Evidence map›Paper›PMID 39487813›Full record

Trial reportJournal of the American Geriatrics Society2025

Exploring geriatric assessment-driven rehabilitation referral patterns and its influence on functional outcomes and survival in older adults with advanced cancer.

Rachelle Brick, Marielle Jensen-Battaglia, Brennan P Streck, Lindsey Page, Rachael Tylock, Jenna Cacciatore, Karen Mustian, Jamil Khatri, Jeff Giguere, Elie G Dib and 2 more

Abstract readClinical Trial
In one paragraph

Trial report in Journal of the American Geriatrics Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Rachelle BrickDivision of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, USA.ORCID 0000-0001-7099-7799
Marielle Jensen-BattagliaJames P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA.
Brennan P StreckDivision of Cancer Prevention, National Cancer Institute, Bethesda, Maryland, USA.
Lindsey PageDivision of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, USA.
Rachael TylockJames P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA.ORCID 0000-0002-5348-4470
Jenna CacciatoreJames P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA.
Karen MustianDepartment of Surgery, Division of Supportive Care in Cancer, University of Rochester Medical Center, Rochester, New York, USA.
Jamil KhatriDelaware/Christiana Care NCORP, Newark, Delaware, USA.
Jeff GiguereNCORP of the Carolinas - Prisma Health System, Greenville, South Carolina, USA.
Elie G DibMichigan Cancer Research Consortium - NCORP, Ann Arbor, Michigan, USA.
Supriya MohileJames P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York, USA.
Eva CulakovaDepartment of Surgery, Division of Supportive Care in Cancer, University of Rochester Medical Center, Rochester, New York, USA.

Funding

URCC NCORP Research BaseUG1CA189961 · NCI · UNIVERSITY OF ROCHESTER · PI Michelle C Janelsins, KAREN M. MUSTIAN · 2014 to 2026
$67.7M
Michigan Cancer Research Consortium NCORPUG1CA189971 · NCI · SAINT JOSEPH MERCY HEALTH SYSTEM · PI Tareq Al baghdadi · 2014 to 2026
$36.6M
A Patient-Oriented Research Program in Geriatric OncologyK24AG056589 · NIA · UNIVERSITY OF ROCHESTER · PI Supriya G. Mohile · 2018 to 2026
$1.5M
Research Capacity Building by a Clinician Scientist within the Michigan Cancer Research Consortium- National Community Oncology Research ProgramR50CA288382 · NCI · SAINT JOSEPH MERCY HEALTH SYSTEM · PI Elie G Dib · 2024 to 2026
$340k
Aging in place for older adults with cancer: The role of physical function and home environmentF99CA284180 · NCI · UNIVERSITY OF ROCHESTER · PI JENSEN-BATTAGLIA, MARIELLE · 2023 to 2024
$95k
Division of Cancer Prevention, National Cancer Institute (Cancer Prevention Fellowship Program Trans-Fellows) UG1CA189961National Cancer Institute Center for Cancer Training F99CA284180NCI NIH HHS F99 CA284180NCI NIH HHS R50 CA288382NCI NIH HHS UG1 CA189961NCI NIH HHS UG1 CA189971NIA NIH HHS K24 AG056589NIA NIH HHS K24AG056589Patient-Centered Outcomes Research Institute CD-12-11-4634
6 · The paper itself

Abstract

backgroundOlder adults with advanced cancer experience functional disability that warrants rehabilitation services; however, evidence indicates inconsistencies in referral. The purpose was to (1) identify predictors of geriatric assessment (GA)-driven referrals to rehabilitation services and (2) explore associations between referral and change in function, health-related quality of life (HRQoL), and overall survival among older adults with advanced cancer.

methodsThis was a secondary analysis (NCT020107443, UG1CA189961) of a nationwide GA clinical trial. Patients were older adults with advanced cancer who had at least one GA-defined physical performance or functional status impairment. Primary outcomes were oncologist-initiated discussion about or referral to rehabilitation services after the GA (Aim 1) and decline in activities of daily living (ADL), Instrumental ADL (IADL), and HRQoL within 3 months, and overall survival at 1 year (Exploratory Aims). Analyses included multivariable logistic regression and Cox proportional hazards models. Demographic and clinical factors were controlled for by using 1:1 propensity score matching.

resultsIn total 265 patients were analyzed. After adjustment, impaired cognition (odds ratio [OR] = 2.25, p = 0.01), Karnofsky score indicating disability (OR = 2.86, p < 0.01), and receipt of monoclonal antibodies (OR = 1.95, p = 0.04) were associated with higher odds of referral. In contrast, polypharmacy was associated with lower odds of referral (OR = 0.31, p < 0.01). Referred patients were less likely to decline in ADL (OR 0.30, p = 0.07) and IADL (OR 0.64, p = 0.35), but more likely to decline in HRQoL (OR 1.20, p = 0.67) and have worse survival (HR 1.18, p = 0.62).

conclusionsCancer treatment, polypharmacy, cognition, and disability status likely influence oncologists' decision to refer for rehabilitation. Referral was not independently associated with change in functional disability, HRQoL, or survival. Future studies should evaluate patients' utilization of rehabilitation services post-referral and determine whether dose/timing of rehabilitation services influence clinical outcomes.

Indexed as

Geriatric AssessmentNeoplasmsReferral and ConsultationActivities of Daily LivingAgedAged, 80 and overFemaleFunctional StatusHumansMaleQuality of Lifecancer rehabilitationgeriatric assessmentgeriatric oncologyoccupational therapyphysical therapy

Identifiers

PMID39487813
PMCPMC12102744

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.