title: Further psychometric validation of the GAH scale: Responsiveness and effect size.
abstract: OBJECTIVE
  The purpose of this study was to assess the responsiveness of the newly developed Geriatric Assessment in Hematology (GAH) scale to clinical change in older patients diagnosed with hematologic malignancies.
  
  
  METHODS
  A prospective observational study conducted in 164 patients aged ≥65years and diagnosed with myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML), multiple myeloma (MM), or chronic lymphocytic leukemia (CLL). Responsiveness of the GAH scales was studied by means of the Eastern Cooperative Oncology Group (ECOG) score, the Karnofsky performance status (KPS) score, the visual analog scale (VAS), and the physician's subjective assessment, used as clinical anchors to identify whether patients had changed clinically (either improved or worsened) or not since the baseline visit. Responsiveness was evaluated on the basis of effect size (ES).
  
  
  RESULTS
  164 patients (men, 63.7%; median age, 77.0 (72.8-81.4) participated. Statistically significant correlations were obtained between the investigator's qualitative assessment and changes in ECOG, KPS, and VAS scores. Likewise, a statistically significant correlation was obtained between the investigator's qualitative assessment and changes in the GAH scale score. Responsiveness of the GAH scale to detect clinical change was satisfactory (ES 0.34).
  
  
  CONCLUSIONS
  Findings confirm that the GAH scale is responsive to clinical changes in patients' health status. Additionally, the GAH scale is a promising tool to improve clinical decision-making in older patients with hematological malignancies.
authors.affiliation: Geriatric Department, H.U. Ramón y Cajal, Ctra. de Colmenar Viejo, km. 9, 100, 28034 Madrid, Spain. Electronic address: alfonsojose.cruz@salud.madrid.org.
authors.forename: Alfonso José
authors.initials: AJ
authors.lastname: Cruz-Jentoft
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: Bernardo
authors.initials: B
authors.lastname: González
authors.affiliation: Hematology Department, H. U. La Fe, Av. Fernando Abril Martorell, 106, 46026 Valencia, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: de la Rubia
authors.affiliation: Hematology Department, H.U. Infanta Leonor, Avenida Gran Vía del Este, 80, 28031 Madrid, Spain.
authors.forename: José Ángel
authors.initials: JÁ
authors.lastname: Hernández Rivas
authors.affiliation: Hematology Department, C.S. Parc Taulí, Parc Taulí, 1, 08208 Sabadell, Barcelona, Spain.
authors.forename: Juan Alfonso
authors.initials: JA
authors.lastname: Soler
authors.affiliation: Hematology Department, C.H.U. A Coruña, As Xubias, 84, 15006, A Coruña, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Fernández Lago
authors.affiliation: Hematology Department, H.U. de La Ribera, Carretera Corbera, km 1, 46600 Alzira, Valencia, Spain.
authors.forename: Mario
authors.initials: M
authors.lastname: Arnao
authors.affiliation: Hematology Department, H. U. Vall d'Hebrón, Passeig de la Vall d'Hebron, 119-129, 08035 Barcelona, Spain.
authors.forename: Mercedes
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: Ernesto
authors.initials: E
authors.lastname: Pérez Persona
authors.affiliation: Hematology Department, C.H. de Navarra, Av. Pío XII, 36, 31008, Pamplona, Navarra, Spain.
authors.forename: María Teresa
authors.initials: MT
authors.lastname: Zudaire
authors.affiliation: Hematology Department, C.H. de Segovia, c/de Miguel Servet, s/n, Segovia, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Olivier
authors.affiliation: Hematology Department, H. Sant Joan de Déu, C/Joan Soler 1-3, 08243 Manresa, Barcelona, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Altés
authors.affiliation: Hematology Department, H.U. Arnau de Vilanova, Avenida Alcalde Rovira Roure, 80, 25198 Lleida, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: García Guiñón
authors.affiliation: Hematology Department, Hospital Clínic de Barcelona, Carrer Villarroel, 170, 08036 Barcelona, Spain.
authors.forename: Benet
authors.initials: B
authors.lastname: Nomdedeu
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: Montserrat
authors.initials: M
authors.lastname: Arnan
authors.affiliation: Hematology Department, H.U. Central de Asturias, Calle Carretera de Rubín, s/n, 33011 Oviedo, Spain.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Ramírez Payer
authors.affiliation: Hematology Department, Hospital Universitario Severo Ochoa, Avenida de Orellana, s/n, 28911 Leganés, Madrid, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Sánchez-Godoy
authors.affiliation: Dynamic Science S.L., c/Azcona, 31, 28028 Madrid, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Pajuelo
authors.affiliation: Celgene S.L.U., Paseo de Recoletos, 37, 28004 Madrid, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Vilanova
authors.affiliation: Celgene S.L.U., Paseo de Recoletos, 37, 28004 Madrid, Spain.
authors.forename: Diego Fernánez
authors.initials: DF
authors.lastname: Monjil
authors.affiliation: Hematology Department, H. U. La Fe, Av. Fernando Abril Martorell, 106, 46026 Valencia, Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: Bonanad
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D018450:Disease Progression; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D019337:Hematologic Neoplasms / Q000523:psychology*; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011594:Psychometrics; D012680:Sensitivity and Specificity; D064232:Visual Analog Scale
keywords: Acute myeloid lymphoma; Chronic lymphoid leukemia; Comprehensive geriatric assessment; Effect size; Multiple myeloma; Myelodysplastic syndrome; Older cancer patients; Psychometric properties; Responsiveness; Scale