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.


Download (4MB)


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

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.

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.
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


Request a Correction Request a Correction
View Item View Item


Downloads per month over past year