Background
cancer [, toxicities, cancer-
Supportive care for pediatric oncology patients focuses on preventing and managing cancer- and treatment-related toxicities. Early assessment and intervention for these toxicities are important as they are associated with morbidity, reduced quality of life, increased healthcare utilization and treatment-related mortality [Clinical practice guidelines (CPGs) include statements intended to optimize patient care,[There are several potential advantages of establishing institution-specific, evidence-based care pathways for supportive care. They may improve the consistency of supportive care and increase the likelihood that the supportive care delivered is CPG-consistent. In addition, they may reduce cognitive decision-making burden for individual clinicians by explicitly outlining the available care options. Finally, these documents may have positive impacts on patient outcomes including reducing toxicities and improving quality of life. If clear and achievable processes to create and adapt institution-specific care pathways were developed, it might provide a mechanism to improve evidence-based symptom management across institutions.We describe procedures performed as a component of a cluster randomized trial of 20 institutions in the United States testing whether a web-based application named Supportive care Prioritization, Assessment and Recommendations for Kids (SPARK) can improve symptom control in newly diagnosed pediatric patients with cancer [