基于全面老年评估指导护理的健康相关生活质量与常规护理在老年癌症患者中的比较：随机试验的系统评价与Meta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
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影响因子:5.6
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
DOI:
10.1016/j.critrevonc.2024.104442
摘要
本研究旨在评估与常规护理相比，基于全面老年评估（CGA）指导的护理是否能改善老年癌症患者的健康相关生活质量（HRQL）。通过生物医学数据库筛选相关的随机对照试验（RCTs）。采用DerSimonian-Laird模型进行Meta分析，总结各个时间点基线至不同时间点HRQL评分变化的平均差异，并利用GRADE工具评估证据的确定性。通过广义估计方程的逻辑回归分析预测HRQL改善的因素。结果显示，CGA指导护理在3个月时对全球HRQL评分的潜在改善（Cohen's d 0.27，95 % CI -0.03-0.58，中等确定性）并不能排除。较大的RCT或要求在抗癌治疗前进行CGA的研究倾向于报告HRQL的改善。CGA指导护理对HRQL的影响具有一定的变异性。大型RCT和强制进行治疗前CGA的研究更倾向于显示HRQL的改善。
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.