Health-related quality of life with comprehensive geriatric assessment guided care versus usual care in older adults with cancer: A systematic review and meta-analysis of randomized trials

IF 5.5 2区医学 Q1 HEMATOLOGY Critical reviews in oncology/hematology Pub Date : 2024-07-14 DOI:10.1016/j.critrevonc.2024.104442

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Abstract

Background

To evaluate if comprehensive geriatric assessment (CGA)-guided care improves health-related quality of life (HRQL) in older adults with cancer compared to usual care.

Methods

Relevant randomized controlled trials (RCTs) were identified through biomedical databases. Meta-analyses using DerSimonian-Laird model summarized the difference in the mean change of HRQL scores from baseline across various time points, with evidence certainty assessed by the GRADE tool. Logistic regression via generalized estimating equations analyzed predictors of HRQL improvement.

Results

Potential improvement in the global HRQL score by CGA-guided care at 3 months (Cohen’s d 0.27, 95 % CI −0.03–0.58, moderate certainty), could not be excluded. Larger RCTs or those mandating CGA before initiating anti-cancer treatment were predictors of improved HRQL.

Conclusion

The effects of CGA-guided care on HRQL were variable. Larger RCTs and those mandating pre-treatment CGA tended to report improved HRQL.

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老年综合评估指导护理与常规护理对老年癌症患者健康相关生活质量的影响：随机试验的系统回顾和荟萃分析。

背景：评估老年病综合评估（CGA）指导下的护理是否能改善癌症老年人的健康相关生活质量：目的：评估与常规护理相比，老年医学综合评估（CGA）指导下的护理是否能改善癌症老年人的健康相关生活质量（HRQL）：方法：通过生物医学数据库确定相关的随机对照试验（RCT）。使用 DerSimonian-Laird 模型进行元分析，总结不同时间点 HRQL 评分与基线相比的平均变化差异，并使用 GRADE 工具评估证据的确定性。通过广义估计方程的逻辑回归分析了HRQL改善的预测因素：不排除在 3 个月时，CGA 指导下的护理可改善总体 HRQL 评分（Cohen's d 0.27，95% CI -0.03 至 0.58，中等确定性）。较大的RCT或在开始抗癌治疗前强制进行CGA的RCT是HRQL改善的预测因素：结论：CGA指导下的治疗对HRQL的影响各不相同。结论：CGA指导护理对HRQL的影响不尽相同，规模较大的RCT研究和规定在治疗前进行CGA的研究往往报告HRQL有所改善。

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来源期刊

Critical reviews in oncology/hematology 医学-血液学

CiteScore

11.00

自引率

3.20%

发文量

213

审稿时长

55 days

期刊介绍： Critical Reviews in Oncology/Hematology publishes scholarly, critical reviews in all fields of oncology and hematology written by experts from around the world. Critical Reviews in Oncology/Hematology is the Official Journal of the European School of Oncology (ESO) and the International Society of Liquid Biopsy.