Evidence map›Paper›PMID 38481215›Full record

GuidelineBMC palliative care2024

A Dutch paediatric palliative care guideline: a systematic review and evidence-based recommendations for symptom treatment.

Kim C van Teunenbroek, Renée L Mulder, Inge M L Ahout, Karen G C B Bindels-de Heus, Catharina M Delsman-van Gelder, Annemie F S Galimont-Collen, Marinka A R de Groot, Katja M J Heitink-Polle, Jeffry Looijestijn, Maarten O Mensink and 10 more

Open access · goldAbstract readPractice GuidelineSystematic Review
In one paragraph

Guideline in BMC palliative care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
5.5field-weighted citation impact, top 5% 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, 5 citations in OpenAlex.

  1. Clinical Dietitians' Perspectives on Nutritional Management in Children's Palliative Care: A Qualitative Study.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2025
    Article
  2. Review
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

20 authors at 8 institutions in 1 country.

Kim C van TeunenbroekPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands. k.c.vanteunenbroek@prinsesmaximacentrum.nl.
Renée L MulderPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
Inge M L AhoutDepartment of Pediatrics, Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, the Netherlands.
Karen G C B Bindels-de HeusDepartment of Pediatrics, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands.
Catharina M Delsman-van GelderDepartment of Pediatrics and Neonatology, Máxima Medical Center, Veldhoven, the Netherlands.
Annemie F S Galimont-CollenDepartment of Dermatology, Bravis Hospital, Roosendaal, the Netherlands.
Marinka A R de GrootEmma Palliative Care Team, Emma Children's Hospital, Amsterdam University Medical Centre (UMC), Amsterdam, the Netherlands.
Katja M J Heitink-PollePrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
Jeffry LooijestijnDepartment of Pediatrics, Beatrix Children's Hospital, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands.
Maarten O MensinkPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
Selma MulderPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
Jolanda H SchievingDepartment of Pediatric Neurology, Radboud University Medical Center, Nijmegen, the Netherlands.
Antoinette Y N Schouten-van MeeterenPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
Johannes M A VerheijdenDutch Knowledge Centre for Children's Palliative Care, Utrecht, the Netherlands.
Hester RippenStichting Kind en Ziekenhuis, Utrecht, the Netherlands.
Brigitt C M Borggrevethe Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, the Netherlands.
Leontien C M KremerPrincess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
A A Eduard Verhagen *Department of Pediatrics, Beatrix Children's Hospital, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands.
Erna M C Michiels *Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
working groups symptom treatment and refractory symptom treatment of the Dutch paediatric palliative care guideline
Princess Máxima Center · NLEmma Kinderziekenhuis · NLRadboud University Nijmegen · NLUniversity Medical Center Groningen · NLBravis Ziekenhuis · NLErasmus MC - Sophia Children’s Hospital · NLNetherlands Comprehensive Cancer Organisation · NLStichting Kind en Groei · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChildren with life-threatening and life-limiting conditions can experience high levels of suffering due to multiple distressing symptoms that result in poor quality of life and increase risk of long-term distress in their family members. High quality symptom treatment is needed for all these children and their families, even more so at the end-of-life. In this paper, we provide evidence-based recommendations for symptom treatment in paediatric palliative patients to optimize care.

methodsA multidisciplinary panel of 56 experts in paediatric palliative care and nine (bereaved) parents was established to develop recommendations on symptom treatment in paediatric palliative care including anxiety and depression, delirium, dyspnoea, haematological symptoms, coughing, skin complaints, nausea and vomiting, neurological symptoms, pain, death rattle, fatigue, paediatric palliative sedation and forgoing hydration and nutrition. Recommendations were based on evidence from a systematic literature search, additional literature sources (such as guidelines), clinical expertise, and patient and family values. We used the GRADE methodology for appraisal of evidence. Parents were included in the guideline panel to ensure the representation of patient and family values.

resultsWe included a total of 18 studies that reported on the effects of specific (non) pharmacological interventions to treat symptoms in paediatric palliative care. A few of these interventions showed significant improvement in symptom relief. This evidence could only (partly) answer eight out of 27 clinical questions. We included 29 guidelines and two textbooks as additional literature to deal with lack of evidence. In total, we formulated 221 recommendations on symptom treatment in paediatric palliative care based on evidence, additional literature, clinical expertise, and patient and family values.

conclusionEven though available evidence on symptom-related paediatric palliative care interventions has increased, there still is a paucity of evidence in paediatric palliative care. We urge for international multidisciplinary multi-institutional collaboration to perform high-quality research and contribute to the optimization of symptom relief in palliative care for all children worldwide.

Indexed as

Palliative CarePediatricsChildEvidence-Based MedicineHumansNetherlandsClinical practice guidelineEvidence-based medicinePaediatric palliative careSymptom treatment

Identifiers

PMID38481215
PMCPMC10935792
OpenAlexW4392752493

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.