原创力文档updated systematic review and meta-analysis of the performance of risk prediction rules in children and young people with febrile neutropenia更新的系统回顾和荟萃分析的风险预测的性能规则与发热性中性粒细胞减少儿童和年轻人.pdfVIP
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updated systematic review and meta-analysis of the performance of risk prediction rules in children and young people with febrile neutropenia更新的系统回顾和荟萃分析的风险预测的性能规则与发热性中性粒细胞减少儿童和年轻人
Updated Systematic Review and Meta-Analysis of the
Performance of Risk Prediction Rules in Children and
Young People with Febrile Neutropenia
1 2 3 3
Robert S. Phillips *, Thomas Lehrnbecher , Sarah Alexander , Lillian Sung
1 Centre for Reviews and Dissemination, University of York, York, United Kingdom, 2 Department of Paediatric Haematology and Oncology, University of Frankfurt,
Frankfurt, Germany, 3 Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada
Abstract
Introduction: Febrile neutropenia is a common and potentially life-threatening complication of treatment for childhood
cancer, which has increasingly been subject to targeted treatment based on clinical risk stratification. Our previous meta-
analysis demonstrated 16 rules had been described and 2 of them subject to validation in more than one study. We aimed
to advance our knowledge of evidence on the discriminatory ability and predictive accuracy of such risk stratification clinical
decision rules (CDR) for children and young people with cancer by updating our systematic review.
Methods: The review was conducted in accordance with Centre for Reviews and Dissemination methods, searching multiple
electronic databases, using two independent reviewers, formal critical appraisal with QUADAS and meta-analysis with
random effects models where appropriate. It was registered with PROSPERO: CRD42011001685.
Results: We found 9 new publications describing a further 7 new CDR, and validations of 7 rules. Six CDR have now been
subject to testing across more than two data sets. Most validations demonstrated the rule to be less efficient than when
initially proposed; geographical differences appeared to be one explanation for this.
Conclusion: The use of clini
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