{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:25:07Z","timestamp":1787847907941,"version":"build-2784847793"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":221,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012524","name":"American Lebanese Syrian Associated Charities","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100012524","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pediatric central nervous system (CNS) tumors are the leading cause of cancer-related death among children and adolescents globally. Despite the complex and multidisciplinary care needed, there is limited evidence on standardized quality indicators (QIs) for pediatric neuro-oncology (PNO).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A modified Delphi process was conducted to develop consensus-based QIs for PNO. Candidate indicators were identified through a systematic review of published literature. After expert screening, indicators were evaluated by a multidisciplinary panel through 2 rounds of Delphi surveys. Consensus was defined as \u226575% agreement. A subsequent consensus meeting and tiering process were conducted to categorize the selected indicators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The systematic review identified 35 studies containing 124 relevant indicators; these were subsequently refined to 63 candidate indicators for evaluation in 2 Delphi surveys. Thirty-two experts from 5 specialties and 15 countries participated in the consensus process. A consensus was established that included that indicators would have the following 3 characteristics: reflect the continuum of PNO care, be continuous variables, and be feasible to measure across diverse resource settings. Through 2 rounds of Delphi surveys, a total of 48 indicators met the consensus threshold. Indicators were subsequently consolidated to 31, following discussion and merging of overlapping items. Final indicators were categorized into 2 sets: 19 core indicators and 12 extended indicators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>By providing a framework for evaluating quality across the continuum of PNO care, these indicators can aid benchmarking and guide quality improvement interventions. Prospective validation and assessment of their impact on patient outcomes are still needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/noajnl\/vdag206","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T11:17:07Z","timestamp":1786101427000},"source":"Crossref","is-referenced-by-count":0,"title":["Quality indicators for the care of children with CNS tumors: An international modified Delphi study"],"prefix":"10.1093","volume":"8","author":[{"given":"Sergio","family":"Licona","sequence":"first","affiliation":[{"name":"Department of Global Pediatric Medicine, St. Jude Children\u2019s Research Hospital , Memphis, Tennessee,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed Ahmer","family":"Hamid","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology & Oncology, Indus Hospital & Health Network , Karachi,","place":["Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Mutura","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Kenyatta National Hospital , Nairobi,","place":["Kenya"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alia","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology\/Oncology, The Children\u2019s Hospital Lahore , Lahore,","place":["Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6164-5863","authenticated-orcid":false,"given":"Asim","family":"Bag","sequence":"additional","affiliation":[{"name":"Department of Radiology, St. Jude Children\u2019s Research Hospital , Memphis, Tennessee,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Bailey","sequence":"additional","affiliation":[{"name":"Pediatric Hematology and Oncology, Great North Children\u2019s Hospital, Newcastle University , Newcastle upon Tyne,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronnie E","family":"Baticulon","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Philippine General Hospital, University of the Philippines Manila , Manila,","place":["Philippines"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick","family":"Boop","sequence":"additional","affiliation":[{"name":"Department of Global Pediatric Medicine, St. Jude Children\u2019s Research Hospital , Memphis, Tennessee,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6832-6539","authenticated-orcid":false,"given":"Eric","family":"Bouffet","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, The Hospital for Sick Children, University of Toronto , Toronto, Ontario,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dian","family":"Cahyanti","sequence":"additional","affiliation":[{"name":"Anatomical Pathology Division, Rumah Sakit Kanker Dharmais , Jakarta,","place":["Indonesia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Chamdine","sequence":"additional","affiliation":[{"name":"Department of Oncology, St. Jude Children\u2019s Research Hospital , Memphis, Tennessee,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth T E","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, KK Women\u2019s and Children\u2019s Hospital , ,","place":["Singapore Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gargi","family":"Das","sequence":"additional","affiliation":[{"name":"Division of Pediatric Oncology, Department of Medical Oncology, Cancer Institute (WIA) , Chennai, Tamil Nadu,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2736-8596","authenticated-orcid":false,"given":"Michael C","family":"Dewan","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Vanderbilt University Medical Center , Nashville, Tennessee,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosdali","family":"Diaz-Coronado","sequence":"additional","affiliation":[{"name":"Pediatric Oncology, Instituto Nacional de Enfermedades Neopl\u00e1sicas, Universidad Peruana Cayetano Heredia Medical School , Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jen Chun","family":"Foo","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology & Oncology, Universiti Malaya Medical Center , Kuala Lumpur,","place":["Malaysia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Giron","sequence":"additional","affiliation":[{"name":"Unidad Nacional de Oncolog\u00eda Pedi\u00e1trica Department of Oncology, , Guatemala, Guatemala"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvaro","family":"Lassaletta","sequence":"additional","affiliation":[{"name":"Pediatric Hematology Oncology, Hospital Infantil Universitario Ni\u00f1o Jesus , Madrid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"John T","family":"Lucas","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, St. Jude Children\u2019s Research Hospital , Memphis, Tennessee,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andres","family":"Morales-La Madrid","sequence":"additional","affiliation":[{"name":"Pediatric Cancer Center Barcelona, Hospital Sant Joan de D\u00e9u , Barcelona,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina M","family":"Navarro-Martin del Campo","sequence":"additional","affiliation":[{"name":"Pediatric Hematology and Oncology Service, Hospital Civil de Guadalajara Dr Juan I. Menchaca , Guadalajara,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuha","family":"Omran","sequence":"additional","affiliation":[{"name":"Radiation Oncology Department, Borg El Arab University Hospital , Alexandria,","place":["Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana S","family":"Osorio","sequence":"additional","affiliation":[{"name":"Division of Pediatrics, The University of Texas MD Anderson Cancer Center , Houston, Texas,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Qaddoumi","sequence":"additional","affiliation":[{"name":"Department of Global Pediatric Medicine, St. Jude Children\u2019s Research Hospital , Memphis, Tennessee,","place":["USA"]},{"name":"Department of Oncology, St. Jude Children\u2019s Research Hospital , Memphis, Tennessee,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bilal Mazhar","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Radiation Oncology Section, Department of Oncology, Aga Khan University , Karachi,","place":["Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noah D","family":"Sabin","sequence":"additional","affiliation":[{"name":"Department of Radiology, St. Jude Children\u2019s Research Hospital , Memphis, Tennessee,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hend","family":"Sharafeldin","sequence":"additional","affiliation":[{"name":"Pathology Department, Borg El Arab University Hospital , Alexandria,","place":["Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay","family":"Sundar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Cancer Institute (WIA) , Chennai, Tamil Nadu,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6101-149X","authenticated-orcid":false,"given":"Santhosh A","family":"Upadhyaya","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology Oncology, Department of Pediatrics, C. 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