Evidence map›Paper›PMID 36868779›Full record

ArticleBMJ paediatrics open2023

Assessing and investigating children with suspected bone and abdominal tumours: an e-Delphi consensus process.

Dhurgshaarna Shanmugavadivel, Jo-Fen Liu, Ashley Gamble, Angela Polanco, Kavita Vedhara, David Walker, Shalini Ojha

Open access · diamondAbstract readConsensus Statement
In one paragraph

Article in BMJ paediatrics open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 14% 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

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
  2. Childhood bone tumours in primary care: helping GPs to identify 'the needle in the haystack'.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023
    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

7 authors at 2 institutions in 1 country.

Dhurgshaarna ShanmugavadivelLifespan and Population Health, University of Nottingham, Nottingham, UK shaarnashan@doctors.org.uk.ORCID 0000-0002-1912-4543
Jo-Fen LiuLifespan and Population Health, University of Nottingham, Nottingham, UK.ORCID 0000-0001-5796-7878
Ashley GambleChief Executive's Office, Children's Cancer and Leukaemia Group, Leicester, UK.ORCID 0000-0002-0708-0918
Angela PolancoChief Executive's Office, Children's Cancer and Leukaemia Group, Leicester, UK.ORCID 0000-0002-4619-0773
Kavita VedharaCentre for Academic Primary Care, School of Medicine, University of Nottingham, Nottingham, UK.
David WalkerLifespan and Population Health, University of Nottingham, Nottingham, UK.ORCID 0000-0002-1753-0839
Shalini OjhaNeonatal Unit, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK.ORCID 0000-0001-5668-4227
University of Nottingham · GBChildren's Cancer and Leukaemia Group · GB

Funding

Cancer Research UK C59357/A22874
6 · The paper itself

Abstract

backgroundThe incidence of childhood cancer has risen by 15% since the 1990s. Early diagnosis is key to optimising outcomes, however diagnostic delays are widely reported. Presenting symptoms are often non-specific causing a diagnostic dilemma for clinicians. This Delphi consensus process was conducted to develop a new clinical guideline for children and young people presenting with signs/symptoms suggestive of a bone or abdominal tumour.

methodsInvitation emails were sent to primary and secondary healthcare professionals to join the Delphi panel. 65 statements were derived from evidence review by a multidisciplinary team. Participants were asked to rank their level of agreement with each statement on a 9-point Likert scale (1=strongly disagree, 9=strongly agree), with responses ≥7 taken to indicate agreement. Statements not reaching consensus were rewritten and reissued in a subsequent round.

resultsAll statements achieved consensus after two rounds. 96/133 (72%) participants responded to round 1 (R1) and 69/96 (72%) completed round 2 (R2). 62/65 (94%) statements achieved consensus in R1 with 29/65 (47%) gaining more than 90% consensus. Three statements did not reach consensus scoring between 61% and 69%. All reached numerical consensus at the end of R2. Strong consensus was reached on best practice of conducting the consultation, acknowledging parental instinct and obtaining telephone advice from a paediatrician to decide the timing and place of review, rather than adult cancer urgent referral pathways. Dissensus in statements was due to unachievable targets within primary care and valid concerns over a potential overinvestigation of abdominal pain.

conclusionsThis consensus process has consolidated statements that will be included in a new clinical guideline for suspected bone and abdominal tumours for use in both primary and secondary care. This evidence base will be translated into awareness tools for the public as part of the Child Cancer Smart national awareness campaign.

Indexed as

Abdominal NeoplasmsAbdominal PainAdolescentAdultChildDelphi TechniqueElectronic MailHumansAdolescent HealthData CollectionHealth services research

Identifiers

PMID36868779
PMCPMC9990668
OpenAlexW4323066795

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.