Health-related quality of life with comprehensive geriatric assessment guided care versus usual care in older adults with cancer: a systematic review and meta-analysis of randomized trials.

Comprehensive Geriatric Assessment Geriatric Oncology Health-related quality of life randomized trials

Journal

Critical reviews in oncology/hematology
ISSN: 1879-0461
Titre abrégé: Crit Rev Oncol Hematol
Pays: Netherlands
ID NLM: 8916049

Informations de publication

Date de publication:
11 Jul 2024
Historique:
received: 25 04 2024
revised: 29 06 2024
accepted: 06 07 2024
medline: 14 7 2024
pubmed: 14 7 2024
entrez: 13 7 2024
Statut: aheadofprint

Résumé

To evaluate if comprehensive geriatric assessment (CGA)-guided care improves health-related quality of life (HRQL) in older adults with cancer compared to usual care. Relevant randomized controlled trials (RCTs) were identified through biomedical databases. Meta-analyses using DerSimonian-Laird model summarized the difference in the mean change of HRQL scores from baseline across various time points, with evidence certainty assessed by the GRADE tool. Logistic regression via generalized estimating equations analyzed predictors of HRQL improvement. Potential improvement in the global HRQL score by CGA-guided care at 3 months (Cohen's d 0.27, 95% CI -0.03 to 0.58, moderate certainty), could not be excluded. Larger RCTs or those mandating CGA before initiating anti-cancer treatment were predictors of improved HRQL. The effects of CGA-guided care on HRQL were variable. Larger RCTs and those mandating pre-treatment CGA tended to report improved HRQL.

Sections du résumé

BACKGROUND BACKGROUND
To evaluate if comprehensive geriatric assessment (CGA)-guided care improves health-related quality of life (HRQL) in older adults with cancer compared to usual care.
METHODS METHODS
Relevant randomized controlled trials (RCTs) were identified through biomedical databases. Meta-analyses using DerSimonian-Laird model summarized the difference in the mean change of HRQL scores from baseline across various time points, with evidence certainty assessed by the GRADE tool. Logistic regression via generalized estimating equations analyzed predictors of HRQL improvement.
RESULTS RESULTS
Potential improvement in the global HRQL score by CGA-guided care at 3 months (Cohen's d 0.27, 95% CI -0.03 to 0.58, moderate certainty), could not be excluded. Larger RCTs or those mandating CGA before initiating anti-cancer treatment were predictors of improved HRQL.
CONCLUSION CONCLUSIONS
The effects of CGA-guided care on HRQL were variable. Larger RCTs and those mandating pre-treatment CGA tended to report improved HRQL.

Identifiants

DOI: 10.1016/j.critrevonc.2024.104442 PMID: 39002788
pubmed: 39002788
pii: S1040-8428(24)00185-9
doi: 10.1016/j.critrevonc.2024.104442
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

104442

Informations de copyright

Copyright © 2024 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no conflict of interest.

Auteurs

Zhi Xuan Ng (ZX)

Department of Radiation Oncology, National University Cancer Institute, Singapore, Singapore.

Pooja Handa (P)

Department of Radiation Oncology, National University Cancer Institute, Singapore, Singapore.

Huili Zheng (H)

Clinical Research Unit, Khoo Teck Puat Hospital, Singapore.

Matthew Zhixuan Chen (MZ)

Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Yu Yang Soon (YY)

Department of Radiation Oncology, National University Cancer Institute, Singapore, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia. Electronic address: yysoon01@gmail.com.

Prunella Blinman (P)

Department of Medical Oncology, Concord Repatriation General Hospital, Sydney, NSW, Australia.

Martin Stockler (M)

NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia; Department of Medical Oncology, Concord Repatriation General Hospital, Sydney, NSW, Australia; Department of Medical Oncology, Chris O'Brien Lifehouse, Sydney, NSW, Australia.

Francis Ho (F)

Department of Radiation Oncology, National University Cancer Institute, Singapore, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Classifications MeSH