Evidence map›Paper›PMID 37738290›Full record

SynthesisJournal of the National Cancer Institute2023

Effectiveness of geriatric assessment and management in older cancer patients: a systematic review and meta-analysis.

Mohammed Rashidul Anwar, Shant Torkom Yeretzian, Ana Patricia Ayala, Emma Matosyan, Henriette Breunis, Kathyrin Bote, Martine Puts, Mohammed Hassan Habib, Qixuan Li, Yeva Sahakyan and 2 more

Open access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of the National Cancer Institute, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 2 pooled it
6.6field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 37 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 2 countries.

Mohammed Rashidul AnwarInstitute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.ORCID 0000-0001-9778-4961
Shant Torkom YeretzianTurpanjian College of Health Sciences, American University of Armenia, Yerevan, Armenia.
Ana Patricia AyalaGerstein Science Information Centre, University of Toronto, Toronto, ON, Canada.
Emma MatosyanUniversity of Western Ontario, London, ON, Canada.
Henriette BreunisDepartment of Supportive Care, University Health Network, Toronto, ON, Canada.
Kathyrin BoteLawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
Martine PutsLawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
Mohammed Hassan HabibDepartment of Medicine, University Health Network, Toronto, ON, Canada.
Qixuan LiBiostatistics Research Unit, University Health Network, Toronto, ON, Canada.
Yeva SahakyanToronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, ON, Canada.
Shabbir M H AlibhaiInstitute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.
Lusine AbrahamyanInstitute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.ORCID 0000-0003-2788-4179
University Health Network · CAUniversity of Toronto · CAAmerican University of Armenia · AMWestern University · CA

Funding

Canada Research Chair in the Care of Frail Older AdultsCanadian Cancer Society #705046
6 · The paper itself

Abstract

backgroundFrailty and multimorbidity among older cancer patients affect treatment tolerance and efficacy. Comprehensive geriatric assessment and management is recommended to optimize cancer treatment, but its effect on various outcomes remains uncertain.

objectiveOur objective was to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) and cost-effectiveness studies comparing comprehensive geriatric assessment (with or without implementation of recommendations) to usual care in older cancer patients.

methodsWe searched MEDLINE, EMBASE, CINAHL, and Cochrane trials from inception to January 27, 2023, for RCTs and cost-effectiveness studies. Pooled estimates for outcomes were calculated using random-effects models.

resultsA total of 19 full-text articles representing 17 RCTs were included. Average participant age was 72-80 years, and 31%-62% were female. Comprehensive geriatric assessment type, mode of delivery, and evaluated outcomes varied across studies. Meta-analysis revealed no difference in risk of mortality (risk ratio [RR] = 1.08. 95% confidence interval [CI] = 0.91 to 1.29), hospitalization (RR = 0.92, 95% CI = 0.77 to 1.10), early treatment discontinuation (RR = 0.89, 95% CI = 0.67 to 1.19), initial dose reduction (RR = 0.99, 95% CI = 0.99 to 1.26), and subsequent dose reduction (RR = 0.87, 95% CI = 0.70 to 1.09). However, the risk of treatment toxicity was statistically significantly lower in the comprehensive geriatric assessment group (RR = 0.78, 95% CI = 0.70 to 0.86). No cost-effectiveness studies were identified.

conclusionCompared with usual care, comprehensive geriatric assessment was not associated with a difference in risk of mortality, hospitalization, treatment discontinuation, and dose reduction but was associated with a lower risk of treatment toxicity indicating its potential to optimize cancer treatment in this population. Further research is needed to evaluate cost-effectiveness.

Indexed as

Geriatric AssessmentNeoplasmsAgedAged, 80 and overFemaleHospitalizationHumansMaleOutcome Assessment, Health Care

Identifiers

PMID37738290
OpenAlexW4386953447

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.