收稿日期: 2022-12-21
网络出版日期: 2023-10-19
Quality appraisal of the frailty screening tools for cancer patients
目的 描述和评价癌症患者衰弱筛查工具的测量属性，为医护人员及研究者选择筛查工具提供参考依据。方法 检索中国知网、万方数据库、维普数据库、PubMed、Embase（Ovid）、CENTRAL、CINAHL、Web of Science、Scopus、PsycINFO，检索时限为建库至2022年5月24日，纳入开发或验证癌症患者衰弱筛查工具的研究。由2名研究人员独立进行文献筛选与资料提取，采用基于共识的健康测量工具选择标准指南中的偏倚风险评估清单、质量准则对纳入研究的方法学质量及工具的测量属性进行系统评价，应用改良版证据质量评价及推荐强度评级指南进行证据质量分级，并结合筛查工具的应用性评价，形成最终推荐意见。结果 共纳入19项研究，涉及16种癌症患者特异性衰弱筛查工具。所有工具均未进行跨文化效度/测量不变性、效标效度、测量误差和反应度测评。纳入工具的证据质量等级均为“中”或“低”，均为B类推荐。老年筛查工具-8和简化版老年综合评估是被验证次数较多的工具。结论 癌症患者衰弱筛查工具多样但质量整体不高。老年筛查工具-8和简化版老年综合评估在应用潜力上相对良好，可暂时推荐使用。未来仍需进一步验证性能，并引进和发展本土化癌症患者衰弱筛查工具。
梁冉 , 江琪 , 石佳景 , 黄铮 , 方一芳 , 吴炜炜 . 癌症患者衰弱筛查工具的质量评价[J]. 中华护理教育, 2023 , 20(10) : 1245 -1252 . DOI: 10.3761/j.issn.1672-9234.2023.10.016
Objectives To describe and evaluate the measurement properties of screening tools assessing the frailty for cancer patients，and to provide a reference for selecting screening tools. Methods CNKI，Wanfang database，VIP，PubMed，Embase（Ovid），CENTRAL，CINAHL，Web of Science，Scopus，PsycINFO databases were electronically searched to collect studies on the screening tools of assessing the frailty in cancer patients from their inception to May 24，2022. Two researchers screened articles and extracted data independently. Consensus-based Standards for the selection of health Measurement Instruments （COSMIN） risk of bias checklist and quality criteria were used to assess the methodological quality of the included studies and the measurement properties of the screening tools. The evidence rating of each measurement properties of the screening tools was evaluated by the modified grading of recommendation assessment，development of evaluation （GRADE），and the final recommendations were formulated based on the application evaluation of the screening tools. Results A total of 19 studies involving sixteen screening tools were included. None of the included screening tools was assessed cross-cultural validity/measurement invariance，criterion validity，measurement error or responsiveness. The included instruments were all rated as "moderate" or "low" in terms of quality of evidence and all tools’ level were B. The Geriatric-8 and abbreviated Comprehensive Geriatric Assessment were the more frequently validated tools. Conclusion The screening tools assessing frailty for cancer patients are diverse，but the overall quality of evidence is not high. The Geriatric-8 and abbreviated Comprehensive Geriatric Assessment have relatively good application potential and can be temporarily recommended for use. In the future，it is still necessary to further validate the properties，and introduce and develop localized frailty screening tools for cancer patients.
