{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T17:36:33Z","timestamp":1785173793040,"version":"3.55.0"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T00:00:00Z","timestamp":1706572800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T00:00:00Z","timestamp":1706572800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["UG1CA189955"],"award-info":[{"award-number":["UG1CA189955"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp;amp; Cancer"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The primary objective was to measure the proportion of episodes where care delivery was inconsistent with selected recommendations of a clinical practice guideline (CPG) on fever and neutropenia (FN) management. The influence of site size on CPG\u2010inconsistent care delivery, and association between patient outcomes and CPG\u2010inconsistent care were described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective, multicenter study included patients less than 21\u00a0years old with cancer who were at high risk of poor FN outcomes and were previously enrolled to a Children's Oncology Group (COG) study at participating National Cancer Institute Community Oncology Research Program (NCORP) institutions from January 2014 through December 2015. Patients were randomly selected for chart review by participating sites from a COG\u2010generated list. Care delivered in each episode was adjudicated (CPG\u2010consistent or CPG\u2010inconsistent) against each of five selected recommendations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 107 patients from 22 sites, representing 157 FN episodes, were included. The most common CPG\u2010inconsistent care delivered was omission of pulmonary computerized tomography in patients with persistent FN (60.3%). Of 74 episodes where assessment of four (episodes without persistent FN) or five (episodes with persistent FN) recommendations was possible, CPG\u2010inconsistent care was delivered with respect to at least one recommendation in 63 (85%) episodes. Site size was not associated with CPG\u2010inconsistent care delivery. No statistically significant association between CPG\u2010inconsistent care and fever recurrence was observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this cohort of pediatric patients at high risk of poor FN outcomes, CPG\u2010inconsistent care was common. Opportunities to optimize resource stewardship by boosting supportive care CPG implementation are highlighted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pbc.30880","type":"journal-article","created":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T00:55:10Z","timestamp":1706662510000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Clinical practice guideline\u2010inconsistent management of fever and neutropenia in pediatric oncology: A Children's Oncology Group study"],"prefix":"10.1002","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7699-1061","authenticated-orcid":false,"given":"L. Lee","family":"Dupuis","sequence":"first","affiliation":[{"name":"Research Institute The Hospital for Sick Children  Toronto Ontario Canada"},{"name":"Department of Pharmacy, The Hospital for Sick Children, Leslie Dan Faculty of Pharmacy University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian T.","family":"Fisher","sequence":"additional","affiliation":[{"name":"The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. J.","family":"Sugalski","sequence":"additional","affiliation":[{"name":"University of Texas Health Science Center San Antonio  San Antonio Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison Caren","family":"Grimes","sequence":"additional","affiliation":[{"name":"University of Texas Health Science Center San Antonio  San Antonio Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Nu\u00f1o","sequence":"additional","affiliation":[{"name":"Children's Oncology Group  Monrovia California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Ramakrishnan","sequence":"additional","affiliation":[{"name":"Children's Oncology Group  Monrovia California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. P.","family":"Beauchemin","sequence":"additional","affiliation":[{"name":"Columbia University Irving Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula D.","family":"Robinson","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Group of Ontario  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Santesso","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence and Impact McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6261-8357","authenticated-orcid":false,"given":"Alexandra","family":"Walsh","sequence":"additional","affiliation":[{"name":"Center for Cancer and Blood Disorders Phoenix Children's Hospital, University of Arizona  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. R.","family":"Wrightson","sequence":"additional","affiliation":[{"name":"Nemours Center for Cancer and Blood Disorders  Wilmington North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lolie","family":"Yu","sequence":"additional","affiliation":[{"name":"LSUHSC\/Children's Hospital  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan K.","family":"Parsons","sequence":"additional","affiliation":[{"name":"Institute for Clinical Research and Health Policy Studies and Division of Hematology\/Oncology Tufts Medical Center  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lillian","family":"Sung","sequence":"additional","affiliation":[{"name":"Research Institute The Hospital for Sick Children  Toronto Ontario Canada"},{"name":"Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,30]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Clinical Practice Guidelines: Directions for a New Program","author":"Institute of Medicine (US) Committee to Advise the Public Health Service on Clinical Practice Guidelines","year":"1990"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.42.7161"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1086\/339215"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2012.062885"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/02664760903046102"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2018.11.008"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.71.7017"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.22.02224"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.29579"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39489.470347.AD"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/1468-0009.00105"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.13899"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.2921"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1155\/2006\/753083"},{"issue":"2","key":"e_1_2_9_16_1","doi-asserted-by":"crossref","first-page":"S14","DOI":"10.1007\/s11606-006-0269-7","article-title":"Toward evidence\u2010based quality improvement. 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