{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T20:45:30Z","timestamp":1786653930388,"version":"build-2736575974"},"reference-count":55,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"8","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Glob Oncol"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Children with cancer in low- and middle-income countries face high preventable in-hospital mortality, often because of delayed recognition of clinical deterioration. Pediatric Early Warning Systems (PEWS) enable early detection but require frequent clinician assessments that are difficult to sustain in resource-constrained settings. The Family-Assisted Severe Illness Therapy (FASTER) tool trains caregivers to perform simple bedside assessments as an alternative screening approach. We evaluated the concurrent validity, feasibility, and acceptability of caregiver-recorded FASTER scores versus clinician-recorded PEWS scores among pediatric oncology inpatients at the Uganda Cancer Institute.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>In this prospective, concurrent validity study, 50 caregiver-patient pairs were enrolled. After structured training, caregivers performed FASTER assessments every 6 hours over 48 hours while a study nurse independently recorded PEWS scores every 8 hours, yielding 321 concurrent paired observations for analysis. Concurrent validity was assessed using Spearman correlation and kappa agreement statistics. Diagnostic performance for PEWS-defined deterioration (PEWS \u22653) was evaluated using sensitivity, specificity, predictive values, and AUROC. Feasibility and acceptability were assessed through adherence monitoring and structured exit interviews.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      FASTER scores correlated moderately to strongly with PEWS scores (\u03c1 = 0.65 [95% CI, 0.58 to 0.71];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), although categorical agreement was poor (unweighted \u03ba = 0.07). For PEWS-defined deterioration, FASTER showed high sensitivity (96.7%) and modest specificity (47.5%); AUROC was 0.89 (95% CI, 0.84 to 0.94), reflecting yellow-threshold discrimination given only two PEWS-red events. The positive predictive value was 29.7%, and the negative predictive value was 98.4%. Caregiver adherence was high (98.3%), and acceptability was strong (100% useful, 78% easy\/very easy), although lower education predicted greater difficulty (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .014).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>FASTER demonstrated concurrent validity with PEWS and high feasibility and acceptability; its predictive validity and impact on clinical outcomes require further study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/go-25-00726","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:59:14Z","timestamp":1786651154000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Feasibility and Concurrent Validity of the Family-Assisted Severe Illness Therapy Tool Compared With Pediatric Early Warning Systems in Pediatric Oncology"],"prefix":"10.1200","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4803-8369","authenticated-orcid":true,"given":"Jane","family":"Namusisi","sequence":"first","affiliation":[{"name":"Uganda Cancer Institute, Kampala, Uganda"},{"name":"Uganda Child Cancer Foundation, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9595-0372","authenticated-orcid":true,"given":"Steven","family":"Kikonyogo","sequence":"additional","affiliation":[{"name":"Uganda Child Cancer Foundation, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babra","family":"Atuheire","sequence":"additional","affiliation":[{"name":"Uganda Cancer Institute, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Racheal","family":"Angom","sequence":"additional","affiliation":[{"name":"Uganda Cancer Institute, Kampala, 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