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The Pathways Project: developing guidelines to facilitate the diagnosis of childhood brain tumours

Wilne, Sophie Helen (2011)
M.D. thesis, University of Birmingham.

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Abstract

The Pathways project was undertaken to devise guidelines to facilitate rapid diagnosis of paediatric brain tumours.

Methods:
A systematic review and meta-analysis of published data on paediatric brain tumour presentation and analysis of the presentation of children newly diagnosed with a brain tumour at four oncology centres was undertaken. The results informed a professional consensus process.

Results:
74 papers met the inclusion criteria for the meta-analysis. 56 symptoms and signs at diagnosis were identified. The most frequent symptoms and signs at diagnosis were: headache (33%), nausea and vomiting (32%), abnormalities of gait and coordination (27%), and papilloedema (13%). 139 patients were recruited to a multi-centre cohort study. Symptoms and signs at disease onset and at diagnosis and factors associated with a long and short symptom interval were determined. A shorter symptom interval was associated with nausea and vomiting and motor system abnormalities. A longer symptom interval was associated with head tilt, cranial nerve palsies, endocrine and growth abnormalities and reduced visual acuity. A multi-disciplinary workshop and Delphi consensus voting were used to translate the evidence into a clinical guideline comprising 76 statements advising on the identification and assessment of children who may have a brain tumour.

Type of Work:M.D. thesis.
Supervisor(s):Grundy, Richard
School/Faculty:Colleges (2008 onwards) > College of Medical & Dental Sciences
Department:Department of Obstetrics and Gynaecology
Subjects:RG Gynecology and obstetrics
Institution:University of Birmingham
ID Code:2881
This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder.
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