title: Development and psychometric validation of a brief comprehensive health status assessment scale in older patients with hematological malignancies: The GAH Scale.
abstract: OBJECTIVE
  The purpose of this study was to develop a new brief, comprehensive geriatric assessment scale for older patients diagnosed with different hematological malignancies, the Geriatric Assessment in Hematology (GAH scale), and to determine its psychometric properties.
  
  
  METHODS
  The 30-item GAH scale was designed through a multi-step process to cover 8 relevant dimensions. This is an observational study conducted in 363 patients aged≥65years, newly diagnosed with different hematological malignancies (myelodysplasic syndrome/acute myeloblastic leukemia, multiple myeloma, or chronic lymphocytic leukemia), and treatment-naïve. The scale psychometric validation process included the analyses of feasibility, floor and ceiling effect, validity and reliability criteria.
  
  
  RESULTS
  Mean time taken to complete the GAH scale was 11.9±4.7min that improved through a learning-curve effect. Almost 90% of patients completed all items, and no floor or ceiling effects were identified. Criterion validity was supported by reasonable correlations between the GAH scale dimensions and three contrast variables (global health visual analogue scale, ECOG and Karnofsky), except for comorbidities. Factor analysis (supported by the scree plot) revealed nine factors that explained almost 60% of the total variance. Moderate internal consistency reliability was found (Cronbach's α: 0.610), and test-retest was excellent (ICC coefficients, 0.695-0.928).
  
  
  CONCLUSIONS
  Our study suggests that the GAH scale is a valid, internally reliable and a consistent tool to assess health status in older patients with different hematological malignancies. Future large studies should confirm whether the GAH scale may be a tool to improve clinical decision-making in older patients with hematological malignancies.
authors.affiliation: Hematology Department, H. U. La Fe, Av. Fernando Abril Martorell, 106, 46026 Valencia, Spain. Electronic address: sbonanad@gmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Bonanad
authors.affiliation: Hematology Department, H. U. La Fe, Av. Fernando Abril Martorell, 106, 46026 Valencia, Spain.
authors.forename: J
authors.initials: J
authors.lastname: De la Rubia
authors.affiliation: Hematology Department, H. U. Vall d'Hebrón, Passeig de la Vall d'Hebron, 119-129, 08035 Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Gironella
authors.affiliation: Hematology Department, H. U. Txagorritxu, c/ Jose Atxotegi, s/n, 01009 Vitoria-Gasteiz, Álava, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Pérez Persona
authors.affiliation: Hematology Department, H. U. de Canarias, Ctra. Ofra, s/n, 38320 San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain.
authors.forename: B
authors.initials: B
authors.lastname: González
authors.affiliation: Hematology Department, C.H.U. A Coruña, As Xubias, 84, 15006, A Coruña, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Fernández Lago
authors.affiliation: Hematology Department, Catalan Institute of Oncology, IDIBELL, Hospital Duran i Reynals, Avinguda Granvia de l'Hospitalet, 199-203 08908 l'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: M
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authors.lastname: Arnan
authors.affiliation: Hematology Department, C.H. de Navarra, Av. Pío XII, 36, 31008 Pamplona, Navarra, Spain.
authors.forename: M
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authors.lastname: Zudaire
authors.affiliation: Hematology Department, H.U. Infanta Leonor, Avenida Gran Vía del Este, 80, 28031 Madrid, Spain.
authors.forename: J A
authors.initials: JA
authors.lastname: Hernández Rivas
authors.affiliation: Hematology Department, C.S. Parc Taulí, Parc Taulí, 1, 08208 Sabadell, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Soler
authors.affiliation: Hematology Department, H. Ntra. Sra. de La Candelaria, Carretera del Rosario, 145, 38010 Santa Cruz de Tenerife, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Marrero
authors.affiliation: Hematology Department, C.H. de Segovia, c/ de Miguel Servet, s/n, Segovia, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Olivier
authors.affiliation: Hematology Department, H. Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Altés
authors.affiliation: Hematology Department, H. U. Vall d'Hebrón, Passeig de la Vall d'Hebron, 119-129, 08035 Barcelona, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Valcárcel
authors.affiliation: Hematology Department, H. U. de Canarias, Ctra. Ofra, s/n, 38320 San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain.
authors.forename: M T
authors.initials: MT
authors.lastname: Hernández
authors.affiliation: Hematology Department, H. U. Txagorritxu, c/ Jose Atxotegi, s/n, 01009 Vitoria-Gasteiz, Álava, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Oiartzabal
authors.affiliation: Hematology Department, H.U. Infanta Leonor, Avenida Gran Vía del Este, 80, 28031 Madrid, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Fernández Ordoño
authors.affiliation: Hematology Department, H.U. de La Ribera, Carretera Corbera, km 1, 46600 Alzira, Valencia, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Arnao
authors.affiliation: Hematology Department, C.S. Parc Taulí, Parc Taulí, 1, 08208 Sabadell, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Esquerra
authors.affiliation: Hematology Department, Catalan Institute of Oncology, IDIBELL, Hospital Duran i Reynals, Avinguda Granvia de l'Hospitalet, 199-203 08908 l'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Sarrá
authors.affiliation: Hematology Department, Catalan Institute of Oncology, IDIBELL, Hospital Duran i Reynals, Avinguda Granvia de l'Hospitalet, 199-203 08908 l'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: E
authors.initials: E
authors.lastname: González-Barca
authors.affiliation: Hematology Department, H.U. Virgen del Rocío, Avenida Manuel Siurot, s/n, 41013 Sevilla, Spain.
authors.forename: J
authors.initials: J
authors.lastname: González
authors.affiliation: Hematology Department, Hospital Clínic de Barcelona, Carrer Villarroel, 170, 08036 Barcelona, Spain.
authors.forename: X
authors.initials: X
authors.lastname: Calvo
authors.affiliation: Hematology Department, Hospital Clínic de Barcelona, Carrer Villarroel, 170, 08036 Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Nomdedeu
authors.affiliation: Hematology Department, H.U. Arnau de Vilanova, Avenida Alcalde Rovira Roure, 80, 25198 Lleida, Spain.
authors.forename: A
authors.initials: A
authors.lastname: García Guiñón
authors.affiliation: Hematology Department, H.U. Central de Asturias, Calle Carretera de Rubín, s/n, 33011 Oviedo, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Ramírez Payer
authors.affiliation: U. Autónoma de Madrid, Dynamic Science S.L., c/Azcona, 31, 28028 Madrid, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Casado
authors.affiliation: Celgene S.L.U., Paseo de Recoletos, 37, 28004 Madrid, Spain.
authors.forename: S
authors.initials: S
authors.lastname: López
authors.affiliation: Celgene S.L.U., Paseo de Recoletos, 37, 28004 Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Durán
authors.affiliation: Celgene S.L.U., Paseo de Recoletos, 37, 28004 Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Marcos
authors.affiliation: Geriatric Department, H.U. Ramón y Cajal, Ctra. de Colmenar Viejo, km. 9,100, 28034 Madrid, Spain.
authors.forename: A J
authors.initials: AJ
authors.lastname: Cruz-Jentoft
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000379:methods*; D006304:Health Status; D019337:Hematologic Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011594:Psychometrics / Q000379:methods*; D015203:Reproducibility of Results; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires
keywords: Acute myeloid lymphoma; Chronic lymphoid leukemia; Geriatric assessment; Multiple myeloma; Myelodysplasic syndrome; Older cancer patients; Validation