Evidence map›Paper›PMID 41702290›Full record

ArticleJournal of geriatric oncology2026

Screening for frailty and malnutrition in a multidisciplinary head and neck cancer program.

Eden R Brauer, Stephanie Lazaro, Denice R Economou, David Rapkin, Deborah J Wong, Maie A St John

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of geriatric oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

6 authors.

Eden R BrauerSchool of Nursing, University of California, Los Angeles (UCLA), Los Angeles, California, USA; Multidisciplinary Head and Neck Cancer Program, University of California, Los Angeles (UCLA), Los Angeles, California, USA. Electronic address: ebrauer@ucla.edu.
Stephanie LazaroSchool of Nursing, University of California, Los Angeles (UCLA), Los Angeles, California, USA; Multidisciplinary Head and Neck Cancer Program, University of California, Los Angeles (UCLA), Los Angeles, California, USA.
Denice R EconomouSchool of Nursing, University of California, Los Angeles (UCLA), Los Angeles, California, USA.
David RapkinMultidisciplinary Head and Neck Cancer Program, University of California, Los Angeles (UCLA), Los Angeles, California, USA; Department of Head & Neck Surgery, David Geffen School of Medicine at UCLA, University of California, Los Angeles (UCLA), Los Angeles, California, USA.
Deborah J WongMultidisciplinary Head and Neck Cancer Program, University of California, Los Angeles (UCLA), Los Angeles, California, USA; Division of Hematology/Oncology, Department of Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles (UCLA), Los Angeles, California, USA.
Maie A St JohnMultidisciplinary Head and Neck Cancer Program, University of California, Los Angeles (UCLA), Los Angeles, California, USA; Department of Head & Neck Surgery, David Geffen School of Medicine at UCLA, University of California, Los Angeles (UCLA), Los Angeles, California, USA.

Funding

Harnessing the EHR for the Delivery of Supportive Care in an Oncology SettingK08CA252615 · NCI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI BRAUER, EDEN R. · 2021 to 2025
$934k
NCI NIH HHS K08 CA252615
6 · The paper itself

Abstract

introductionFrailty and malnutrition are strong predictors of adverse outcomes in patients with head and neck cancer, yet remain underassessed in routine clinical care. This project aimed to develop, implement, and evaluate a standardized screening process for frailty and malnutrition in a multidisciplinary head and neck cancer program to identify high-risk patients and inform treatment planning. MATERIALS AND

methodsThrough a quality improvement initiative, a multidisciplinary team integrated the Risk Analysis Index for Cancer (RAI-C) for frailty and Malnutrition Screening Tool (MST) into routine intake for new referrals of patients with head and neck cancer. Implementation was evaluated across three domains: feasibility, measured through completion rates, acceptability, assessed using clinician feedback via a survey, and impact on patient outcomes, using survival analysis.

resultsAmong 585 eligible patients, 488 (83.4%) were successfully screened. The cohort (mean age 63.1 years, 64% male) demonstrated high frailty prevalence with 57.2% categorized as frail (RAI-C score ≥ 37) and 14.3% at risk for malnutrition (MST score ≥ 2). In multivariable analysis adjusted for tumor site, treatment intensity, and comorbidities, frail patients had a more than 3-fold increased mortality risk compared to non-frail patients (adjusted HR 3.07, 95% CI 1.50-6.30, p = 0.002). Similarly, malnourished patients showed a 2.8-fold increased mortality risk compared to non-malnourished patients (adjusted HR 2.77, 95% CI 1.52-5.03, p < 0.001). Clinician feedback (n = 14) emphasized the value of screening in promoting "whole person" treatment planning, with suggestions for developing standardized pathways for interventions based on screening results. DISCUSSION: Implementing frailty and malnutrition screening in multidisciplinary head and neck cancer care is feasible, acceptable to clinicians, and identifies patients at significantly higher mortality risk. The strong association between screening results and survival validates these tools' clinical utility and supports their integration into routine practice. Future directions include developing a structured prehabilitation program targeted to modifiable risk factors identified through screening to potentially improve outcomes in this vulnerable population.

Indexed as

FrailtyGeriatric AssessmentHead and Neck NeoplasmsMalnutritionMass ScreeningAgedAged, 80 and overFeasibility StudiesFemaleHumansMaleMiddle AgedNutrition AssessmentQuality ImprovementRisk AssessmentFrailtyHead and neck cancerImplementationMalnutritionScreening

Identifiers

PMID41702290
PMCPMC13317500

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Registered trials

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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.