与健康相关的生活质量，具有全面的老年评估指导性护理与癌症老年人的常规护理：随机试验的系统评价和荟萃分析
Health-related quality of life with comprehensive geriatric assessment guided care versus usual care in older adults with cancer: A systematic review and meta-analysis of randomized trials
影响因子:5.60000
分区:医学2区 Top / 血液学2区 肿瘤学2区
发表日期:2024 Sep
作者:
Zhi Xuan Ng, Pooja Handa, Huili Zheng, Matthew Zhixuan Chen, Yu Yang Soon, Prunella Blinman, Martin Stockler, Francis Ho
摘要
为了评估与常规护理相比，癌症老年人的健康相关生活质量（HRQL）是否可以改善与健康相关的生活质量（HRQL），与常规护理相比，通过生物医学数据库确定了癌症的老年人生活质量（HRQL）。使用Dersimonian-Laird模型的荟萃分析总结了HRQL分数从基线到各个时间点的平均变化的差异，并通过等级工具评估了证据确定性。通过广义估计方程分析了HRQL改进的预测指标的逻辑回归。在3个月时通过CGA引导的CARE进行了全局HRQL评分（Cohen的D 0.27，95％CI -0.03-0.58，中度确定性），不能排除。较大的RCT或在启动抗癌治疗之前强制性CGA是改善HRQL的预测指标。CGA引导护理对HRQL的影响是可变的。较大的RCT和强制性预处理CGA倾向于报告改善的HRQL。
Abstract
To evaluate if comprehensive geriatric assessment (CGA)-guided care improves health-related quality of life (HRQL) in older adults with cancer compared to usual care.Relevant randomized controlled trials (RCTs) were identified through biomedical databases. Meta-analyses using DerSimonian-Laird model summarized the difference in the mean change of HRQL scores from baseline across various time points, with evidence certainty assessed by the GRADE tool. Logistic regression via generalized estimating equations analyzed predictors of HRQL improvement.Potential improvement in the global HRQL score by CGA-guided care at 3 months (Cohen's d 0.27, 95 % CI -0.03-0.58, moderate certainty), could not be excluded. Larger RCTs or those mandating CGA before initiating anti-cancer treatment were predictors of improved HRQL.The effects of CGA-guided care on HRQL were variable. Larger RCTs and those mandating pre-treatment CGA tended to report improved HRQL.