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

Wilne, Sophie Helen (2011). The Pathways Project: developing guidelines to facilitate the diagnosis of childhood brain tumours. University of Birmingham. M.D.

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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: Thesis (Higher Doctorates > M.D.)
Award Type: Higher Doctorates > M.D.
Supervisor(s):
Supervisor(s)EmailORCID
Grundy, RichardUNSPECIFIEDUNSPECIFIED
Licence:
College/Faculty: Colleges (2008 onwards) > College of Medical & Dental Sciences
School or Department: School of Clinical and Experimental Medicine, Academic Department of Obstetrics and Gynacology
Funders: Other
Other Funders: Big Lottery Fund, The Brain Tumour Charity, The Brain Tumour Charity
Subjects: R Medicine > RG Gynecology and obstetrics
URI: http://etheses.bham.ac.uk/id/eprint/2881

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