Improving guideline sensitivity and specificity for the identification of proactive gastrostomy placement in patients with head and neck cancer

Brown, Teresa E., Crombie, Jane, Spurgin, Ann-Louise, Tripcony, Lee, Keller, Jacqui, Hughes, Brett G. M., Dickie, Graeme, Kenny, Lizbeth Moria and Hodge, Robert A. (2015) Improving guideline sensitivity and specificity for the identification of proactive gastrostomy placement in patients with head and neck cancer. Head and Neck, 1-9. doi:10.1002/hed.24184


Author Brown, Teresa E.
Crombie, Jane
Spurgin, Ann-Louise
Tripcony, Lee
Keller, Jacqui
Hughes, Brett G. M.
Dickie, Graeme
Kenny, Lizbeth Moria
Hodge, Robert A.
Title Improving guideline sensitivity and specificity for the identification of proactive gastrostomy placement in patients with head and neck cancer
Journal name Head and Neck   Check publisher's open access policy
ISSN 1097-0347
1043-3074
Publication date 2015-08-13
Sub-type Article (original research)
DOI 10.1002/hed.24184
Open Access Status Not Open Access
Start page 1
End page 9
Total pages 9
Place of publication Hoboken, NJ, United States
Publisher John Wiley & Sons
Language eng
Formatted 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.
Keyword Gastrostomy
Guidelines
Head and neck cancer
Nutrition
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Medicine Publications
 
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