Diagnostic Accuracy of Self-Reported Tools for Frailty Assessment in Older Adults With Cancer: A Diagnostic Meta-Analysis

IF 1.6 4区医学 Q4 GERIATRICS & GERONTOLOGY

International Journal of Older People Nursing Pub Date : 2025-05-15 DOI:10.1111/opn.70030

Dwi Apriadi, Saranya Pimolkatekul, Evi Susanti, Hsiao-Yean Chiu, Hui-Chuan Huang

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Abstract

Introduction

Questionnaires are commonly used for rapid frailty assessment. However, which scale is most appropriate for the identification of frailty in older adults with cancer remains unclear.

Objective

A diagnostic meta-analysis was conducted to examine the sensitivity and specificity of questionnaire-based assessment tools in detecting frailty among older adults with cancer.

Methods

Five databases were searched for eligible studies from inception to January 26, 2025. Study quality was evaluated using the revised Quality Assessment of Diagnostic Accuracy Studies tool. The pooled sensitivity and specificity of the frailty assessment tools were assessed through a bivariate random-effects model. Factors influencing the heterogeneity of sensitivity and specificity values were assessed through moderator analysis, which comprised a subgroup analysis and metaregression.

Results

Five questionnaire-based tools (i.e., the Edmonton Frailty Scale, FRAIL scale, Groningen Frailty Indikator [GFI], Tilburg Frailty Indikator, and Vulnerable Elders Survey-13 [VES-13]) for assessing frailty in older adults with cancer were identified in the literature; the most commonly used were the GFI and VES-13. The sensitivity and specificity of the GFI (67% and 81%, respectively) and VES-13 (65% and 81%) were calculated. Studies with a high proportion of male participants had poorer GFI sensitivity. Older patient samples were associated with lower VES-13 sensitivity, and a high prevalence of frailty or patients having stage III–IV cancer was associated with higher sensitivity.

Conclusion

The GFI and VES-13 demonstrated high specificity but low sensitivity for frailty assessment in older adults with cancer. Frequent assessment with the GFI or VES-13 is recommended to improve frailty detection.

Implications for Practice

Health-care professionals, including oncology nurses, care managers, and oncologists, can incorporate the GFI and VES-13 into cancer care settings to improve early frailty detection and management.

Pre-Registration: The study protocol was registered at PROSPERO (CRD42024505836)

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老年癌症患者虚弱评估自我报告工具的诊断准确性：诊断荟萃分析

问卷调查通常用于快速虚弱评估。然而，对于识别老年癌症患者的虚弱程度，哪种标准最合适仍不清楚。目的进行诊断荟萃分析，以检验基于问卷的评估工具在检测老年癌症患者虚弱方面的敏感性和特异性。方法从数据库建立至2025年1月26日检索5个符合条件的研究。使用修订后的诊断准确性研究质量评估工具评估研究质量。通过双变量随机效应模型评估脆弱性评估工具的综合敏感性和特异性。通过调节因子分析评估影响敏感性和特异性值异质性的因素，调节因子分析包括亚组分析和元回归。结果在文献中确定了五种基于问卷的工具（即埃德蒙顿衰弱量表、虚弱量表、格罗宁根衰弱指标[GFI]、蒂尔堡衰弱指标和脆弱老年人调查-13 [VES-13]）用于评估老年癌症患者的衰弱；最常用的是GFI和VES-13。计算GFI的敏感性（67%）和特异性（81%），vs -13的敏感性（65%）和特异性（81%）。男性参与者比例高的研究具有较差的GFI敏感性。年龄较大的患者样本与较低的vs -13敏感性相关，体弱者或III-IV期癌症患者的高患病率与较高的敏感性相关。结论GFI和VES-13对老年癌症患者的虚弱评估具有高特异性和低敏感性。建议经常使用GFI或VES-13进行评估，以改善脆弱性检测。医疗保健专业人员，包括肿瘤护士、护理管理人员和肿瘤学家，可以将GFI和VES-13纳入癌症护理环境，以改善早期虚弱的检测和管理。预注册：研究方案已在PROSPERO注册（CRD42024505836）。

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来源期刊

International Journal of Older People Nursing Nursing-Gerontology

CiteScore

3.60

自引率

9.10%

发文量

期刊介绍： International Journal of Older People Nursing welcomes scholarly papers on all aspects of older people nursing including research, practice, education, management, and policy. We publish manuscripts that further scholarly inquiry and improve practice through innovation and creativity in all aspects of gerontological nursing. We encourage submission of integrative and systematic reviews; original quantitative, qualitative, and mixed methods research; secondary analyses of existing data; historical works; theoretical and conceptual analyses; evidence based practice projects and other practice improvement reports; and policy analyses. All submissions must reflect consideration of IJOPN''s international readership and include explicit perspective on gerontological nursing. We particularly welcome submissions from regions of the world underrepresented in the gerontological nursing literature and from settings and situations not typically addressed in that literature. Editorial perspectives are published in each issue. Editorial perspectives are submitted by invitation only.