Comparing SARC-F with SARC-CalF for screening sarcopenia in advanced cancer patients

Fu, Xi; Tian, Zhen; Thapa, Sudip; Sun, Huihui; Su, Wen; Xiong, Huihua; Yu, Shiying

doi:10.1016/j.clnu.2020.02.020

Cited by 41 publications

(46 citation statements)

References 31 publications

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“…Because of the grown interest in this tool, other researchers also verified that SARC-CalF have better diagnostic performance as compared to the original questionnaire in the same population [ 40 – 42 ]. Similar results also were observed in cancer patients, when it was compared SARC-F wit SARC-CalF for screening sarcopenia in 309 advanced cancer patients [ 43 ].…”

Section: Discussionsupporting

confidence: 70%

Comparison of revised EWGSOP2 criteria of sarcopenia in patients with cancer using different parameters of muscle mass

Fayh

Sousa

2021

PLoS ONE

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Calf circumference (CC) has been established as a marker of muscle mass (MM) with good performance for predicting survival in individuals with cancer. The study aims to determine the prevalence of sarcopenia according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria and to evaluate the accuracy of sarcopenia using low CC relative to MM assessment by computed tomography (CT) at third lumbar vertebra level (L3) as a reference. Cross-sectional study with cancer patients aged ≥ 60 years. Data included socio-demographic, clinical and anthropometric variables. MM was assessed by CC and by CT images at the L3. Sarcopenia was diagnosed according to the EWGSOP2 criteria: a) low handgrip strength (HGS) + reduced MM evaluated by CT; and b) low HGS + low CC. Pearson’s correlation, accuracy, sensitivity, specificity, positive predictive and negative predictive value were analyzed. A total of 108 patients were evaluated, age of 70.6 ± 7.4 years (mean ± standard deviation). The prevalence of sarcopenia was of 24.1% (low MM) and 25.9% (low CC). The Kappa test showed a substantial agreement (K = 0.704), 81% sensitivity, and 92% specificity. Although the EWGSOP2 advises that we should use CC measures in the algorithm for sarcopenia when no other MM diagnostic methods are available, the findings allow the use of CC instead of MM by CT in cancer patients.

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Section: Discussionsupporting

confidence: 70%

Comparison of revised EWGSOP2 criteria of sarcopenia in patients with cancer using different parameters of muscle mass

Fayh

Sousa

2021

PLoS ONE

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“…In an observational study of 384 patients aged 60 years or older, the sensitivity, specificity, and AUC for sarcopenia as determined by AWGS were 0.295, 0.981, and 0.89 for the SARC-F, compared with 0.607, 0.947, and 0.92 for the SARC-calf (30). In 309 patients with advanced cancer, the sensitivity, specificity, and AUC for sarcopenia as determined by AWGS were 0.321, 0.907, and 0.70 for the SARC-F vs. 0.666, 0.701, and 0.75 for the SARC-calf, respectively (31). In a recent metaanalysis, the sensitivity of SARC-calf for sarcopenia was reported to be 0.459-0.572 and specificity 0.877-0.913, while the sensitivity of SARC-F for sarcopenia was reported to be 0.289-0.553 and specificity 0.689-0.889 (32).…”

Section: Sarcopenia Detection Power Of the Sarc-f The Sarc-calf And The Sarc-ebmmentioning

confidence: 93%

Screening Tools for Sarcopenia

Nishikawa

Asai

Fukunishi

et al. 2021

In Vivo

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The elderly people are characterized by multiple comorbidities, dementia, and are at risk of developing sarcopenia and frailty. Sarcopenia is defined by loss of muscle mass and muscle strength or physical decline. Sarcopenia is a main component of physical frailty. Screening tools for sarcopenia that can be easily determined in daily practice are useful and include the SARC-F screening tool. SARC-F is a questionnaire consisting of five questions: Strength (S), Assistance walking (A), Rising from a chair (R), Climbing stairs (C), and Falls (F) on a scale of 0 to 2. The recommended cutoff value is ≥4 points. The SARC-F has been shown to correlate well with clinical outcomes in the elderly and various underlying diseases, while it is also true that the SARC-F has its shortcomings such as low sensitivity for sarcopenia. In this review, we mainly outline the SARC-F and mention other screening tools for sarcopenia.The aging of Japan's population continues to accelerate (1). According to the Japanese government report, the aging rate (65 years old or older) was 15.1% of the total population in 1996, but it increased significantly to 28.4% in 2019 (2). In addition, the estimated aging rate as of January 1997 is projected to be 27.4% in 2025, but as of 2019, it has already exceeded the projection. The number of people aged 65 or older will continue to increase, and is estimated to reach 33.3% in 2036 and 38.4% in 2065. In order to improve the quality of life (QOL) of the increasing number of elderly people, efforts have been made in the fields of health, medical care, and welfare to extend healthy life expectancy (the period of time during which there are no limitations in daily life), but there are still many issues to be addressed. The elderly people are characterized by multiple comorbidities, dementia, and risk of sarcopenia and frailty (3). In 2019, the Ministry of Health, Labour and Welfare (MHLW) in Japan published the "Guidelines for Health Services Based on the Characteristics of the Elderly, Version 2", and announced the strengthening of measures against frailty, especially for elderly people aged 75 or older. The guidelines newly added the implementation of "health checkups for frailty" with the aim of integrating health guidance and care prevention. Specifically, the report has recommended the use of a "questionnaire for the elderly aged 75 or older" focusing on frailty in health checkups and other examinations conducted by municipalities since fiscal 2020. This questionnaire is expected to help prevent and raise awareness of frailty among many elderly people. Early intervention through such efforts will lead to a prolongation in healthy life expectancy. In addition, sarcopenia is a condition that forms the basis of physical frailty (4). Sarcopenia leads to decreased physical activity, and decreased physical activity leads to sarcopenia. Both are involved in frailty, forming the so-called "frailty cycle" (4). On the other hand, the number of people aged 60 or older in the world was estimated to be 600 million ...

