Barber test as a screening tool in multidimensional geriatric evaluation in elderly women with early breast cancer

Abstract

e20645 Background: The Comprehensive Geriatric Assessment (CGA) is a key component of the treatment approach for older cancer patients, but it is time consuming. In this study, we have evaluated the validity of a brief frailty screening tool, the Barber test (BT), for identifying disability in older patients with early breast cancer (BC) in the University General Hospital in Elche. Methods: Between January 2007 and December 2007, a total of 41 patients older than 65 years who were actively receiving chemotherapy for early BC, were enrolled in our study. Eligible patients were screened with the Barber test and completed a standardized CGA (Activities of Daily Living measured by Barthel Scale, Instrumental Activities of Daily Living measured by Lawton-Brody Scale, cognitive evaluation measured by Pfeiffer Test, comorbidity (Charlson´s index), risk of malnutrition (Nutritive Initiative Screening), and ECOG). The validity of the BT in this population was assessed by comparing the BT results with results from a simultaneous CGA. A receiver operating characteristic (ROC) analysis was employed. The ROC evaluated the BT as a screening measure for impairment compared with the CGA (using the definition of impairment on the CGA as deficits on ≥2 individual tests within the battery, and on the BT as a score >0). The area under the ROC curve (AUC) was calculated to reflect the predictive value of the BT for identifying impairment. Results: Forty-one women were recruited. Median age was 72.88 years (range 65.03 to 85.46). 30 patients (73.2%) were older than 70 years. 36.6% were dependent in Barthel Scale, and 46,3% were dependent in Lawton-Brody Scale. 19,5% had cognitive impairment. The Barber test was moderate predictive for identifying impairment compared with the CGA, with an AUC of 0.730 (standard error, 0.081; 95% confidence interval for detecting asymptomatic normals, 0.571–0.889); p=0.012). Conclusions: Functional impairments are prevalent among older patients with early BC who receive adjuvant chemotherapy treatment. The current results indicate that the brief Barber test performed nearly as well as a conventional CGA in detecting geriatric impairment in this population. No significant financial relationships to disclose.