Key words： Cancer; Frailty; Screening tools; Measurement properties; Quality appraisal
| [1] | Ethun CG, Bilen MA, Jani AB, et al. Frailty and cancer:implica-tions for oncology surgery,medical oncology,and radiation onco-logy[J]. CA Cancer J Clin, 2017, 67(5):362-377. |
| [2] | Handforth C, Clegg A, Young C, et al. The prevalence and out-comes of frailty in older cancer patients:a systematic review[J]. Ann Oncol, 2015, 26(6):1091-1101. |
| [3] | 裴丽, 田昕玉, 窦昊颖, 等. 老年衰弱与慢性病的研究进展[J]. 中国老年学杂志, 2020, 40(20):4471-4473. |
| [3] | Pei L, Tian XY, Dou HY, et al. Research progress of senile weakness and chronic diseases[J]. Chin J Gerontol, 2020, 40(20):4471-4473. |
| [4] | 李智, 胡秀英. 老年肿瘤患者衰弱筛查工具及其应用研究进展[J]. 中国老年学杂志, 2018, 38(7):1786-1789. |
| [4] | Li Z, Hu XY. Research progress of debilitating screening tools for elderly cancer patients and their application[J]. Chin J Gerontol, 2018, 38(7):1786-1789. |
| [5] | 张妍妍, 姚俊涛. 衰弱筛查工具在老年肿瘤患者中应用的研究进展[J]. 肿瘤学杂志, 2020, 26(3):245-249. |
| [5] | Zhang YY, Yao JT. Research progress on application of frailty screening tools in elderly cancer patients[J]. J Chin Oncol, 2020, 26(3):245-249. |
| [6] | 丁玲玉, 陆金玲, 朱涵菲, 等. 消化道肿瘤患者衰弱的研究进展[J]. 中华现代护理杂志, 2021, 27(1):116-120. |
| [6] | Ding LY, Lu JL, Zhu HF, et al. Research progress on the frailty of gastrointestinal cancer patients[J]. Chin J Mod Nurs, 2021, 27(1):116-120. |
| [7] | Mokkink LB, Terwee CB, Patrick DL, et al. The COSMIN study reached international consensus on taxonomy,terminology,and definitions of measurement properties for health-related patient-reported outcomes[J]. J Clin Epidemiol, 2010, 63(7):737-745. |
| [8] | Mokkink LB, de Vet HCW, Prinsen CC, et al. COSMIN Risk of Bias checklist for systematic reviews of Patient-Reported Outcome Measures[J]. Qual Life Res, 2018, 27(5):1171-1179. |
| [9] | Terwee CB, Prinsen CC, Chiarotto A, et al. COSMIN methodo-logy for evaluating the content validity of patient-reported out-come measures:a Delphi study[J]. Qual Life Res, 2018, 27(5):1159-1170. |
| [10] | Prinsen CAC, Mokkink LB, Bouter LM, et al. COSMIN guide-line for systematic reviews of patient-reported outcome mea-sures[J]. Qual Life Res, 2018, 27(5):1147-1157. |
| [11] | Terwee CB, Bot SD, de Boer MR, et al. Quality criteria were proposed for measurement properties of health status question-naires[J]. J Clin Epidemiol, 2007, 60(1):34-42. |
| [12] | 陈祎婷, 沈蓝君, 彭健, 等. 改良版定量系统评价证据分级方法对患者报告结局测量工具的评价[J]. 解放军护理杂志, 2020, 37(10):57-60. |
| [12] | Chen YT, Shen LJ, Peng J, et al. Modified GRADE evaluation of COSMIN method for patient reported outcome measures[J]. Nurs J Chin PLA, 2020, 37(10):57-60. |
| [13] | 任芯雨, 古满平. 老年患者风险筛查工具在急诊护理中的应用研究进展[J]. 中国护理管理, 2023, 23(1):74-79. |
| [13] | Ren XY, Gu MP. Research progress in risk screening tools for elderly patients in acute care[J]. Chin Nurs Manag, 2023, 23(1):74-79. |
| [14] | Valéro S, Migeot V, Bouche G, et al. Who needs a comprehen-sive geriatric assessment? A French Onco-Geriatric Screening tool(OGS)[J]. J Geriatr Oncol, 2011, 2(2):130-136. |
| [15] | Bellera CA, Rainfray M, Mathoulin-Pélissier S, et al. Screening older cancer patients:first evaluation of the G-8 geriatric scree-ning tool[J]. Ann Oncol, 2012, 23(8):2166-2172. |
| [16] | Smets IH, Kempen GI, Janssen-Heijnen ML, et al. Four scree-ning instruments for frailty in older patients with and without cancer:a diagnostic study[J]. BMC Geriatr, 2014, 14:26. |
| [17] | Russo C, Giannotti C, Signori A, et al. Predictive values of two frailty screening tools in older patients with solid cancer:a comparison of SAOP2 and G8[J]. Oncotarget, 2018, 9(80):35056-35068. |
