Who needs a comprehensive geriatric assessment? A French Onco-Geriatric Screening tool (OGS)

Objectives: To establish the accuracy of an Onco-Geriatric Screening tool (OGS) to be used by oncologists to identify patients age 75 and over whose treatment could be optimized by undergoing a Comprehensive Geriatric Assessment (CGA). Materials and Methods: Patients (174) were recruited for a prospective observational study. The OGS is a short 10-item score exploring five frailty risks. This test was performed by the oncologist. Each patient recruited also completed a reference test (geriatric assessment battery) performed by a geriatrician. For both tests, we identified the number of frailty risk factors (0 to 5): patients with no risk factors were considered as "fit"; patients presenting with 1 to 3 risk factors were "vulnerable"; and patients presenting 24 risk factors were "frail". Results: Patients (126; 72%) underwent both the OGS and the reference test. According to the OGS, 14 patients (11%) were "fit", 102(81%) were "vulnerable" and 10(8%) were "frail". According to the reference test, 14 patients (11%) were "fit", 99 (79%) were "vulnerable" and 13 (10%) were "frail". The OGS had a sensitivity of 88% (CI 95%: 80% to 93%) and a specificity of 44% (CI 95%: 28% to 63%). Conclusion: The OGS is a short decision-making algorithm in French with high sensitivity that can easily help to identify vulnerable patients for whom a CGA could potentially optimize their cancer treatment. This tool is easy to implement and could be used by oncologists at the time of the first consultation. (C) 2010 Elsevier Ltd. All rights reserved.