{
    "abstract": "Ten pediatric cancer treatment sites previously implemented site-specific symptom management care pathways for 15 symptoms, which were based upon clinical practice guidelines (CPGs). The primary objective of this analysis was to describe the prevalence of care pathway- and CPG-consistent care for symptom management. The secondary objective was to identify factors associated with care pathway-consistent care.\nParticipants were patients age 8-18 years diagnosed with cancer within the previous 4 weeks. We identified any intervention to manage each of 15 symptoms during a 3-day period 8 weeks after enrollment. We determined whether the intervention appeared in that site's care pathway and whether it was recommended in the CPG. We determined whether type of symptom (observable \nTwo hundred twenty participants were analyzed. The prevalence of care pathway-consistent care for each symptom ranged from 0% (problems thinking, body or face changes, and diarrhea) to 52.3% (throwing up) and was <27% for 14 of 15 symptoms. Similarly, the prevalence of CPG-consistent care was <50% across all symptoms. Participants received significantly more care pathway-consistent interventions for observable symptoms compared with nonobservable symptoms (difference 30% [95% CI, 3 to 54]). Factors associated with receipt of at least one care pathway-consistent intervention were age group, race, ethnicity, and cancer type.\nCare pathway- and CPG-consistent care were surprisingly uncommon. Care pathway-consistent interventions were more common for observable than nonobservable symptoms and were associated with patient characteristics. Future work should identify approaches to improve care pathway-consistent care delivery.",
    "authors": [
        {
            "affiliation": "Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada.",
            "firstname": "Nicole",
            "initials": "N",
            "lastname": "Crellin-Parsons"
        },
        {
            "affiliation": "Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada.\nDepartment of Pharmacy, The Hospital for Sick Children and Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.",
            "firstname": "L Lee",
            "initials": "LL",
            "lastname": "Dupuis"
        },
        {
            "affiliation": "Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada.",
            "firstname": "Emily",
            "initials": "E",
            "lastname": "Vettese"
        },
        {
            "affiliation": "Division of Pediatric Hematology, Oncology, Stem Cell Transplant and Regenerative Medicine, Stanford University, Stanford, CA.",
            "firstname": "Catherine",
            "initials": "C",
            "lastname": "Aftandilian"
        },
        {
            "affiliation": "Nemours Children's Hospital, Orlando, FL.",
            "firstname": "Vibhuti",
            "initials": "V",
            "lastname": "Agarwal"
        },
        {
            "affiliation": "Division of Pediatric Hematology, Oncology, Stem Cell Transplant and Regenerative Medicine, Stanford University, Stanford, CA.",
            "firstname": "Christina",
            "initials": "C",
            "lastname": "Baggott"
        },
        {
            "affiliation": "Nemours Children's Health, Jacksonville, FL.",
            "firstname": "Scott M",
            "initials": "SM",
            "lastname": "Bradfield"
        },
        {
            "affiliation": "Cancer and Blood Disease Institute, Children's Hospital Los Angeles, Los Angeles, CA.",
            "firstname": "David R",
            "initials": "DR",
            "lastname": "Freyer"
        },
        {
            "affiliation": "Department of Pediatrics, Roswell Park Comprehensive Cancer Center, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY.",
            "firstname": "Kara M",
            "initials": "KM",
            "lastname": "Kelly"
        },
        {
            "affiliation": "Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO.\nDivision of Pediatric Hematology and Oncology, Washington University School of Medicine, St. Louis, MO.",
            "firstname": "Allison A",
            "initials": "AA",
            "lastname": "King"
        },
        {
            "affiliation": "Kapi'olani Medical Center for Women & Children, Honolulu, HI.",
            "firstname": "Wade",
            "initials": "W",
            "lastname": "Kyono"
        },
        {
            "affiliation": "Nemours Children's Hospital, Orlando, FL.",
            "firstname": "Ramamoorthy",
            "initials": "R",
            "lastname": "Nagasubramanian"
        },
        {
            "affiliation": "Cancer and Blood Disease Institute, Children's Hospital Los Angeles, Los Angeles, CA.",
            "firstname": "Etan",
            "initials": "E",
            "lastname": "Orgel"
        },
        {
            "affiliation": "Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX.",
            "firstname": "Michael E",
            "initials": "ME",
            "lastname": "Roth"
        },
        {
            "affiliation": "Driscoll Children's Hospital, Cancer and Blood Disorders Center and Texas A&M University, Corpus Christi, TX.",
            "firstname": "Farha",
            "initials": "F",
            "lastname": "Sherani"
        },
        {
            "affiliation": "Louisiana State University Health Sciences Center/Children's Hospital, New Orleans, LA.",
            "firstname": "Lolie",
            "initials": "L",
            "lastname": "Yu"
        },
        {
            "affiliation": "Pediatric Hematology Oncology, University of Texas Health Science Center at San Antonio, San Antonio, TX.",
            "firstname": "Allison C",
            "initials": "AC",
            "lastname": "Grimes"
        },
        {
            "affiliation": "Columbia University School of Nursing/Herbert Irving Comprehensive Cancer Center, New York, NY.",
            "firstname": "Melissa P",
            "initials": "MP",
            "lastname": "Beauchemin"
        },
        {
            "affiliation": "Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO.",
            "firstname": "Lisa M",
            "initials": "LM",
            "lastname": "Klesges"
        },
        {
            "affiliation": "Department of Medicine, Toronto General Hospital, Toronto, Canada.",
            "firstname": "George A",
            "initials": "GA",
            "lastname": "Tomlinson"
        },
        {
            "affiliation": "Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada.\nDivision of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada.",
            "firstname": "Lillian",
            "initials": "L",
            "lastname": "Sung"
        }
    ],
    "conclusions": "Care pathway- and CPG-consistent care were surprisingly uncommon. Care pathway-consistent interventions were more common for observable than nonobservable symptoms and were associated with patient characteristics. Future work should identify approaches to improve care pathway-consistent care delivery.",
    "copyrights": null,
    "doi": "10.1200/OP-24-00912",
    "journal": "JCO oncology practice",
    "keywords": [],
    "methods": null,
    "publication_date": "2025-04-23",
    "pubmed_id": "40267372",
    "results": "Two hundred twenty participants were analyzed. The prevalence of care pathway-consistent care for each symptom ranged from 0% (problems thinking, body or face changes, and diarrhea) to 52.3% (throwing up) and was <27% for 14 of 15 symptoms. Similarly, the prevalence of CPG-consistent care was <50% across all symptoms. Participants received significantly more care pathway-consistent interventions for observable symptoms compared with nonobservable symptoms (difference 30% [95% CI, 3 to 54]). Factors associated with receipt of at least one care pathway-consistent intervention were age group, race, ethnicity, and cancer type.",
    "title": "Care Pathway- and Guideline-Consistent Care in Pediatric Cancer Symptom Management.",
    "xml": "<Element 'PubmedArticle' at 0x7885028ce250>"
}