Evidence map›Paper›PMID 42005160›Full record

ArticleCureus2026

A Hospitalist-Run Procedure Service Safely Streamlines Inpatient Intrathecal Chemotherapy.

Ghadi Ghanem, Allyson Malone, Lillian Chen, Gary S Feigenbaum, Alexandra M Glaeser

Abstract read
In one paragraph

Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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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

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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

5 authors.

Ghadi GhanemDepartment of Medicine, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, USA.
Allyson MaloneDepartment of Medicine, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, USA.
Lillian ChenDepartment of Medicine Statistics Core, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, USA.
Gary S FeigenbaumDepartment of Medicine, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, USA.
Alexandra M GlaeserDepartment of Medicine, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background In patients with hematologic malignancies, intrathecal chemotherapy by means of a lumbar puncture (LP) has found a critical role in delivering vital medications to patients with central nervous system (CNS) spread. However, many oncology patients who require this procedure have refractory thrombocytopenia that can lead to delays in intrathecal chemotherapy administration, as well as potentially the excess use of platelet transfusions, which are a limited resource. At our institution, intrathecal chemotherapy is delivered by radiology with a strict minimum number of platelets or a hospitalist-led medical procedure service (MPS), with a more individualized threshold. We sought to compare outcomes and complications of intrathecal chemotherapy administered using radiologist-guided fluoroscopy or bedside with the MPS. Methods We conducted a retrospective cohort study of adult inpatients referred for intrathecal chemotherapy from August 2019 to May 2022. An electronic medical record tool extracted demographics, laboratory results, and procedure timing. Relevant imaging within seven days of the LP was individually reviewed to determine major complications. Separately, patients were evaluated for traumatic taps based on their cerebrospinal fluid (CSF) red blood cell (RBC) count. Results There were 564 procedures that fit the inclusion criteria, 485 done by radiology and 79 by MPS. MPS teams conducted the procedure at lower platelet thresholds (49% with platelets below 50,000 in MPS as opposed to 6.4%, p < 0.001). Both teams had a low complication rate, 1.3% for MPS and 1.6% for radiology, though the MPS completed LPs sooner after consultation requests (six versus 24 hours; odds ratio {OR}: 0.41; p<0.001), with a 71% decrease in traumatic tap occurrence compared to those performed by radiology (OR = 0.29; p = 0.002). Conclusions Our study suggests that a hospitalist-run MPS can substantially expedite patient care in this vulnerable oncology population with a low complication rate, despite conducting the procedures with a higher proportion of patients with thrombocytopenia. Further research is warranted to determine MPS's impact on the length of stay (LOS), as well as potential cost savings associated with the procedure.

Indexed as

hospitalist medicineintrathecal chemotherapyintrathecal infusionlength of staylumbar puncture (lp)medical proceduremedical proceduresprocedure servicethrombocytopeniatransfusion threshold

Identifiers

PMID42005160
PMCPMC13089776

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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.