Browsing by Author "Coronado, RD"

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Development of the pediatric neuro-oncology services assessment aid: An assessment tool for pediatric neuro-oncology service delivery capacity
(Oxford University Press, 2024) Rajagopal, R; Coronado, RD; Hamid, SA; Martin, del, Campo, RN; Boop, F; Bag, A; Reséndiz, AEB; Vasudeva, Bhat, K; Campos, D; Chang, K; Cirt, R; Rahmartani, LD; Foo, JC; Hoveyan, J; Lucas, JT,, Jr; Ngcana, T; Ul, Ain, R; Omran, N; Osorio, DS; Qureshi, BM; Sabin, ND; Schandorf, E; Bankah, P; Dadzie, M-A; Gbadamos, H; Sharafeldin, H; Somathilaka, M; Yang, P; Jean-Jacques, YA; Zhang, A; Salman, Z; Gonzalez, M; Friedrich, P; Rodriguez-Galindo, C; Qaddoumi, I; Moreira, DC
Background. To enhance the quality of care available for children with central nervous system (CNS) tumors across the world, a systematic evaluation of capacity is needed to identify gaps and prioritize interventions.To that end, we created the pediatric neuro-oncology (PNO) resource assessment aid (PANORAMA) tool. Methods. The development of PANORAMA encompassed 3 phases: operationalization, consensus building, and piloting. PANORAMA aimed to capture the elements of the PNO care continuum through domains with weighted assessments reflecting their importance. Responses were ordinally scored to reflect the level of satisfaction. PANORAMA was revised based on feedback at various phases to improve its relevance, usability, and clarity. Results. The operationalization phase identified 14 domains by using 252 questions.The consensus phase involved 15 experts (6 pediatric oncologists, 3 radiation oncologists, 2 neurosurgeons, 2 radiologists, and 2 pathologists). The consensus phase validated the identified domains, questions, and scoring methodology.The PANORAMA domains included national context, hospital infrastructure, organization and service integration, human resources, financing, laboratory, neurosurgery, diagnostic imaging, pathology, chemotherapy, radiotherapy, supportive care, and patient outcomes. PANORAMA was piloted at 13 institutions in 12 countries, representing diverse patient care contexts. Face validity was assessed by examining the correlation between the estimated score by respondents and calculated PANORAMA scores for each domain (r = 0.67, P < .0001). Conclusions. PANORAMA was developed through a systematic, collaborative approach, ensuring its relevance to evaluate core elements of PNO service capacity. Distribution of PANORAMA will enable quantitative service evaluations across institutions, facilitating benchmarking and the prioritization of interventions.
Impact of COVID-19 in pediatric oncology care in Latin America during the first year of the pandemic
(John Wiley and Sons Inc, 2022) Villanueva, G; Sampor, C; Palma, J; Villarroel, M; Valencia, D; Lombardi, MG; Garcia, WG; Caceres, EL; Sobrero, V; Garcia, L; Cabrera, V; Maza, I; Velasquez,T; Ugaz, C; Vasquez, JM; Coronado, RD; Gonzalez, N; Aguiar, S; Dabezies A; Moreno, F; Sardinas, S; Gamboa, Y; Maradiegue, E; Fu, L; Gassant, P; Moreno, K; Gonzales, O; Schelotto, M; Luna-Fineman, S; Antoneli, CG; Fuentes-Alabi, S; Luciani, S; Cappellano, A; Chantada, G; Vasquez, L
Background: The ongoing coronavirus 2019 disease (COVID-19) pandemic strained medical systems worldwide. We report on the impact on pediatric oncology care in Latin American (LATAM) during its first year. Method: Four cross-sectional surveys were electronically distributed among pediatric onco-hematologists in April/June/October 2020, and April/2021 through the Latin American Society of Pediatric Oncology (SLAOP) email list and St Jude Global regional partners. Results: Four hundred fifty-three pediatric onco-hematologists from 20 countries responded to the first survey, with subsequent surveys response rates above 85%. More than 95% of participants reported that treatment continued without interruption for new and active ongoing patients, though with disruptions in treatment availability. During the first three surveys, respondents reported suspensions of outpatient procedures (54.2%), a decrease in oncologic surgeries (43.6%), radiotherapy (28.4%), stem cell transplants (SCT) (69.3%), and surveillance consultations (81.2%). Logistic regression analysis showed that at the beginning of the first wave, participants from countries with healthcare expenditure below 7% were more likely to report a decrease in outpatient procedures (odds ratio [OR]: 1.84, 95% CI: 1.19–2.8), surgeries (OR: 3, 95% CI: 1.9–4.6) and radiotherapy (OR: 6, 95% CI: 3.5–10.4). Suspension of surveillance consultations was higher in countries with COVID-19 case fatality rates above 2% (OR: 3, 95% CI: 1.4–6.2) and SCT suspensions in countries with COVID-19 incidence rate above 100 cases per 100,000 (OR: 3.48, 95% CI: 1.6–7.45). Paradoxically, at the beginning of the second wave with COVID-19 cases rising exponentially, most participants reported improvements in cancer services availability. Conclusion: Our data show the medium-term collateral effects of the pandemic on pediatric oncology care in LATAM, which might help delineate oncology care delivery amid current and future challenges posed by the pandemic. © 2022 Wiley Periodicals LLC.
Risk factors associated with abandonment of care in retinoblastoma: analysis of 692 patients from 10 countries
(BMJ Publishing Group, 2023) Nishath, T; Li, X; Chandramohan, A; Othus, M; Ji, X; Zou, Y; Sultana, S; Rashid, R; Sherief, ST; Cassoux, N; Leon, JLG; Coronado, RD; Lopez, AMZ; Ushakova, TL; Polyakov, VG; Roy, SR; Ahmad, A; Reddy, A; Sagoo, MS; Harby, LA; Kim, JW; Berry, JL; Polski, A; Astbury, N; Bascaran, C; Blum, S; Bowman, R; Burton, MJ; Foster, A; Gomel, N; Keren-Froim, N; Madgar, S; Zondervan, M; Kaliki, S; Fabian, ID; Stacey, A
Background Rates of care abandonment for retinoblastoma (RB) demonstrate significant geographical variation; however, other variables that place a patient at risk of abandoning care remain unclear. This study aims to identify the risk factors for care abandonment across a multinational set of patients. Methods A prospective, observational study of 692 patients from 11 RB centres in 10 countries was conducted from 1 January 2019 to 31 December 2019. Multivariate logistic regression was used to identify risk factors associated with higher rates of care abandonment. Results Logistic regression showed a higher risk of abandoning care based on country (high-risk countries include Bangladesh (OR=18.1), Pakistan (OR=45.5) and Peru (OR=9.23), p<0.001), female sex (OR=2.39, p=0.013) and advanced clinical stage (OR=4.22, p<0.001). Enucleation as primary treatment was not associated with a higher risk of care abandonment (OR=0.59, p=0.206). Conclusion Country, advanced disease and female sex were all associated with higher rates of abandonment. In this analysis, enucleation as the primary treatment was not associated with abandonment. Further research investigating cultural barriers can enable the building of targeted retention strategies unique to each country. © Author(s) (or their employer(s)) 2023.