A decision tree to guide long term venous access placement in children and adolescents undergoing surgery for renal tumors
jpedsurg.org shows its articles on its own site.
Read the article on jpedsurg.org ↗Article · May 2019 · 1 min read
In brief
In brief
This study developed and validated a decision tree using intraoperative data to guide long-term venous access placement in pediatric renal tumor patients. The tool demonstrated high interrater reliability (kappa=0.97) and correctly identified which patients would require venous access for adjuvant chemotherapy, potentially reducing unnecessary procedures in children who don't need long-term access.
Written by the GCMD Library team from the article.
Background/Purpose
While many children with renal tumors require long term venous access (VA) for adjuvant chemotherapy, certainly not all do. This study develops and tests a VA decision tree (DT) to direct the placement of VA in patients with renal tumors.
Methods
Utilizing data readily available at surgery a VADT was developed. The VADT was tested retrospectively by 2 independent reviewers on a historic cohort. The ability of the VADT to appropriately select which patients would benefit from VA placement was tested.
Results
160 patients underwent renal tumor surgery between 2005 and 2018. 70 (43.8%) patients met study criteria with median age of 45.1 months (range 1.1–224); 73% required VA. Using the VADT, VA placement was "needed" in 67.1% of patients and "deferred" in 32.9%. Interrater reliability was very high (kappa = 0.97, 95% CI 0.91–1, p