BACKGROUND: Structured care processes that provide a framework for how oncologists can incorporate geriatric assessment (GA) into clinical practice could improve outcomes for vulnerable older adults with cancer, a growing population at high risk of toxicity from cancer treatment. We sought to obtain consensus from an expert panel on the use of GA in clinical practice and to develop algorithms of GA-guided care processes. METHODS: The Delphi technique, a well-recognized structured and reiterative process to reach consensus, was used. Participants were geriatric oncology experts who attended NIH-funded U13 or Cancer and Aging Research Group conferences. Consensus was defined as an interquartile range of 2 or more units, or 66.7% or greater, selecting a utility/helpfulness rating of 7 or greater on a 10-point Likert scale. For nominal data, consensus was defined as agreement among 66.7% or more of the group. RESULTS: From 33 invited, 30 participants completed all 3 rounds. Most experts (75%) used GA in clinical care, and the remainder were involved in geriatric oncology research. The panel met consensus that "all patients aged 75 years or older and those who are younger with age-related health concerns" should undergo GA and that all domains (function, physical performance, comorbidity/polypharmacy, cognition, nutrition, psychological status, and social support) should be included. Consensus was met for how GA could guide nononcologic interventions and cancer treatment decisions. Algorithms for GA-guided care processes were developed. CONCLUSIONS: This Delphi investigation of geriatric oncology experts demonstrated that GA should be performed for older patients with cancer to guide care processes.
BACKGROUND: Structured care processes that provide a framework for how oncologists can incorporate geriatric assessment (GA) into clinical practice could improve outcomes for vulnerable older adults with cancer, a growing population at high risk of toxicity from cancer treatment. We sought to obtain consensus from an expert panel on the use of GA in clinical practice and to develop algorithms of GA-guided care processes. METHODS: The Delphi technique, a well-recognized structured and reiterative process to reach consensus, was used. Participants were geriatric oncology experts who attended NIH-funded U13 or Cancer and Aging Research Group conferences. Consensus was defined as an interquartile range of 2 or more units, or 66.7% or greater, selecting a utility/helpfulness rating of 7 or greater on a 10-point Likert scale. For nominal data, consensus was defined as agreement among 66.7% or more of the group. RESULTS: From 33 invited, 30 participants completed all 3 rounds. Most experts (75%) used GA in clinical care, and the remainder were involved in geriatric oncology research. The panel met consensus that "all patients aged 75 years or older and those who are younger with age-related health concerns" should undergo GA and that all domains (function, physical performance, comorbidity/polypharmacy, cognition, nutrition, psychological status, and social support) should be included. Consensus was met for how GA could guide nononcologic interventions and cancer treatment decisions. Algorithms for GA-guided care processes were developed. CONCLUSIONS: This Delphi investigation of geriatric oncology experts demonstrated that GA should be performed for older patients with cancer to guide care processes.
Authors: Paul A Harris; Robert Taylor; Robert Thielke; Jonathon Payne; Nathaniel Gonzalez; Jose G Conde Journal: J Biomed Inform Date: 2008-09-30 Impact factor: 6.317
Authors: Arti Hurria; Kayo Togawa; Supriya G Mohile; Cynthia Owusu; Heidi D Klepin; Cary P Gross; Stuart M Lichtman; Ajeet Gajra; Smita Bhatia; Vani Katheria; Shira Klapper; Kurt Hansen; Rupal Ramani; Mark Lachs; F Lennie Wong; William P Tew Journal: J Clin Oncol Date: 2011-08-01 Impact factor: 44.544
Authors: Ivan R Diamond; Robert C Grant; Brian M Feldman; Paul B Pencharz; Simon C Ling; Aideen M Moore; Paul W Wales Journal: J Clin Epidemiol Date: 2014-04 Impact factor: 6.437
Authors: Arti Hurria; Constance T Cirrincione; Hyman B Muss; Alice B Kornblith; William Barry; Andrew S Artz; Linda Schmieder; Rafat Ansari; William P Tew; Douglas Weckstein; Jeffrey Kirshner; Kayo Togawa; Kurt Hansen; Vani Katheria; Richard Stone; Ilene Galinsky; John Postiglione; Harvey Jay Cohen Journal: J Clin Oncol Date: 2011-02-28 Impact factor: 44.544
Authors: R McCorkle; N E Strumpf; I F Nuamah; D C Adler; M E Cooley; C Jepson; E J Lusk; M Torosian Journal: J Am Geriatr Soc Date: 2000-12 Impact factor: 5.562
Authors: Matthew T Seymour; Lindsay C Thompson; Harpreet S Wasan; Gary Middleton; Alison E Brewster; Stephen F Shepherd; M Sinead O'Mahony; Timothy S Maughan; Mahesh Parmar; Ruth E Langley Journal: Lancet Date: 2011-05-11 Impact factor: 79.321
Authors: Christine Miaskowski; Melisa L Wong; Bruce A Cooper; Judy Mastick; Steven M Paul; Katherine Possin; Michael Steinman; Janine Cataldo; Laura B Dunn; Christine Ritchie Journal: J Pain Symptom Manage Date: 2017-07-15 Impact factor: 3.612
Authors: Lisa M Lowenstein; Robert J Volk; Richard Street; Marie Flannery; Allison Magnuson; Ronald Epstein; Supriya G Mohile Journal: J Geriatr Oncol Date: 2018-06-06 Impact factor: 3.599
Authors: Jean V Joseph; Ralph Brasacchio; Chunkit Fung; Jay Reeder; Kevin Bylund; Deepak Sahasrabudhe; Shu Yuan Yeh; Ahmed Ghazi; Patrick Fultz; Deborah Rubens; Guan Wu; Eric Singer; Edward Schwarz; Supriya Mohile; James Mohler; Dan Theodorescu; Yi Fen Lee; Paul Okunieff; David McConkey; Hani Rashid; Chawnshang Chang; Yves Fradet; Khurshid Guru; Janet Kukreja; Gerald Sufrin; Yair Lotan; Howard Bailey; Katia Noyes; Seymour Schwartz; Kathy Rideout; Gennady Bratslavsky; Steven C Campbell; Ithaar Derweesh; Per-Anders Abrahamsson; Mark Soloway; Leonard Gomella; Dragan Golijanin; Robert Svatek; Thomas Frye; Seth Lerner; Ganesh Palapattu; George Wilding; Michael Droller; Donald Trump Journal: Bladder Cancer Date: 2018-10-03
Authors: Sukeshi Patel Arora; Gabor Liposits; Susan Caird; Richard F Dunne; Gordon Taylor Moffat; David Okonji; Maria Grazia Rodriquenz; Divyanshu Dua; Efrat Dotan Journal: J Geriatr Oncol Date: 2019-11-06 Impact factor: 3.599
Authors: Kah Poh Loh; Supriya G Mohile; Ronald M Epstein; Colin McHugh; Marie Flannery; Eva Culakova; Lianlian Lei; Megan Wells; Nikesha Gilmore; Dilip Babu; Mary I Whitehead; William Dale; Arti Hurria; Marsha Wittink; Allison Magnuson; Alison Conlin; Melanie Thomas; Jeffrey Berenberg; Paul R Duberstein Journal: Cancer Date: 2019-03-28 Impact factor: 6.860
Authors: Allison Magnuson; Heather Allore; Harvey Jay Cohen; Supriya G Mohile; Grant R Williams; Andrew Chapman; Martine Extermann; Rebecca L Olin; Valerie Targia; Amy Mackenzie; Holly M Holmes; Arti Hurria Journal: J Geriatr Oncol Date: 2016-07-05 Impact factor: 3.599