The Development of Geriatric Assessment and Intervention Guidelines for an Online Geriatric Assessment Tool: A Canadian Modified Delphi Panel Study

Abstract

Background: There are no guidelines available for what assessment tools to use in a patient’s self-completed online geriatric assessment (GA) with management recommendations. Therefore, we used a modified Delphi approach with Canadian expert clinicians to develop a consensus online GA plus recommendations tool. Methods: The panel consisted of experts in geriatrics, oncology, nursing, and pharmacy. Experts were asked to rate the importance and feasibility of assessments and interventions to be included in an online GA for patients. The items included in the first round were based on guidelines for in-person GA and literature review. The first two rounds were conducted using an online survey. A virtual 2 h meeting was held to discuss the items where no consensus was reached and then voted on in the final round. Results: 34 experts were invited, and 32 agreed to participate. In round 1, there were 85 items; in round 2, 50 items; and in round 3, 25 items. The final tool consists of fall history, assistive device use, weight loss, medication review, need help taking medication, social supports, depressive symptoms, self-reported vision and hearing, and current smoking status and alcohol use. Conclusion: This first multidisciplinary consensus on online GA will benefit research and clinical care for older adults with cancer.

Virtual geriatric and frailty assessment for older adults with cancer

“…Some months earlier, in 2022, a dedicated expert panel issued a clinical practice guideline on how to perform an online CGA in older adults with cancer based on a modified Delphi panel methodology approach [15▪▪]. The sample of experts consisted in 32 participants from different healthcare fields (medical and radiation oncologists, surgeons, geriatricians, pharmacists and nurses, among other disciplines) who after three rounds of voting and meetings, agreed on a consensus on what a virtual CGA tools should be routinely used when performing online assessments, out of nine CGA domains and 85 indicators.…”

“…Although there are clinical practice guidelines on how to perform online assessments in older adults with cancer [15▪▪], the evidence supporting the recommendations is scarce, and mostly based on expert consensus. Nonetheless, the feasibility and reproducibility of online assessments in non-cancer populations should be used by the scientific community to validate tools for their specific use in cancer patients.…”