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

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

Do decision aids and other tools improve the quality of oncofertility service provision?

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