S Bonanad1, J De la Rubia2, M Gironella3, E Pérez Persona4, B González5, C Fernández Lago6, M Arnan7, M Zudaire8, J A Hernández Rivas9, A Soler10, C Marrero11, C Olivier12, A Altés13, D Valcárcel3, M T Hernández5, I Oiartzabal4, R Fernández Ordoño9, M Arnao14, A Esquerra10, J Sarrá7, E González-Barca7, J González15, X Calvo16, M Nomdedeu16, A García Guiñón17, A Ramírez Payer18, A Casado19, S López20, M Durán20, M Marcos20, A J Cruz-Jentoft21. 1. Hematology Department, H. U. La Fe, Av. Fernando Abril Martorell, 106, 46026 Valencia, Spain. Electronic address: sbonanad@gmail.com. 2. Hematology Department, H. U. La Fe, Av. Fernando Abril Martorell, 106, 46026 Valencia, Spain. 3. Hematology Department, H. U. Vall d'Hebrón, Passeig de la Vall d'Hebron, 119-129, 08035 Barcelona, Spain. 4. Hematology Department, H. U. Txagorritxu, c/ Jose Atxotegi, s/n, 01009 Vitoria-Gasteiz, Álava, Spain. 5. Hematology Department, H. U. de Canarias, Ctra. Ofra, s/n, 38320 San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain. 6. Hematology Department, C.H.U. A Coruña, As Xubias, 84, 15006, A Coruña, Spain. 7. Hematology Department, Catalan Institute of Oncology, IDIBELL, Hospital Duran i Reynals, Avinguda Granvia de l'Hospitalet, 199-203 08908 l'Hospitalet de Llobregat, Barcelona, Spain. 8. Hematology Department, C.H. de Navarra, Av. Pío XII, 36, 31008 Pamplona, Navarra, Spain. 9. Hematology Department, H.U. Infanta Leonor, Avenida Gran Vía del Este, 80, 28031 Madrid, Spain. 10. Hematology Department, C.S. Parc Taulí, Parc Taulí, 1, 08208 Sabadell, Barcelona, Spain. 11. Hematology Department, H. Ntra. Sra. de La Candelaria, Carretera del Rosario, 145, 38010 Santa Cruz de Tenerife, Spain. 12. Hematology Department, C.H. de Segovia, c/ de Miguel Servet, s/n, Segovia, Spain. 13. Hematology Department, H. Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain. 14. Hematology Department, H.U. de La Ribera, Carretera Corbera, km 1, 46600 Alzira, Valencia, Spain. 15. Hematology Department, H.U. Virgen del Rocío, Avenida Manuel Siurot, s/n, 41013 Sevilla, Spain. 16. Hematology Department, Hospital Clínic de Barcelona, Carrer Villarroel, 170, 08036 Barcelona, Spain. 17. Hematology Department, H.U. Arnau de Vilanova, Avenida Alcalde Rovira Roure, 80, 25198 Lleida, Spain. 18. Hematology Department, H.U. Central de Asturias, Calle Carretera de Rubín, s/n, 33011 Oviedo, Spain. 19. U. Autónoma de Madrid, Dynamic Science S.L., c/Azcona, 31, 28028 Madrid, Spain. 20. Celgene S.L.U., Paseo de Recoletos, 37, 28004 Madrid, Spain. 21. Geriatric Department, H.U. Ramón y Cajal, Ctra. de Colmenar Viejo, km. 9,100, 28034 Madrid, Spain.
Abstract
OBJECTIVES: The purpose of this study was to develop a new brief, comprehensive geriatric assessment scale for older patients diagnosed with different hematological malignancies, the Geriatric Assessment in Hematology (GAH scale), and to determine its psychometric properties. MATERIALS AND METHODS: The 30-item GAH scale was designed through a multi-step process to cover 8 relevant dimensions. This is an observational study conducted in 363 patients aged≥65years, newly diagnosed with different hematological malignancies (myelodysplasic syndrome/acute myeloblastic leukemia, multiple myeloma, or chronic lymphocytic leukemia), and treatment-naïve. The scale psychometric validation process included the analyses of feasibility, floor and ceiling effect, validity and reliability criteria. RESULTS: Mean time taken to complete the GAH scale was 11.9±4.7min that improved through a learning-curve effect. Almost 90% of patients completed all items, and no floor or ceiling effects were identified. Criterion validity was supported by reasonable correlations between the GAH scale dimensions and three contrast variables (global health visual analogue scale, ECOG and Karnofsky), except for comorbidities. Factor analysis (supported by the scree plot) revealed nine factors that explained almost 60% of the total variance. Moderate internal consistency reliability was found (Cronbach's α: 0.610), and test-retest was excellent (ICC coefficients, 0.695-0.928). CONCLUSION: Our study suggests that the GAH scale is a valid, internally reliable and a consistent tool to assess health status in older patients with different hematological malignancies. Future large studies should confirm whether the GAH scale may be a tool to improve clinical decision-making in older patients with hematological malignancies.
OBJECTIVES: The purpose of this study was to develop a new brief, comprehensive geriatric assessment scale for older patients diagnosed with different hematological malignancies, the Geriatric Assessment in Hematology (GAH scale), and to determine its psychometric properties. MATERIALS AND METHODS: The 30-item GAH scale was designed through a multi-step process to cover 8 relevant dimensions. This is an observational study conducted in 363 patients aged≥65years, newly diagnosed with different hematological malignancies (myelodysplasic syndrome/acute myeloblastic leukemia, multiple myeloma, or chronic lymphocytic leukemia), and treatment-naïve. The scale psychometric validation process included the analyses of feasibility, floor and ceiling effect, validity and reliability criteria. RESULTS: Mean time taken to complete the GAH scale was 11.9±4.7min that improved through a learning-curve effect. Almost 90% of patients completed all items, and no floor or ceiling effects were identified. Criterion validity was supported by reasonable correlations between the GAH scale dimensions and three contrast variables (global health visual analogue scale, ECOG and Karnofsky), except for comorbidities. Factor analysis (supported by the scree plot) revealed nine factors that explained almost 60% of the total variance. Moderate internal consistency reliability was found (Cronbach's α: 0.610), and test-retest was excellent (ICC coefficients, 0.695-0.928). CONCLUSION: Our study suggests that the GAH scale is a valid, internally reliable and a consistent tool to assess health status in older patients with different hematological malignancies. Future large studies should confirm whether the GAH scale may be a tool to improve clinical decision-making in older patients with hematological malignancies.