ArticleEClinicalMedicine2020
Risk stratification in children with cancer and febrile neutropenia: A national, prospective, multicentre validation of nine clinical decision rules.
Article in EClinicalMedicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 57 citations in OpenAlex.
- Procalcitonin and Interleukin-10 May Assist in Early Prediction of Bacteraemia in Children With Cancer and Febrile Neutropenia.Frontiers in immunology · 2021Trial
- S. aureus infections in hospitalized children with hematological, hepatological or kidney diseases over a 16-year period at a tertiary care hospital in Sweden: a retrospective observational study.Italian journal of pediatrics · 2026Observational
- Implementation of an electronic registry to monitor quality of care for febrile episodes in pediatric patients with cancer in Central America and the Caribbean.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Early clinical determinants of adverse outcomes in paediatric febrile neutropenia: a prospective cohort study.Frontiers in oncology · 2026Article
- Severe outcomes and risk factors of non-neutropenic fever episodes in hospitalized children with cancer in Kenya.Frontiers in oncology · 2025Article
- Impact of time to antibiotics on clinical outcome in paediatric febrile neutropenia: a target trial emulation of 1685 episodes.The Lancet regional health. Western Pacific · 2024Article
- "Better at home": Mixed methods report of intricacies in pediatric febrile neutropenia management.Cancer medicine · 2024Article
- Does age play a role in fever and neutropenia events and complications: A comparison of adolescents versus younger children with cancer at a tertiary care pediatric hospital, a pilot project.Cancer reports (Hoboken, N.J.) · 2023Review
- Does Fever Response to Acetaminophen Predict Bloodstream Infections in Febrile Neutropenia?Cureus · 2023Article
- Internal evaluation of risk stratification tool using serial procalcitonin and clinical risk factors in pediatric febrile neutropenia: The non-interventional, single institution experience prior to clinical implementation.Pediatric hematology and oncology · 2023Article
- Article
- Diagnosis and Management of Febrile Neutropenia in Pediatric Oncology Patients-A Systematic Review.Diagnostics (Basel, Switzerland) · 2022Review
- Blood transcriptomics identifies immune signatures indicative of infectious complications in childhood cancer patients with febrile neutropenia.Clinical & translational immunology · 2022Article
- Examining health-related quality of life in pediatric cancer patients with febrile neutropenia: Factors predicting poor recovery in children and their parents.EClinicalMedicine · 2021Article
- Managing low-risk febrile neutropenia in children in the time of COVID-19: What matters to parents and clinicians.Journal of paediatrics and child health · 2021Article
- Home-based care of low-risk febrile neutropenia in children-an implementation study in a tertiary paediatric hospital.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021Article
- Optimising Antimicrobial Selection and Duration in the Treatment of Febrile Neutropenia in Children.Infection and drug resistance · 2021Review
- Pulmonary Infectious Complications in Children with Hematologic Malignancies and Chemotherapy-Induced Neutropenia.Diseases (Basel, Switzerland) · 2020Review
- Re-evaluating and recalibrating predictors of bacterial infection in children with cancer and febrile neutropenia.EClinicalMedicine · 2020Article
- Clinical decision rules for infectious risk stratification of children with febrile neutropenia: Are we looking for the Yeti?EClinicalMedicine · 2020Article
Corrections and comments
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Authors and funding
9 authors at 7 institutions in 3 countries.
Funding
Abstract
backgroundReduced intensity treatment of low-risk febrile neutropenia (FN) in children with cancer is safe and improves quality of life. Identifying children with low-risk FN using a validated risk stratification strategy is recommended. This study prospectively validated nine FN clinical decision rules (CDRs) designed to predict infection or adverse outcome.
methodsData were collected on consecutive FN episodes in this multicentre, prospective validation study. The reproducibility and discriminatory ability of each CDR in the validation cohort was compared to the derivation dataset and details of missed outcomes were reported.
findingsThere were 858 FN episodes in 462 patients from eight hospitals included. Bacteraemia occurred in 111 (12·9%) and a non-bacteraemia microbiological documented infection in 185 (21·6%). Eight CDRs exhibited reproducibility and sensitivity ranged from 64% to 96%. Rules that had >85% sensitivity in predicting outcomes classified few patients (<20%) as low risk. For three CDRs predicting a composite outcome of any bacterial or viral infection, the sensitivity and discriminatory ability improved for prediction of bacterial infection alone. Across all CDRs designed to be implemented at FN presentation, the sensitivity improved at day 2 assessment.
interpretationWhile reproducibility was observed in eight out of the nine CDRs, no rule perfectly differentiated between children with FN at high or low risk of infection. This is in keeping with other validation studies and highlights the need for additional safeguards against missed infections or adverse outcomes before implementation can be considered.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.