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“…A total of 21,855 individuals were included (20 to 3997 individuals per article), with a weighted mean age of 63.3 AE 14.6 years (range: 54.7 AE 11.3 years to 84.6 AE 9.17 years) and of which 61.3% were females (Table 1). Populations included community-dwelling older adults (n ¼ 1,618,957 individuals), 37e40,47e51,56,57,59e61, 63,64 geriatric inpatients (n ¼ 51,598 individuals), 41,43,44,53,54 geriatric outpatients (n ¼ 5802 individuals), 42,45,46,58 nursing home residents (n ¼ 2357 individuals), 62,65 and long-term care residents (n ¼ 1141 individuals). 52 Fifteen articles included individuals from Asia, 8 articles from Europe, 3 articles from South America, and 3 articles from North America.…”

Section: Study Characteristicsmentioning

confidence: 99%

Reliability and Concurrent Validity of the SARC-F and Its Modified Versions: A Systematic Review and Meta-Analysis

Voelker

Michalopoulos

Maier

et al. 2021

Journal of the American Medical Directors Association

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Objectives: Sarcopenia, being prevalent in up to 40% of older adults, is associated with adverse health outcomes. The international sarcopenia guidelines recommend screening for sarcopenia using the SARC-F. A previous meta-analysis (2017) reported poor validity of the SARC-F among community-dwelling older adults. Since then, modified SARC-F versions were developed and new sarcopenia definitions were published, including the SARC-F for case-finding. This systematic review and meta-analysis aimed to assess the reliability of the SARC-F and its concurrent validity to identify sarcopenia. Design: Systematic review and meta-analyses. Setting and Participants: Adults (all ages) from any study population. Methods: A systematic search was conducted in MEDLINE, EMBASE, Cochrane, and CINAHL (January 1, 2013, to April 6, 2020). Articles were included if they reported on the reliability and/or concurrent validity of the (modified) SARC-F. No restrictions were applied for sex, age, study population, or sarcopenia definition. Reliability measures included inter-rater reliability, test-retest reliability, and internal consistency. Meta-analyses were performed for concurrent validity. Results: The 29 included articles included 21,855 individuals (mean age of 63.3AE14.6 years, 61.3% females) among community-dwelling (n ¼ 16), geriatric inpatient (n ¼ 5), geriatric outpatient (n ¼ 2), nursing home (n ¼ 2), and long-term care (n ¼ 1) populations. The SARC-F had good (2/4 articles) to excellent (2/4 articles) inter-rater reliability, moderate (1/6 articles) to good (5/6 articles) test-retest reliability, and low (4/8 articles) to high (4/8 articles) internal consistency. The SARC-F had low to moderate sensitivity (28.9%-55.3%) and moderate to high specificity (68.9%-88.9%) according to the European Working Group on Sarcopenia in Older People (EWGSOP; n ¼ 13), revised EWGSOP definition (EWGSOP2; n ¼ 6), Asian Working Group for Sarcopenia (AWGS; n ¼ 13), Foundation for the National Institutes of Health (FNIH; n ¼ 8), International Working Group on Sarcopenia (IWGS; n ¼ 9), and Society on Sarcopenia, Cachexia and Wasting Disorders (n ¼ 2). The SARC-CalF had low to moderate sensitivity (45.9%-57.2%) and high specificity (87.7%-91.3%) according to the EWGSOP (n ¼ 5), AWGS (n ¼ 4), FNIH (n ¼ 3), and IWGS (n ¼ 3). Conclusions and Implications: Despite the good reliability of the SARC-F, its low to moderate sensitivity and moderate to high specificity make it nonoptimal to use for sarcopenia screening. It is recommended to apply the diagnostic criteria for sarcopenia without screening.

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Comparing SARC-F with SARC-CalF for screening sarcopenia in advanced cancer patients

Cited by 41 publications

References 31 publications

Comparison of revised EWGSOP2 criteria of sarcopenia in patients with cancer using different parameters of muscle mass

Comparison of revised EWGSOP2 criteria of sarcopenia in patients with cancer using different parameters of muscle mass

Screening Tools for Sarcopenia

Reliability and Concurrent Validity of the SARC-F and Its Modified Versions: A Systematic Review and Meta-Analysis

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