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A Novel Geriatric Screening Tool in Older Patients with Cancer: The Korean Cancer Study Group Geriatric Score (KG)-7.

Kim JW, Kim SH, Kim YJ, Lee KW, Kim KI, Lee JS, Kim CH, Kim JH, Korean Cancer Study Group Geriatric Oncology Working Par - PLoS ONE (2015)

Bottom Line: Furthermore, patients with higher KG-7 scores showed significantly longer overall survival (OS) in the development and validation cohorts.In conclusions, the KG-7 showed high SE and NPV to predict abnormal GA.Given the results of our studies, the KG-7 could be used effectively in countries with high patient burden and low resources to select patients in need of full GA and intervention.

View Article: PubMed Central - PubMed

Affiliation: Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.

ABSTRACT
Geriatric assessment (GA) is resource-consuming, necessitating screening tools to select appropriate patients who need full GA. The objective of this study is to design a novel geriatric screening tool with easy-to-answer questions and high performance objectively selected from a large dataset to represent each domain of GA. A development cohort was constructed from 1284 patients who received GA from May 2004 to April 2007. Items representing each domain of functional status, cognitive function, nutritional status, and psychological status in GA were selected according to sensitivity (SE) and specificity (SP). Of the selected items, the final questions were chosen by a panel of oncologists and geriatricians to encompass most domains evenly and also by feasibility and use with cancer patients. The selected screening questions were validated in a separate cohort of 98 cancer patients. The novel screening tool, the Korean Cancer Study Group Geriatric Score (KG)-7, consisted of 7 items representing each domain of GA. KG-7 had a maximal area under the curve (AUC) of 0.93 (95% confidence interval (CI) 0.92-0.95) in the prediction of abnormal GA, which was higher than that of G-8 (0.87, 95% CI 0.85-0.89) within the development cohort. The cut-off value was decided at ≤ 5 points, with a SE of 95.0%, SP of 59.2%, positive predictive value (PPV) of 85.3%, and negative predictive value (NPV) of 82.6%. In the validation cohort, the AUC was 0.82 (95% CI 0.73-0.90), and the SE, SP, PPV, and NPV were 89.5%, 48.6%, 77.3%, and 75.0%, respectively. Furthermore, patients with higher KG-7 scores showed significantly longer overall survival (OS) in the development and validation cohorts. In conclusions, the KG-7 showed high SE and NPV to predict abnormal GA. The KG-7 also predicted OS. Given the results of our studies, the KG-7 could be used effectively in countries with high patient burden and low resources to select patients in need of full GA and intervention.

No MeSH data available.


Related in: MedlinePlus

Overall survival according to KG-7 score in development cohort.(A) According to each KG-7 score. (B) According to categorized KG-7 score. (C) Between normal and abnormal KG-7 score.
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pone.0138304.g002: Overall survival according to KG-7 score in development cohort.(A) According to each KG-7 score. (B) According to categorized KG-7 score. (C) Between normal and abnormal KG-7 score.

Mentions: KG-7 scores showed prognostic value for OS in the development cohort (p < 0.001; Fig 2A). When patients were categorized into 1 of 4 groups based on KG-7 score, patients with higher scores showed longer OS (p < 0.001; Fig 2B). Patients with normal KG-7 score (>5) had better survival than patients with abnormal KG-7 score (≤5; Fig 2C). The HR for survival between the groups with the lowest and highest KG-7 scores was 5.1 (95% CI 3.8−7.0, p < 0.001). In the validation cohort, KG-7 score could discriminate OS (p = 0.006; S4 Fig). Categorized groups also showed significantly different OS (p = 0.005). The HR for survival between patients with the highest versus lowest KG-7 scores was 3.7 (95% CI 1.6−8.8, p = 0.003).


A Novel Geriatric Screening Tool in Older Patients with Cancer: The Korean Cancer Study Group Geriatric Score (KG)-7.

Kim JW, Kim SH, Kim YJ, Lee KW, Kim KI, Lee JS, Kim CH, Kim JH, Korean Cancer Study Group Geriatric Oncology Working Par - PLoS ONE (2015)

Overall survival according to KG-7 score in development cohort.(A) According to each KG-7 score. (B) According to categorized KG-7 score. (C) Between normal and abnormal KG-7 score.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4581840&req=5

pone.0138304.g002: Overall survival according to KG-7 score in development cohort.(A) According to each KG-7 score. (B) According to categorized KG-7 score. (C) Between normal and abnormal KG-7 score.
Mentions: KG-7 scores showed prognostic value for OS in the development cohort (p < 0.001; Fig 2A). When patients were categorized into 1 of 4 groups based on KG-7 score, patients with higher scores showed longer OS (p < 0.001; Fig 2B). Patients with normal KG-7 score (>5) had better survival than patients with abnormal KG-7 score (≤5; Fig 2C). The HR for survival between the groups with the lowest and highest KG-7 scores was 5.1 (95% CI 3.8−7.0, p < 0.001). In the validation cohort, KG-7 score could discriminate OS (p = 0.006; S4 Fig). Categorized groups also showed significantly different OS (p = 0.005). The HR for survival between patients with the highest versus lowest KG-7 scores was 3.7 (95% CI 1.6−8.8, p = 0.003).

Bottom Line: Furthermore, patients with higher KG-7 scores showed significantly longer overall survival (OS) in the development and validation cohorts.In conclusions, the KG-7 showed high SE and NPV to predict abnormal GA.Given the results of our studies, the KG-7 could be used effectively in countries with high patient burden and low resources to select patients in need of full GA and intervention.

View Article: PubMed Central - PubMed

Affiliation: Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.

ABSTRACT
Geriatric assessment (GA) is resource-consuming, necessitating screening tools to select appropriate patients who need full GA. The objective of this study is to design a novel geriatric screening tool with easy-to-answer questions and high performance objectively selected from a large dataset to represent each domain of GA. A development cohort was constructed from 1284 patients who received GA from May 2004 to April 2007. Items representing each domain of functional status, cognitive function, nutritional status, and psychological status in GA were selected according to sensitivity (SE) and specificity (SP). Of the selected items, the final questions were chosen by a panel of oncologists and geriatricians to encompass most domains evenly and also by feasibility and use with cancer patients. The selected screening questions were validated in a separate cohort of 98 cancer patients. The novel screening tool, the Korean Cancer Study Group Geriatric Score (KG)-7, consisted of 7 items representing each domain of GA. KG-7 had a maximal area under the curve (AUC) of 0.93 (95% confidence interval (CI) 0.92-0.95) in the prediction of abnormal GA, which was higher than that of G-8 (0.87, 95% CI 0.85-0.89) within the development cohort. The cut-off value was decided at ≤ 5 points, with a SE of 95.0%, SP of 59.2%, positive predictive value (PPV) of 85.3%, and negative predictive value (NPV) of 82.6%. In the validation cohort, the AUC was 0.82 (95% CI 0.73-0.90), and the SE, SP, PPV, and NPV were 89.5%, 48.6%, 77.3%, and 75.0%, respectively. Furthermore, patients with higher KG-7 scores showed significantly longer overall survival (OS) in the development and validation cohorts. In conclusions, the KG-7 showed high SE and NPV to predict abnormal GA. The KG-7 also predicted OS. Given the results of our studies, the KG-7 could be used effectively in countries with high patient burden and low resources to select patients in need of full GA and intervention.

No MeSH data available.


Related in: MedlinePlus