Screening older cancer patients for a Comprehensive Geriatric Assessment: A comparison of three instruments Cynthia Owusu a,b,* , Siran M. Koroukian b,c , Mark Schluchter b,c , Paul Bakaki b,c , and Nathan A. Berger a,b a Division of Hematology/Oncology, University Hospitals of Cleveland, Cleveland, USA b Case Comprehensive Cancer Center, Cleveland, OH, USA c Department of Epidemiology and Biostatistics, Case Western Reserve School of Medicine, USA Abstract Background—The Vulnerable Elders Survey (VES-13) has been validated for screening older cancer patients for a Comprehensive Geriatric Assessment (CGA). To identify a widely acceptable approach that encourages oncologists to screen older cancer patients for a CGA, we examined the Eastern Cooperative Oncology Group Performance Status (ECOG-PS) and Karnofsky Index of Performance Status (KPS) scales’ ability to identify abnormalities on a CGA and compared the performance of the two instruments with the VES-13. Methods—We enrolled 117 participants, ᚣ65 years with stage I–IV cancer into this cross- sectional study. Our primary outcome variable was ᚣtwo abnormalities on the CGA, (Yes or No). We employed receiver operating characteristic curve analysis to compare the discriminatory abilities of the three instruments to identify ᚣtwo abnormalities on the CGA. Results—Of the 117 participants, 43% had ᚣtwo abnormalities on the CGA. The VES-13 was predictive of ᚣtwo abnormalities on the CGA, area under the curve (AUC)=0.85 [(95% CI: 0.78– 0.92); sensitivity=88%, specificity=69%, at cut-off ᚣ3]. The ECOG-PS and KPS showed similar discriminatory powers, AUC=0.88 [(95% CI: 0.83–0.94); sensitivity=94%, specificity=55%, at cut-off ᚣ1]; and AUC=0.90 [(95% CI: 0.84–0.96); sensitivity=78%, specificity=91%, at cut-off ᚢ80%], respectively. Conclusion—The ECOG-PS and KPS were equivalent to the VES-13 in identifying older cancer patients with at least two abnormalities on the CGA. Given that oncologists are already conversant with the KPS and ECOG-PS, these two instruments offer medical oncologists a widely acceptable approach for screening older patients for a CGA. Keywords Older; Cancer; Comprehensive Geriatric Assessment; Screening; VES-13; KPS; ECOG-PS © 2010 Elsevier Ltd. All rights reserved. * Corresponding author. Case Western Reserve University, UHHS Ireland Cancer Center-BHC 5055, 11100 Euclid Avenue, Cleveland, OH 44106-5055, USA. Tel.: +1 216 844 7670; fax: +1 216 844 5234. Cynthia.owusu@case.edu (C. Owusu). Disclosure None of the authors have any actual or potential conflict of interest to report. Author Contribution Cynthia Owusu: conception and design, data collection, analysis and interpretation of data, manuscript writing; Siran Koroukian: analysis and interpretation of data, manuscript writing; Mark Schluchter: analysis and interpretation of data, manuscript writing; Paul Bakaki: analysis; and Nathan Berger: concept and design, analysis and interpretation of data, manuscript writing. NIH Public Access Author Manuscript J Geriatr Oncol. Author manuscript; available in PMC 2011 September 14. Published in final edited form as: J Geriatr Oncol. 2011 April ; 2(2): 121–129. doi:10.1016/j.jgo.2010.12.002. NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript