Evidence map›Paper›PMID 41834188›Full record

ArticlePediatric blood & cancer2026

Facilitators and Barriers for Implementing Diagnostic Sequencing Technology for Pediatric Oncology in Low- and Middle-Income Countries.

Kenneth M Busby, Nathaniel Webb, Javeria Aijaz, Federico Antillon-Klussmann, Vaskar Saha, Rui M Reis, Gevorg Tamamyan, Patricia Alcasabas, Eva Cutiongdo-de la Paz, Jamie Zeal and 7 more

Abstract read
In one paragraph

Article in Pediatric blood & cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

17 authors.

Kenneth M BusbyDepartment of Pediatrics, University of North Carolina, Chapel Hill, North Carolina, USA.ORCID https://orcid.org/0000-0003-1199-0081
Nathaniel WebbCollege of Arts and Science, University of North Carolina, Chapel Hill, North Carolina, USA.
Javeria AijazIndus Hospital, Karachi, Pakistan.
Federico Antillon-KlussmannUnidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala.
Vaskar SahaTata Translational Cancer Research Centre, Tata Medical Center, Kolkata, West Bengal, India.
Rui M ReisMolecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil.ORCID https://orcid.org/0000-0002-9639-7940
Gevorg TamamyanPediatric Cancer and Blood Disorders Center of Armenia, Yerevan, Armenia.
Patricia AlcasabasPhilippine General Hospital, Manila, Philippines.
Eva Cutiongdo-de la PazNational Institutes of Health, University of the Philippines, Manila, Philippines.
Jamie ZealDepartment of Pediatrics, University of North Carolina, Chapel Hill, North Carolina, USA.
Dylan GraetzDepartment of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.ORCID https://orcid.org/0000-0002-4541-6910
Nickhill BhaktaDepartment of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
Angelo NavasEshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina, USA.
Samantha RubioEshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina, USA.
Stuart RennieDepartment of Pediatrics, University of North Carolina, Chapel Hill, North Carolina, USA.
Thomas B AlexanderDepartment of Pediatrics, University of North Carolina, Chapel Hill, North Carolina, USA.ORCID https://orcid.org/0000-0002-0484-1574
Megan C RobertsEshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina, USA.

Funding

North Carolina Translational and Clinical Sciences Institute (NC TraCS)UM1TR004406 · NCATS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI NICHOLAS J SHAHEEN · 2023 to 2026
$37.5M
Cancer Control Education ProgramT32CA057726 · NCI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Melissa B Gilkey, Melissa A. Troester · 2017 to 2026
$3.7M
NCATS NIH HHS UM1 TR004406NCI NIH HHS T32 CA057726NIH Cancer Control Education 2T32CA057726-31NIH Cancer Control Education UM1TR004406
6 · The paper itself

Abstract

backgroundInaccurate or imprecise diagnosis is a major contributor to treatment failure for children with cancer in low- and middle-income countries (LMICs). Sequencing-based diagnostic testing presents an opportunity to overcome diagnostic deficiencies. It is important to identify facilitators and barriers which are common to the implementation of sequencing-based diagnostics in LMICs. PROCEDURE: Pediatric oncology research collaborators at six hospitals in LMICs were invited to participate in the study. Snowball sampling identified additional participants. Thirty-nine virtual, semi-structured interviews were conducted using interview guides informed by the Consolidated Framework for Implementation Research (CFIR) with suggested adaptations for LMICs. Rapid qualitative analysis was conducted to identify facilitators and barriers to the implementation of diagnostic sequencing for pediatric cancers. Barriers were then matched with expert recommendation for implementation change (ERIC) strategies.

resultsImplementation facilitators and barriers were organized by CFIR construct. Predominant facilitators were relative advantage, culture, collective efficacy, self-efficacy, patient needs and resources, leadership engagement, knowledge and beliefs, tension for change, monitoring services for action, and implementation climate. Key barriers to implementation were cost, available resources, resource continuity, engaging participants, and resource source.

conclusionsParticipants communicated that the lack of diagnostic classification for pediatric cancer in LMICs is a common key limitation to current cancer care. They described considerable motivating strengths to leverage toward this goal of developing sequencing-based diagnostic testing capacity. Resource availability, continuity, and sustainability are current barriers that must be addressed. Our data highlight the urgent need for creative global implementation partnerships as many centers in LMICs are poised to advance novel diagnostic solutions.

Indexed as

Developing CountriesMedical OncologyNeoplasmsChildFemaleHumansResource-Limited Settingscancerdiagnostic sequencinglow‐ and middle‐income countries (LMIC)pediatrics

Identifiers

PMID41834188
PMCPMC13673947

What OpenQuestion holds

Textmetadata
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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.