| [18] | Atakul E. Geriatric assessment in oncology:G8 screening tool validation and reliability study[J]. TJ Oncol, 2019, 34(4):236-242. |
| [19] | Bruijnen CP, Heijmer A, van Harten-Krouwel DG, et al. Valida-tion of the G8 screening tool in older patients with cancer considered for surgical treatment[J]. J Geriatr Oncol, 2021, 12(5):793-798. |
| [20] | Keng J, Szlbat K, Mitu J, et al. Usefulness of eight screening tools for predicting frailty and postoperative short-and long-term outcomes among older patients with cancer who qualify for abdominal surgery[J]. Eur J Surg Oncol, 2020, 46(11):2091-2098. |
| [21] | Chen SY, Chou WC, Lin YC, et al. Performance of two frailty screening tools among patients with cancer in Taiwan[J]. Biomed J, 2022, 45(2):361-369. |
| [22] | Martinez-Tapia C, Laurent M, Paillaud E, et al. Predicting frailty and geriatric interventions in older cancer patients:performance of two screening tools for seven frailty definitions-ELCAPA cohort[J]. Cancers (Basel), 2022, 14(1):244. |
| [23] | Petit-Monéger A, Rainfray M, Soubeyran P, et al. Detection of frailty in elderly cancer patients:improvement of the G8 screen-ing test[J]. J Geriatr Oncol, 2016, 7(2):99-107. |
| [24] | Guerard EJ, Deal AM, Chang Y, et al. Frailty index developed from a cancer-specific geriatric assessment and the association with mortality among older adults with cancer[J]. J Natl Compr Canc Netw, 2017, 15(7):894-902. |
| [25] | Isaacs A, Fiala M, Tuchman S, et al. A comparison of three different approaches to defining frailty in older patients with multiple myeloma[J]. J Geriatr Oncol, 2020, 11(2):311-315. |
| [26] | Kirkhus L, ?altyt? Benth J, Rostoft S, et al. Geriatric assessment is superior to oncologists’ clinical judgement in identifying frailty[J]. Br J Cancer, 2017, 117(4):470-477. |
| [27] | McCarthy AL, Peel NM, Gillespie KM, et al. Validation of a frailty index in older cancer patients with solid tumours[J]. BMC Cancer, 2018, 18(1):892. |
| [28] | Soma O, Hatakeyama S, Okamoto T, et al. Multicenter prospective study validating the efficacy of a quantitative assessment tool for frailty in patients with urological cancers[J]. Med Oncol, 2019, 36(10):88. |
| [29] | van Walree IC, Vondeling AM, Vink GR, et al. Development of a self-reported version of the G8 screening tool[J]. J Geriatr Oncol, 2019, 10(6):926-930. |
| [30] | Shahrokni A, Tin A, Alexander K, et al. Development and evaluation of a new frailty index for older surgical patients with cancer[J]. JAMA Netw Open, 2019, 2(5):e193545. |
| [31] | Orlandini L, Nestola T, Colloca GF, et al. The Frailty Index in older women with gynecological cancer[J]. Aging Clin Exp Res, 2020, 32(8):1561-1565. |
| [32] | Nishijima TF, Shimokawa M, Esaki T, et al. A 10-item frailty index based on a comprehensive geriatric assessment(FI-CGA-10) in older adults with cancer:development and construct validation[J]. Oncologist, 2021, 26(10):e1751-e1760. |
| [33] | 沈蓝君, 彭健, 陈祎婷, 等. COSMIN方法介绍:评价患者报告结局测量工具内容效度的评分系统[J]. 循证护理, 2021, 7(5):609-614. |
| [33] | Shen LJ, Peng J, Chen YT, et al. COSMIN methodology introduc-tion:rating system for evaluating the content validity of patient-reported outcome measures[J]. Chin Evid Based Nurs, 2021, 7(5):609-614. |
| [34] | 彭健, 沈蓝君, 陈祎婷, 等. COSMIN-RoB清单简介及测量工具内部结构研究的偏倚风险清单解读[J]. 中国循证医学杂志, 2020, 20(10):1234-1240. |
| [34] | Peng J, Shen LJ, Chen YT, et al. An overview of the COSMIN-RoB checklist and the interpretation of it in evaluating the risk of bias of studies on internal structure[J]. Chin J Evid Based Med, 2020, 20(10):1234-1240. |
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