Feasibility of computer-based self-administered Cancer-Specific Geriatric Assessment in older patients with gastrointestinal malignancy

摘要

Background. The Cancer-Specific Geriatric Assessment (CSGA) is a primarily self-administered paper survey of validated measures. Methods. We developed and tested the feasibility of a computer- based CSGA in patients ??70 years of age who were receiving treatment for gastrointestinal malignancies at the Dana-Farber Cancer Institute. From December 2009 to June 2011, patientswereinvited tocompletetheCSGAat baseline (start of new treatment) and follow-up (at the first of 4 months later or within 4 weeks of completing treatment). Feasibility endpoints were proportion of eligible patients consented, proportion completing CSGA at baseline and follow- up,timetocompleteCSGA,andproportion of physicians reporting CSGA results that led to a change in clinical decision- making. Results. Of the 49 eligible patients, 38 consented (76% were treatment naive). Median age was 77 years (range: 70-89 years), and 48% were diagnosed with colorectal cancer. Mean physician-rated Karnofsky Performance Status was 87.5 at baseline (SD 8.4)and83.5 at follow-up (SD 8). At baseline, 92% used a touchscreen computer; 97% completed the CSGA (51% independently). At follow-up, all patients used a touchscreen computer; 71% completed the CSGA (41% independently). Mean time to completion was 23 minutes at baseline (SD 8.4) and 20 minutes at follow-up (SD 5.1). The CSGA added information to clinical assessment for 75% at baseline (n=27) and65%at follow-up (n=17), but it did not alter immediate clinical decision-making. Conclusion. The computer-based CSGA feasibility endpoints were met, although approximately half of patients required assistance. The CSGA added information to clinical assessmentbutdidnotaffect clinical decision-making, possiblydue to limited alternate treatment options in this subset of patients. ? AlphaMed Press.