ArticleCancer medicine2023
Development and pilot testing of PROACTIVE: A pediatric onco-critical care capacity and quality assessment tool for resource-limited settings.
Article in Cancer medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Treatment-related mortality in children with cancer in low-income and middle-income countries: a systematic review and meta-analysis.The Lancet. Oncology · 2023Pooled it
- Disseminating a Pediatric Oncology Critical Care Intervention in Latin America and Spain: An Integrated-Knowledge-Translation Approach.Global implementation research and applications · 2026Article
- Strategies to improve healthcare team communication structure and quality in resource-variable childhood cancer hospitals (TeamTalk): a study protocol.Implementation science communications · 2025Article
- Development and Pilot Testing of PrOFILE-ST: A Pediatric Surgical Oncology Capacity and Quality Assessment Tool for Resource-Limited Settings.Cancer medicine · 2025Article
- Multilevel mortality risk factors among pediatric hematology-oncology patients with deterioration.Cancer · 2025Article
- Connecting Clinical Capacity and Intervention Sustainability in Resource-Variable Pediatric Oncology Centers in Latin America.Global implementation research and applications · 2024Article
- Effect of paediatric early warning systems (PEWS) implementation on clinical deterioration event mortality among children with cancer in resource-limited hospitals in Latin America: a prospective, multicentre cohort study.The Lancet. Oncology · 2023Article
- Development and pilot testing of PROACTIVE: A pediatric onco-critical care capacity and quality assessment tool for resource-limited settings.Cancer medicine · 2023Article
- CritCom: assessment of quality of interdisciplinary communication around deterioration in pediatric oncologic patients.Frontiers in oncology · 2023Article
- Impact of hospital characteristics on implementation of a Pediatric Early Warning System in resource-limited cancer hospitals.Frontiers in oncology · 2023Article
- Editorial: Critical complications in pediatric oncology and hematopoietic cell transplant - how far we have come and how much further we must go.Frontiers in oncology · 2023Article
- Development of the pediatric neuro-oncology services assessment aid: An assessment tool for pediatric neuro-oncology service delivery capacity.Neuro-oncology advancesArticle
- Management of septic shock in children with cancer-Common challenges and research priorities.Jornal de pediatriaArticle
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21 authors.
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Abstract
backgroundNearly 90% children with cancer reside in low- and middle-income countries, which face multiple challenges delivering high-quality pediatric onco-critical care (POCC). We recently identified POCC quality and capacity indicators for PROACTIVE (PediatRic Oncology cApaCity assessment Tool for IntensiVe carE), a tool that evaluates strengths and limitations in POCC services. This study describes pilot testing of PROACTIVE, development of center-specific reports, and identification of common POCC challenges.
methodsThe original 119 consensus-derived PROACTIVE indicators were converted into 182 questions divided between 2 electronic surveys for intensivists and oncologists managing critically ill pediatric cancer patients. Alpha-testing was conducted to confirm face-validity with four pediatric intensivists. Eleven centers representing diverse geographic regions, income levels, and POCC services conducted beta-testing to evaluate usability, feasibility, and applicability of PROACTIVE. Centers' responses were scored and indicators with mean scores ≤75% in availability/performance were classified as common POCC challenges.
resultsAlpha-testing ensured face-validity and beta-testing demonstrated feasibility and usability of PROACTIVE (October 2020-June 2021). Twenty-two surveys (response rate 99.4%) were used to develop center-specific reports. Adjustments to PROACTIVE were made based on focus group feedback and surveys, resulting in 200 questions. Aggregated data across centers identified common POCC challenges: (1) lack of pediatric intensivists, (2) absence of abstinence and withdrawal symptoms monitoring, (3) shortage of supportive care resources, and (4) limited POCC training for physicians and nurses.
conclusionsPROACTIVE is a feasible and contextually appropriate tool to help clinicians and organizations identify challenges in POCC services across a wide range of resource-levels. Widespread use of PROACTIVE can help prioritize and develop tailored interventions to strengthen POCC services and outcomes globally.
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