Evidence map›Paper›PMID 32780426›Full record

ArticleCancer2020

Development and validation of a Surgical Prioritization and Ranking Tool and Navigation Aid for Head and Neck Cancer (SPARTAN-HN) in a scarce resource setting: Response to the COVID-19 pandemic.

John R de Almeida, Christopher W Noel, David Forner, Han Zhang, Anthony C Nichols, Marc A Cohen, Richard J Wong, Caitlin McMullen, Evan M Graboyes, Vasu Divi and 19 more

Open access · bronzeAbstract readValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
4.8field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 26 citations in OpenAlex.

  1. Observational
  2. Article
  3. Review
  4. Article
  5. Article
  6. Review
  7. Making the Best of Limited Resources: Improving Outcomes in Head and Neck Cancer.American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting · 2021
    Article
  8. Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

29 authors at 14 institutions in 3 countries.

John R de AlmeidaDivision of Surgical Oncology, Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0002-1546-5033
Christopher W NoelDivision of Surgical Oncology, Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0002-6625-0809
David FornerDivision of Surgical Oncology, Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0002-1014-3545
Han ZhangDivision of Otolaryngology-Head and Neck Surgery, McMaster University, Hamilton, Ontario, Canada.
Anthony C NicholsDepartment of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada.
Marc A CohenDepartment of Otolaryngology-Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
Richard J WongDepartment of Otolaryngology-Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
Caitlin McMullenHead and Neck-Endocrine Oncology, Moffitt Cancer Center, Tampa, Florida.
Evan M GraboyesDepartment of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina.ORCID 0000-0003-3766-468X
Vasu DiviDepartment of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California.
Andrew G ShumanDepartment of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan.ORCID 0000-0002-9305-7860
Andrew J RoskoDepartment of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan.
Carol M LewisDepartment of Otolaryngology-Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Ehab Y HannaDepartment of Otolaryngology-Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Jeffrey MyersDepartment of Otolaryngology-Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Vinidh PaleriHead and Neck Unit, The Royal Marsden Hospital, London, United Kingdom.
Brett MilesDepartment of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
Eric GendenDepartment of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
Antoine EskanderDepartment of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0003-4326-1393
Danny J EnepekidesDepartment of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
Kevin M HigginsDepartment of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
Dale BrownDivision of Surgical Oncology, Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Douglas B ChepehaDivision of Surgical Oncology, Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0001-9062-3719
Ian J WitterickDepartment of Otolaryngology-Head and Neck Surgery, Sinai Health System, University of Toronto, Toronto, Ontario, Canada.
Patrick J GullaneDivision of Surgical Oncology, Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Jonathan C IrishDivision of Surgical Oncology, Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Eric MonteiroDepartment of Otolaryngology-Head and Neck Surgery, Sinai Health System, University of Toronto, Toronto, Ontario, Canada.
David P GoldsteinDivision of Surgical Oncology, Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Ralph GilbertDivision of Surgical Oncology, Department of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, Ontario, Canada.
University Health Network · CASunnybrook Health Science Centre · CAThe University of Texas MD Anderson Cancer Center · USIcahn School of Medicine at Mount Sinai · USMemorial Sloan Kettering Cancer Center · USUniversity of Michigan · USUniversity of Toronto · CADalhousie University · CAMcMaster University · CAMedical University of South Carolina · USMoffitt Cancer Center · USRoyal Marsden NHS Foundation Trust · GBStanford University · USWestern University · CA

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Hongbiao Carl Lekaye · 1985 to 2026
$347.4M
Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Fabien Delerue · 1985 to 2026
$290.8M
NCI NIH HHS P30 CA008748NCI NIH HHS P30 CA016672
6 · The paper itself

Abstract

backgroundIn the wake of the coronavirus disease 2019 (COVID-19) pandemic, access to surgical care for patients with head and neck cancer (HNC) is limited and unpredictable. Determining which patients should be prioritized is inherently subjective and difficult to assess. The authors have proposed an algorithm to fairly and consistently triage patients and mitigate the risk of adverse outcomes.

methodsTwo separate expert panels, a consensus panel (11 participants) and a validation panel (15 participants), were constructed among international HNC surgeons. Using a modified Delphi process and RAND Corporation/University of California at Los Angeles methodology with 4 consensus rounds and 2 meetings, groupings of high-priority, intermediate-priority, and low-priority indications for surgery were established and subdivided. A point-based scoring algorithm was developed, the Surgical Prioritization and Ranking Tool and Navigation Aid for Head and Neck Cancer (SPARTAN-HN). Agreement was measured during consensus and for algorithm scoring using the Krippendorff alpha. Rankings from the algorithm were compared with expert rankings of 12 case vignettes using the Spearman rank correlation coefficient.

resultsA total of 62 indications for surgical priority were rated. Weights for each indication ranged from -4 to +4 (scale range; -17 to 20). The response rate for the validation exercise was 100%. The SPARTAN-HN demonstrated excellent agreement and correlation with expert rankings (Krippendorff alpha, .91 [95% CI, 0.88-0.93]; and rho, 0.81 [95% CI, 0.45-0.95]).

conclusionsThe SPARTAN-HN surgical prioritization algorithm consistently stratifies patients requiring HNC surgical care in the COVID-19 era. Formal evaluation and implementation are required. LAY SUMMARY: Many countries have enacted strict rules regarding the use of hospital resources during the coronavirus disease 2019 (COVID-19) pandemic. Facing delays in surgery, patients may experience worse functional outcomes, stage migration, and eventual inoperability. Treatment prioritization tools have shown benefit in helping to triage patients equitably with minimal provider cognitive burden. The current study sought to develop what to the authors' knowledge is the first cancer-specific surgical prioritization tool for use in the COVID-19 era, the Surgical Prioritization and Ranking Tool and Navigation Aid for Head and Neck Cancer (SPARTAN-HN). This algorithm consistently stratifies patients requiring head and neck cancer surgery in the COVID-19 era and provides evidence for the initial uptake of the SPARTAN-HN.

Indexed as

BetacoronavirusHealth ResourcesAlgorithmsClinical Decision-MakingConsensusCoronavirus InfectionsCOVID-19Head and Neck NeoplasmsHumansInternational CooperationPandemicsPneumonia, ViralReproducibility of ResultsResearch DesignSARS-CoV-2Surgeonscoronavirus disease 2019 (COVID-19)delivery of health carehead and neck cancerhealth prioritiespatient selectionsurgical procedureswaiting lists

Identifiers

PMID32780426
PMCPMC7436362
OpenAlexW3047989485

What OpenQuestion holds

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Registered trials

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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.