Improving guideline sensitivity and specificity for the identification of proactive gastrostomy placement in patients with head and neck cancer.
Head Neck
; 38 Suppl 1: E1163-71, 2016 04.
Article
in En
| MEDLINE
| ID: mdl-26268152
ABSTRACT
BACKGROUND:
Swallowing and nutrition guidelines for patients with head and neck cancer are available for identification of proactive gastrostomy placement in patients with high nutritional risk. The purpose of this study was to investigate improvements to the validity of these guidelines.METHODS:
A multivariate analysis was fitted to the original dataset (n = 501) to examine the variables that may predict gastrostomy placement (eg, tumor site, treatment, sex, and age). Using these factors, the high risk category was modified and retrospectively validated in the same cohort to provide new measures of sensitivity and specificity.RESULTS:
The following were positive predictors of gastrostomy placement T3 (p = .01), T4 (p < .001), and chemoradiotherapy (p < .001). Laryngeal (p = .02) and skin cancer (p < .001) were negative predictors. Modification of the high risk definition improved sensitivity to 58% and maintained specificity at 92%.CONCLUSION:
Minor modifications to the high risk definition in the guidelines have improved the guideline sensitivity for future use. © 2015 Wiley Periodicals, Inc. Head Neck 38 E1163-E1171, 2016.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Gastrostomy
/
Head and Neck Neoplasms
Type of study:
Diagnostic_studies
/
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Head Neck
Journal subject:
NEOPLASIAS
Year:
2016
Document type:
Article
Affiliation country:
Australia