Evidence map›Paper›PMID 37974546›Full record

ArticleJournal of the American Geriatrics Society2024

Geriatric assessment-derived deficit accumulation and patient-reported treatment burden in older adults with bladder cancer.

Tullika Garg, Katie Frank, Alicia Johns, Kirstin Rabinowitz, John F Danella, H Lester Kirchner, Matthew E Nielsen, Carmit K McMullen, Terrence E Murphy, Harvey J Cohen

Open access · hybridAbstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.9field-weighted citation impact, top 14% 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

5 citing papers in PubMed, 6 citations in OpenAlex.

  1. Measuring treatment burden with the treatment burden questionnaire (TBQ): a narrative literature review and implications for geriatric research and clinical practice.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 7 institutions in 1 country.

Tullika GargDepartment of Urology, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA.ORCID 0000-0003-2679-7460
Katie FrankBiostatistics Core, Geisinger, Danville, Pennsylvania, USA.
Alicia JohnsBiostatistics Core, Geisinger, Danville, Pennsylvania, USA.
Kirstin RabinowitzInvestigator Initiated Research Operations, Geisinger, Danville, Pennsylvania, USA.
John F DanellaDepartment of Urology, Geisinger, Danville, Pennsylvania, USA.
H Lester KirchnerDepartment of Population Health Sciences, Geisinger, Danville, Pennsylvania, USA.
Matthew E NielsenDepartment of Urology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA.
Carmit K McMullenCenter for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA.
Terrence E MurphyDepartment of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA.ORCID 0000-0002-9649-517X
Harvey J CohenCenter for the Study of Aging and Human Development, Duke University School of Medicine, Durham, North Carolina, USA.
Geisinger Medical Center · USDuke University · USGeisinger Health System · USKaiser Permanente Center for Health Research · USPenn State Milton S. Hershey Medical Center · USPennsylvania State University · USUniversity of North Carolina at Chapel Hill · US

Funding

Yale Study Support Suite (YES3): Dashboard and Web Portal Software Supporting Research Workflow through integrated, customizable REDCap External ModulesP30AG021342 · NIA · YALE UNIVERSITY · PI Lauren Ferrante · 2002 to 2026
$37.9M
Penn State Clinical and Translational Science InstituteUL1TR002014 · NCATS · PENNSYLVANIA STATE UNIV HERSHEY MED CTR · PI KRASCHNEWSKI, JENNIFER L. · 2016 to 2025
$33.7M
Resource Core 3 - Metabolomics CoreP30AG028716 · NIA · DUKE UNIVERSITY · PI CATHLEEN S COLON-EMERIC, Susan Nicole Hastings · 2006 to 2026
$24.6M
Geriatric Conditions and Treatment Burden in Older Adults with Non-Muscle-Invasive Bladder Cancer and Their CaregiversR03AG064382 · NIA · GEISINGER CLINIC · PI GARG, TULLIKA · 2019 to 2020
$272k
NCATS NIH HHS UL1 TR002014NIA NIH HHS P30 AG021342NIA NIH HHS P30AG021342NIA NIH HHS P30 AG028716NIA NIH HHS P30AG028716NIA NIH HHS R03 AG064382NIA NIH HHS R03AG064382
6 · The paper itself

Abstract

backgroundWhen a person's workload of healthcare exceeds their resources, they experience treatment burden. At the intersection of cancer and aging, little is known about treatment burden. We evaluated the association between a geriatric assessment-derived Deficit Accumulation Index (DAI) and patient-reported treatment burden in older adults with early-stage, non-muscle-invasive bladder cancer (NMIBC).

methodsWe conducted a cross-sectional survey of older adults with NMIBC (≥65 years). We calculated DAI using the Cancer and Aging Research Group's geriatric assessment and measured urinary symptoms using the Urogenital Distress Inventory-6 (UDI-6). The primary outcome was Treatment Burden Questionnaire (TBQ) score. A negative binomial regression with LASSO penalty was used to model TBQ. We further conducted qualitative thematic content analysis of responses to an open-ended survey question ("What has been your Greatest Challenge in managing medical care for your bladder cancer") and created a joint display with illustrative quotes by DAI category.

resultsAmong 119 patients, mean age was 78.9 years (SD 7) of whom 56.3% were robust, 30.3% pre-frail, and 13.4% frail. In the multivariable model, DAI and UDI-6 were significantly associated with TBQ. Individuals with DAI above the median (>0.18) had TBQ scores 1.94 times greater than those below (adjusted IRR 1.94, 95% CI 1.33-2.82). Individuals with UDI-6 greater than the median (25) had TBQ scores 1.7 times greater than those below (adjusted IRR 1.70, 95% CI 1.16-2.49). The top 5 themes in the Greatest Challenge question responses were cancer treatments (22.2%), cancer worry (19.2%), urination bother (18.2%), self-management (18.2%), and appointment time (11.1%).

conclusionsDAI and worsening urinary symptoms were associated with higher treatment burden in older adults with NMIBC. These data highlight the need for a holistic approach that reconciles the burden from aging-related conditions with that resulting from cancer treatment.

Indexed as

Non-Muscle Invasive Bladder NeoplasmsUrinary Bladder NeoplasmsAgedCross-Sectional StudiesGeriatric AssessmentHumansPatient Reported Outcome Measuresbladder cancergeriatric assessmentgeriatric oncologytreatment burdenurinary symptoms

Identifiers

PMID37974546
PMCPMC10922080
OpenAlexW4388768101

What OpenQuestion holds

Textmetadata
LicenceTDM
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.