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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

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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

Resilient health care in global pediatric oncology during the COVID-19 pandemic

Publicado por
Graetz, DE, Sniderman, E, Villegas, CA, Kaye, EC, Ragab, I, Laptsevich, A, Maliti, B, Naidu, G, Huang, H, Gassant, PY, Nunes Silva, L, Arce, D, Montoya Vasquez, J, Arora, RS, Alcasabas, AP, Rusmawatiningtyas, D, Raza, MR, Velasco, P, Kambugu, J, Vinitsky, A, Rodriguez-Galindo, C, Agulnik, A, Moreira DC, COVIMPACT Study Group

Publicado 2021

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Background: In the face of unprecedented challenges because of coronavirus disease 2019, interdisciplinary pediatric oncology teams have developed strategies to continue providing high-quality cancer care. This study explored factors contributing to health care resilience as perceived by childhood cancer providers in all resource level settings. Methods: This qualitative study consisted of 19 focus groups conducted in 16 countries in 8 languages. Seven factors have been previously defined as important for resilient health care including: 1) in situ practical experience, 2) system design, 3) exposure to diverse views on the patient's situation, 4) protocols and checklists, 5) teamwork, 6) workarounds, and 7) trade-offs. Rapid turn-around analysis focused on these factors. Results: All factors of health care resilience were relevant to groups representing all resource settings. Focus ...