Critical appraisal:Kemertzis MA, Ranjithakumaran H, Hand M, Peate M, Gillam L, McCarthy M, et al 2018

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Critical Appraisal

Article being appraised

Kemertzis MA, Ranjithakumaran H, Hand M, Peate M, Gillam L, McCarthy M, et al. Fertility Preservation Toolkit: A Clinician Resource to Assist Clinical Discussion and Decision Making in Pediatric and Adolescent Oncology. J Pediatr Hematol Oncol 2018 Apr;40(3):e133-e139 Available from: http://www.ncbi.nlm.nih.gov/pubmed/29481385.


Applicable clinical question

Key Facts

Study Design

case series

Study aims:

evaluated a fertility toolkit for clinicians involved in FP discussions with pediatric, adolescent, and young adult patients and parents.
survey-based, longitudinal study of clinicians

Number of Patients:

109

clinicians at The Royal Children’s Hospital Melbourne involved in FP discussions undertaken at 3 time-points: 2014, along side an education session for baseline assessment of oncofertility practices (survey 1); after each toolkit use to evaluate case-specificimplementation (survey 2); 2016, to evaluate impact on clinical practice (survey 3).

59 clinicians completed survey 1.
11 clinicians completed survey 2.

39 clinicians completed survey 3.
Reported outcome(s):

Impact of tool kit on practice over time (pre/ post -implementation)

Results of outcome(s):

Survey 1: >66% reported baseline dissatisfaction with the existing FP system; 56.7% were not confident in providing up-to-date information. Only 34.5% “often” or “always” provided verbal information; 14.0% “often” or “always” provided written information.

Survey 2: clinician was satisfied with the toolkit in 63.6% of discussions (7/11), and extremely satisfied or satisfied with the FP discussion in 100% of cases (11/11). The clinician perceived the patient or family to have extremely well understood or reasonably well understood the FP discussion in 90.9% of cases (10/11) and were perceived to be satisfied with the FP discussion in 100% of cases (11/11).

Survey 3: Over 70% felt confident providing up-to-date FP knowledge, 67.7% “often” or “always” provided verbal information, and 35.4% “often” or “always” provided written information.

Clinicians desire improvement in FP practice. The toolkit provided significant perceived and actual benefits.

Comments on results:

no controls
small sample

Includes an economic evaluation

no

Evidence ratings

Level of evidence

IV

Risk of bias
High risk of bias Comments: Small sample, single centre study, subjective measures


Size of effect
5 Reason for decision: Did not measure size of effect
Relevance of evidence
2 Additional comments: Case series

subjective measures

Result of appraisal

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Completed by

Dr Michelle Peate

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Article
Kemertzis MA, Ranjithakumaran H, Hand M, Peate M, Gillam L, McCarthy M, et al. Fertility Preservation Toolkit: A Clinician Resource to Assist Clinical Discussion and Decision Making in Pediatric and Adolescent Oncology. J Pediatr Hematol Oncol 2018 Apr;40(3):e133-e139 Available from: http://www.ncbi.nlm.nih.gov/pubmed/29481385.
Assigned to
User:Michelle.peate
Topic area
Guidelines:COSA:Cancer fertility preservation guidelines/Oncofertility service development
Clinical question
Form
Form:Critical appraisal


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