considered time to complete MRA acceptable, 96% rated it as easy/fairly easy to complete. Individual study site populations differed on health-related characteristics (excellent/good physician-rated general health KSGR 71% vs. KSSG 32%, p = 0.007). The overall mean C-SGA score was 2.4 ± 1.12. Patients at KSGR had lower C-SGA scores (2.00 ± 1.19 vs. 2.81 ± 0.90, p = 0.009) and a smaller proportion (28% vs.65%, p = 0.008) was above the C-SGA cut-off score compared to KSSG.
  
  
  CONCLUSIONS
  These results suggest the SAKK C-SGA is a feasible practical tool for use in clinical practice. It demonstrated discriminative ability based on objective geriatric assessment measures, but additional investigations on use for clinical decision-making are warranted. The SAKK C-SGA also provides important usable domain information for intervention to optimize outcomes in older cancer patients.
authors: Kerri M
authors: KM
authors: Clough-Gorr
authors: Lea
authors: L
authors: Noti
authors: Peter
authors: P
authors: Brauchli
authors: Richard
authors: R
authors: Cathomas
authors: Marius R
authors: MR
authors: Fried
authors: Gillian
authors: G
authors: Roberts
authors: Andreas E
authors: AE
authors: Stuck
authors: Felicitas
authors: F
authors: Hitz
authors: Ulrich
authors: U
authors: Mey
mesh_terms: D000368:Aged; D003657:Decision Making; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000175:diagnosis*; D010865:Pilot Projects; D011795:Surveys and Questionnaires / Q000592:standards*
references: J Nutr Health Aging. 2006 Nov-Dec;10(6):456-63; discussion 463-5
references: 17183418
references: Eur J Cancer. 2013 Sep;49(13):2806-14
references: 23735702
references: J Gerontol A Biol Sci Med Sci. 2008 Mar;63(3):272-4
references: 18375875
references: J Am Geriatr Soc. 2001 Dec;49(12):1691-9
references: 11844005
references: J Clin Oncol. 2011 Apr 1;29(10):1290-6
references: 21357782
references: Eur J Cancer. 2012 Apr;48(6):805-12
references: 21741826
references: Cancer. 2009 Oct 1;115(19):4547-53
references: 19562776
references: J Clin Oncol. 2010 Apr 20;28(12):2046-50
references: 20308657
references: J Clin Oncol. 2011 Sep 20;29(27):3636-42
references: 21709194
references: Eur J Cancer. 2007 Oct;43(15):2161-9
references: 17855074
references: Crit Rev Oncol Hematol. 2004 Jan;49(1):53-67
references: 14734155
references: J Natl Cancer Inst. 2012 Aug 8;104(15):1133-63
references: 22851269
references: Crit Rev Oncol Hematol. 2011 Feb;77(2):148-61
references: 20353897
references: Crit Rev Oncol Hematol. 2006 Sep;59(3):205-10
references: 16904902
references: Crit Rev Oncol Hematol. 2010 Sep;75(3):243-8
references: 20060313
references: J Am Geriatr Soc. 2003 May;51(5):694-8
references: 12752847
references: Br J Cancer. 2009 Dec 3;101 Suppl 2:S92-S101
references: 19956172
references: Curr Treat Options Oncol. 2011 Sep;12(3):276-85
references: 21656152
references: J Clin Oncol. 2007 May 10;25(14):1945-8
references: 17488995
references: Cancer Treat Rev. 2009 Oct;35(6):487-92
references: 19481353
references: Am J Clin Oncol. 1982 Dec;5(6):649-55
references: 7165009
references: Ann Oncol. 2012 Aug;23(8):2166-2172
references: 22250183
references: Clin Geriatr Med. 2012 Feb;28(1):19-31
references: 22326033
references: Cancer. 2007 Feb 15;109(4):802-10
references: 17219443
references: Crit Rev Oncol Hematol. 2005 Sep;55(3):241-52
references: 16084735
references: Eur J Cancer. 2010 Jun;46(9):1502-13
references: 20227872
references: J Clin Oncol. 2012 May 20;30(15):1829-34
references: 22508806
references: J Am Geriatr Soc. 2007 Oct;55(10):1604-8
references: 17697101
references: Cancer Pract. 1997 Mar-Apr;5(2):81-6
references: 9110643
references: J Clin Oncol. 2013 Apr 10;31(11):1464-70
references: 23460711
references: BMJ. 2011 Oct 27;343:d6553
references: 22034146
references: J Geriatr Oncol. 2011 Apr;2(2):121-129
references: 21927633
references: J Chronic Dis. 1987;40(5):373-83
references: 3558716
references: Hematol Oncol Clin North Am. 2000 Feb;14(1):1-16
references: 10680068
references: J Am Geriatr Soc. 2009 Nov;57 Suppl 2:S246-9
references: 20122022
references: J Gerontol A Biol Sci Med Sci. 2008 Mar;63(3):298-307
references: 18375879
references: J Clin Oncol. 2010 Jan 20;28(3):380-6
references: 20008637
references: J Am Geriatr Soc. 2003 Oct;51(10):1451-4
references: 14511167
references: BMC Cancer. 2004 Dec 20;4:94
references: 15610554
references: Curr Probl Cancer. 2001 Jan-Feb;25(1):6-76
references: 11261937
references: Am J Clin Oncol. 2012 Aug;35(4):322-8
references: 21422992
references: J Support Oncol. 2003 Nov-Dec;1(4 Suppl 2):30-7
references: 15346998
references: Surg Oncol. 2010 Sep;19(3):117-23
references: 20006489
references: J Clin Epidemiol. 2012 Oct;65(10):1107-16
references: 22818947
references: Crit Rev Oncol Hematol. 2007 Oct;64(1):1-9
references: 17613243