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Assessment measures for chemotherapy-induced peripheral neuropathy among pediatric oncology patients: an updated
Ting Mao1,2, Janelle Yorke1,2, Yan Shi3
1School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR , China.
Insights
This systematic review found that the pediatric-modified Total Neuropathy Score (ped-mTNS) and Total Neuropathy Score-Pediatric Vincristine (TNS-PV) remain the best tools for assessing chemotherapy-induced peripheral neuropathy (CIPN) in children. Two new patient-reported outcome measures (PROMs) were also identified as valuable for CIPN assessment.
Area of Science:
- Pediatric Oncology
- Neurology
- Clinical Assessment Tools
Background:
- Chemotherapy-induced peripheral neuropathy (CIPN) is a significant concern in pediatric oncology.
- Accurate assessment tools are crucial for managing CIPN in young patients.
- Previous reviews have identified key assessment methods, but updates are needed.
Purpose of the Study:
- To systematically review and update the evidence on assessment tools for CIPN in pediatric oncology patients.
- To identify newly developed or validated tools since the last review in 2020.
- To provide recommendations for the most appropriate assessment strategies.
Main Methods:
- A comprehensive search of seven major databases was conducted for studies published between November 2018 and May 2024.
- Inclusion criteria focused on studies involving cancer patients under 18 years assessing CIPN.
- Study quality was evaluated using Joanna Briggs Institute tools and a modified QUADAS tool for diagnostic accuracy.
Main Results:
- Five studies, including 633 patients, were included in this updated review.
- Only one study met high-quality standards.
- Two new patient-reported outcome measures (PROMs), one objective assessment, and a pain scale were identified, alongside new studies on previously identified measures.
Conclusions:
- The pediatric-modified Total Neuropathy Score (ped-mTNS) and Total Neuropathy Score-Pediatric Vincristine (TNS-PV) are recommended for clinical use in assessing pediatric CIPN.
- Two newly identified PROMs offer acceptable quality for evaluating CIPN in pediatric oncology.
- A combined approach using physician-based tools and PROMs is advised for comprehensive CIPN symptom evaluation.
Objective:
To update the systematic review of assessment tools on chemotherapy-induced peripheral neuropathy (CIPN) for pediatric oncology patients based on the evidence available after the published review in 2020.
Data Sources:
Seven English-language databases (PubMed, CINAHL, PsycINFO, EMBASE, the Cochrane Central Register of Controlled Trials, Scopus and Web of Science) were searched for studies published from Nov 9, 2018, to May 20, 2024.
Study Selection:
Studies that contained subjects who had a cancer diagnosis and were aged under 18 years and discussed the development of a tool to measure CIPN or assessed all test items and response categories for CIPN were included.
Data Extraction And Synthesis:
Data were screened and extracted independently using predesigned tables. The quality of each study was assessed based on Joanna Briggs Institute's critical appraisal tools for analytical cross-sectional studies and case control studies. The quality of identified instruments for CIPN was evaluated by the modified version of Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool.
Results:
A total of 5 studies (with 633 patients) were included in the systematic review. Only one study was rated as high quality. We newly identified two patient-reported outcome measures (PROMs), one objective assessment and a pain scale, and three new studies about the previous identified CIPN assessment measures.
Conclusions And Relevance:
Based on the current evidence, the pediatric-modified Total Neuropathy Score (ped-mTNS) and the Total Neuropathy Score-Pediatric Vincristine (TNS-PV) are still the two most appropriate tools for healthcare professionals to use in clinical settings. Our results also addressed the gap in existing literature by showing two newly PROMs for CIPN in pediatric oncology patients with acceptable quality. The combination of physician-based assessment tools and PROMs are recommended to evaluate the patients' CIPN-related symptoms.
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