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Challenges of mucositis assessment in children: expert opinion
Deborah Tomlinson1, Faith Gibson, Nathaniel Treister
1Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada. deborah.tomlinson@sickkids.ca
Insights
Assessing oral mucositis in pediatric cancer patients is difficult due to age and cooperation challenges. New tools are needed for accurate, simple oral mucositis assessment in children undergoing cancer therapy.
Area of Science:
- Pediatric Oncology
- Clinical Assessment Tools
- Oral Medicine
Background:
- Mucositis is a significant treatment complication in pediatric cancer patients.
- Accurate oral cavity evaluation is crucial for mucositis clinical trials.
- Existing instruments for pediatric mucositis assessment are limited.
Purpose of the Study:
- To identify challenges in assessing oral mucositis in children.
- To explore potential solutions for improving mucositis assessment.
- To inform the development of a new pediatric oral mucositis assessment scale.
Main Methods:
- A focus group of nine healthcare professionals with expertise in pediatric cancer and mucositis assessment was convened.
- Discussions centered on challenges and solutions for oral mucositis evaluation in children.
Main Results:
- Key challenges include patient age, cooperation, and reliance on proxy reports.
- A need for a simple, quick, and universally applicable assessment instrument was identified.
- Educational needs for healthcare professionals were also highlighted.
Conclusions:
- Findings provide a foundation for developing guidelines for pediatric oral mucositis assessment.
- The results support the creation of a novel scale for assessing oral mucositis in children.
- Addressing assessment challenges is vital for advancing mucositis research and care.
Abstract:
Mucositis is a challenging treatment-related complication in children receiving therapy for cancer. The conduct of clinical trials that investigate mucositis prevention and treatment requires adequate evaluation of the oral cavity. However, few instruments to measure mucositis in children have been appropriately developed or evaluated. A focus group of nine health care professionals with expertise in mucositis assessment, oral assessment in children and paediatric cancer aimed to determine the challenges and possible solutions to mucositis assessment in children. The results led to the identification of several areas of concern that included: (1) challenges in oral assessment in children related to age and cooperation, (2) the need for proxy responses while recognizing the challenges of reporting pain and function attributed to oral mucositis, (3) the need for an instrument that is simple, quick to complete, and easy to use in almost all children and (4) educational considerations. The results provide a basis from which guidelines for the oral assessment of mucositis in children can begin. This information could be used to aid in the development of a new scale for the assessment of oral mucositis in children.
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