Melgar Mario, Reljic Tea, Barahona Guillermo, Camacho Kattia, Chang Alicia, Contreras Johanny, Espinoza Darrell, Estripeaut Dora, Gamero Mario, Luque Marco, Mentor Girlande, Zacasa Pamela, Homsi Maysam, Caniza Miguela A, Kumar Ambuj, Mukkada Sheena
Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala.
Department of Internal Medicine, University of South Florida, Tampa, FL.
JCO Glob Oncol. 2020 Mar;6:508-517. doi: 10.1200/JGO.19.00329.
Our objective was to provide regionally appropriate, resource-conscious recommendations for the diagnosis and treatment of pediatric patients with febrile neutropenia.
A multinational panel of Central American and Caribbean clinicians who deliver pediatric oncology care prioritized clinically important questions and then used the Grading of Recommendations Assessment, Development and Evaluation methodology to provide recommendations on the selected topics.
Twenty-two questions and 2 definitions were included in the guideline, which was intended to establish minimum care standards for pediatric patients treated in regional centers. Of all the included studies, 6.9% were conducted in low- and middle-income countries, and no studies were performed in countries represented on the panel.
The panel made recommendations on the basis of existing evidence but identified important gaps in knowledge from the region and from resource-limited settings that may affect the clinical applicability of these recommendations. These deficiencies suggest a research agenda that will enable future guidelines to be more responsive to the local context.
我们的目标是为发热性中性粒细胞减少症的儿科患者提供适合该地区且注重资源利用的诊断和治疗建议。
一个由提供儿科肿瘤护理的中美洲和加勒比地区临床医生组成的跨国小组,对临床重要问题进行了优先级排序,然后使用推荐评估、制定和评价分级方法,就选定的主题提供建议。
该指南纳入了22个问题和2个定义,旨在为地区中心治疗的儿科患者确立最低护理标准。在所有纳入的研究中,6.9%是在低收入和中等收入国家进行的,且没有在该小组所代表国家进行的研究。
该小组根据现有证据提出了建议,但指出了该地区以及资源有限环境中存在的重要知识空白,这些空白可能会影响这些建议的临床适用性。这些不足表明了一项研究议程,该议程将使未来的指南能更好地适应当地情况。