Systematic review of frailty assessment in ovarian cancer studies.
Notice bibliographique
Résumé
5564 Background: Frailty is a state of vulnerability to poor resolution of homeostasis following a stressor event, such as chemotherapy or surgery. Better knowledge of frailty assessments (FA) in ovarian cancer could help drive a global and individualized care strategy. Methods: A search was performed in 10 databases including Medline, Embase and Cochrane (up to March 2022). The search strategy utilized a combination of keywords and controlled vocabulary related to ovarian cancer, frailty/geriatric assessment. Studies performing FA in patients with ovarian cancer on systemic therapy, surgery and surveillance were included. The 2020 PRISMA checklists were followed, and the study was registered in PROSPERO (CRD42022323409). Primary objective was to identify frailty scales used in ovarian cancer studies. Secondary objectives were to describe impact of results on decision making and outcomes, adherence to ASCO Vulnerability Assessment (VA) guidelines. Results: 2,259 articles were screened, and 48 included in the final analysis. Studies were published between 2004-2022 and included 84,575 patients. 23 studies (48%) had an age limit for inclusion (≥65 to ≥80 years). Six studies were interventional (1 phase 3 clinical trial [CT], rest phase 2) and 42 were observational (45% retrospective). FA were highly variable. Median number of tests to assess frailty were 3 (range 1-13). Most studies used a combination of tests (several may apply): validated frailty scales (21 studies, 43.7%), nutritional/sarcopenia status (20 studies, 41.7%), functionality/physical performance (19 studies, 39.6%), geriatric assessment (7 studies, 14.6%). Global measures with all the comprehensive assessment items of the ASCO VA guideline were included in 14.6% of studies. FA was not used for decision making in any study. One FA designed for ovarian cancer was identified, the GINECO Geriatric Vulnerability score. Frailty was the primary objective in 26 studies (54%), out of which 12 were retrospective. Among them, study objectives were highly variable including survival, complications, or cost of surgery (13 studies) and systemic therapy (7 studies), prognosis (4 studies), treatment compliance and dependence (1 each). All but one (a prognostic study) met its primary outcome demonstrating worse outcomes in frail patients. Conclusions: Frailty assessments are heterogeneous in ovarian cancer studies. Most studies do not adhere to the ASCO vulnerability assessment guidelines. An association between frailty and poor outcomes was detected in surgical and systemic therapy studies. There is room for improvement, as none of the assessed studies used the frailty for decision making.[Table: see text]
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,015 | 0,063 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,012 | 0,008 |
| Bibliométrie | 0,023 | 0,021 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,003 |
| Science ouverte | 0,003 | 0,003 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,010 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».