Reliability, Validity, and Feasibility of a Computer-Based Geriatric Assessment for Older Adults With Cancer

Abstract

QUESTION ASKED: Does a computer-based approach for collecting geriatric assessment information provide a practical and efficient means of obtaining reliable and reproducible data from older adults with cancer?SUMMARY ANSWER: Computer-based geriatric assessment provides a feasible, reliable, and valid approach in older adults with cancer. WHAT WE DID:Older patients ($ 65 years) with cancer were randomly assigned to one of four treatment arms to compare the feasibility, reliability, and validity of two computer-based platforms for geriatric assessment with traditional paper-and-pencil data capture.WHAT WE FOUND: Completion times were similar for computer-based and paper-and-pencil assessments (Fig), and data gathered via computer-based assessment showed high test-retest reliability as well as internal consistency. BIAS, CONFOUNDING FACTOR(S), REAL-LIFE IMPLICATIONS:Many of the patients in our study were white, non-Hispanic, and college-educated older adults. This patient population may be more comfortable using computer technologies than other demographic groups; thus our results may not be generalizable to other segments of the patient population. Older patients with cancer are at increased risk for treatment toxicity. Geriatric assessment captures a range of physiological and psychological metrics that predict toxicity and survival, and thus have high utility in guiding interventions. In the current study, we found that computer-based geriatric assessment provides an efficient method for acquiring reliable and valid data. Adoption of computer-based geriatric assessment into oncology practice thus can provide a cost-and time-efficient approach for acquiring high-value data to be used in formulating treatment decisions for older adults with cancer. Completion Time (minutes) Abstract PurposeThe goal of this study was to evaluate the feasibility, reliability, and validity of a computerbased geriatric assessment via two methods of electronic data capture (SupportScreen and REDCap) compared with paper-and-pencil data capture among older adults with cancer. MethodsEligible patients were $ 65 years old, had a cancer diagnosis, and were fluent in English.Patients were randomly assigned to one of four arms, in which they completed the geriatric assessment twice: (1) REDCap and paper and pencil in sessions 1 and 2; (2) REDCap in both sessions; (3) SupportScreen and paper and pencil in sessions 1 and 2; and (4) SupportScreen in both sessions. The feasibility, reliability, and validity of the computer-based geriatric assessment compared with paper and pencil were evaluated. ResultsThe median age of participants (N = 100) was 71 years (range, 65 to 91 years) and the diagnosis was solid tumor (82%) or hematologic malignancy (18% ). There were no significant differences in completion times between SupportScreen and paper and pencil (P = .50). The computer-based geriatric assessment was feasible. Few participants (8%) needed help with completing the geriatric assessment (REDCap, n = 7 and SupportScreen, n = 1), 89% reported th...

Geriatric assessment among older adults receiving intensive therapy for acute myeloid leukemia: Report of CALGB 361006 (Alliance)

“…Use of tablets for direct data capture can further minimize missing data and staff time. [29,30] Attrition is a particular challenge in a dynamic patient population with high morbidity. While some attrition is unavoidable, collecting the GA/patient-reported outcome data as an integrated part of the treatment trial, rather than as a companion study requiring separate consent, can maximize participation and further minimize opportunities for missed assessments.…”

What Every Oncologist Should Know About Geriatric Assessment for Older Patients With Cancer: Young International Society of Geriatric Oncology Position Paper

“…8,9,87 We recommend mailing the self-administered portions of the geriatric assessment to patients before their appointment so they can complete these at home to limit disruptions to clinic workflow and to allow patients to complete the geriatric assessment at their leisure. If they are unable to complete the assessment at home, patients can complete these in the clinic while waiting to be seen by their oncologist.…”

“…7 These geriatric assessment tools were subsequently simplified and transferred to oncology clinics for the assessment of older patients with cancer. [8][9][10] As shown in Table 1, a geriatric assessment includes an assessment of several domains, including functional status, psychological health, polypharmacy, comorbidity, nutrition, social support, and cognition. There are several well-validated tools available to assess these domains.…”

Effects of cancer history on functional age and mortality

“…In addition, GA has been shown to be effective when using self-administered mail-in or electronic questionnaires. 17,36,37 Women who did not complete the 2004 questionnaire and specifically the questions related to the current analysis, or who had more contact and assessment with the medical system, may have reported more deficits. The prospective cohort design, predominance of early-stage disease, and lengthy time between cancer diagnosis and assessment of deficits may reduce the potential for differential reporting by cancer status.…”