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artículo

Exploring treatment decision-making at diagnosis for children with advanced cancer in low- and middle-income countries

Publicado por
Salek, M, Porter, AS, Maradiege, E, Dolendo, MCJ, Figueredo, D, Geriga, F, Gunasekera, S, Kizyma, R, Nguyen, HTK, Nzamu, I, Raza, MR, Rustamova, K, Sari, NM, Rodriguez-Galindo, C, Graetz, D, Bhakta, N, Kaye, EC, Wise, PH, Hunleth, JM, Friedrich, P, Force, L, Baker, JN

Publicado 2024

Enlace

Purpose: Global childhood cancer survival outcomes correlate with regional contextual factors, yet upfront treatment decision-making for children with advanced or poor prognosis cancer in low- and middle-income countries (LMICs) is not well understood. This study aimed to (1) characterize the landscape of contextual factors that shape physician decision-making at diagnosis for these children in LMICs and (2) describe physician rationales for if/when to offer treatment with non-curative intent, including how they define “poor prognosis” during treatment decision-making. Methods: An international panel of pediatric oncologists practicing in LMICs participated in two focus groups structured for the collaborative generation of factors influencing treatment decision-making, including consideration of non-curative treatment pathways at diagnosis. Thematic analysis of qualitative data was c...

artículo

Documenting adaptations to an evidence-based intervention in 58 resource-variable pediatric oncology hospitals across implementation phases

Publicado por
Quesada-Stoner, AC, Islam, S, Siječić, A, Malone, S, Puerto-Torres, MF, Cardenas, A, Prewitt, K, Alfonso, Carreras, Y, Alvarez-Arellano, SY, Argüello-Vargas, D, Ceballo-Batista, GI, Diaz-Coronado, R, Diniz, Borborema, MDC, Toledo, JE, Fing, E, Garay, Z, Hernández-González, CJ, Jimenez-Antolinez, YV, Juárez, Tobías, MS, Lemos, de, Mendonça, e, Fontes, L, Lopez-Facundo, NA, Mijares, Tobias, JM, Miralda-Méndez, ST, Montalvo, E, Cawich, ZN, Portilla, Figueroa, CA, Sahonero, M, Sánchez-Martín, M, Serrano-Landivar, MX, Soledad, García, V, Vasquez, A, Velásquez, Cabrera, DM, Carothers, BJ, Shelton, RC, Graetz, D, Acuña, C, Luke, DA, McKay, VRR, Agulnik, A

Publicado 2024

Enlace

Background: Adaptation of evidence-based interventions (EBIs) often occurs when implemented in new local contexts and settings. It is unclear, however, during which phase of implementation adaptations are most frequently made and how these changes may impact the fidelity, effectiveness, and sustainability of the EBI. Pediatric Early Warning Systems (PEWS) are EBIs for early identification of deterioration in hospitalized children with cancer. This study evaluates adaptations of PEWS made among resource-variable pediatric oncology hospitals in Latin America implementing and sustaining PEWS. Methods: We conducted a cross-sectional survey among pediatric oncology centers participating in Proyecto Escala de Valoración de Alerta Temprana (EVAT), a collaborative to implement PEWS. Adaptations to PEWS were assessed via 3 multiple choice and 1 free text question administered as part of a large...