Development of symptom management care pathway templates
cancer
CANCER, PEDIATRIC CANCER
This study was focused on the management of the 15 symptoms captured by the Symptom Screening in Pediatrics Tool (SSPedi). SSPedi is a reliable, valid and responsive self-report symptom assessment tool for English, French and Spanish-speaking children and adolescents 8–18 years of age receiving cancer treatments [The approach to the systematic identification of applicable CPGs relevant to pediatric cancer supportive care has previously been described in detail [The care pathway templates for all 14 symptoms were similarly structured and included three sections: prevention, assessment and treatment (see Additional file 1 for an example). The template formatting provided visual cues for statements stemming from conditional recommendations from the source CPGs. These recommendations reflected situations where intervention benefits were closely matched with their downsides or where there was considerable imprecision in the estimates. In these cases, institutions could choose to adopt the statement without change, reject the statement entirely or leave decision making to individual clinicians. The template formatting also provided visual cues for statements stemming from strong recommendations from the source CPGs. These recommendations reflected situations in which the intervention benefits clearly outweighed its downsides or vice versa. Consequently, it was anticipated most institutions would choose to adopt the statement with or without center-specific modifications. Finally, potential resources to provide the care outlined in the statements such as consulting services were listed.