Poster Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

Predictors of cancer-related muscle loss: an international Delphi study (126250)

Annie R Curtis 1 , Carla M Prado 2 , Linda Denehy 3 4 5 , Lara Edbrooke 3 4 5 , Robin M Daly 1 , Judy Bauer 6 , Brenton Baguley 1 7 , Liliana Orellana 8 , Sharad Sharma 9 , Nicole Kiss 1 7
  1. Institute for Physical Activity and Nutrition , Deakin University, Geelong, VIC, Australia
  2. Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Canada
  3. Physiotherapy Department, University of Melbourne, Parkville, Melbourne, Australia
  4. Centre for Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  5. Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
  6. Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Australia
  7. Nutrition and Speech Pathology Department, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  8. Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Australia
  9. Department of Medical Oncology, Grampians Health, Ballarat, Victoria, Australia

Purpose: To engage international experts to identify a minimum set of evidence-based predictors of cancer-related muscle loss for consideration in a screening tool.  

Sample and setting: A two-round international Delphi study with a purposive sample of experts in cancer-related muscle loss.

Procedures: Twenty-five predictors of muscle loss were identified through a scoping review. In two subsequent Delphi rounds, experts rated each predictor on a 9-point Likert scale for its importance (‘not important’–‘critical’), and agreement (‘strongly disagree’–‘strongly agree’) with the operationalisation of predictors into screening tool questions and response options. No predictors were removed between rounds. Experts could suggest additional predictors in Round 1. After Round 2, a 10-person steering committee reviewed predictors and questions rated important but not critical (>70% rated 4-6).

Results: Round 1 was completed by 33 experts, and Round 2 by 30 experts from eight countries and five disciplines (47% physicians, 27% dietitians). Fifteen predictors were rated as critical (>70% rated 7-9): low physical performance, poor physical function (i.e. gait speed), fatigue, energy intake, protein intake, multimorbidity, weight loss, reduced muscle strength, reduced appetite, dysphagia, low calf circumference, physical inactivity, prolonged immobilisation, sedentary behaviour, and age. Low mid-upper arm circumference was rated as important but not critical and was included by the steering committee. Treatment side-effects was removed. Following Round 2, consensus was reached on 10 complete questions with responses, one standalone question, and one standalone response. The wording of items not reaching consensus was revised by the steering committee.

Conclusion and clinical implications: This study will inform a screening tool for cancer-related muscle loss to identify at-risk patients and support triage to treatment. The tool’s questions will undergo face validity testing with consumers and health professionals. After which, the optimal set of questions with the highest sensitivity and specificity to predict muscle loss will be determined.