The Role of Nutrition Support in Pediatric Patients with Solid Malignancies: A Systematic Review
Bibliographic record
Abstract
Objective.Using the evidence-analysis process of the Academy of Nutrition and Dietetics, we systematically examined the evidence between nutrition interventions (enteral and parenteral feeding) and four outcome variables (nutrition status, treatment delays, protein energy malnutrition, and rate of infection) in pediatric patients with solid, malignant tumors. Methods.Four evidence-analysis questions were formulated based on nutritional care and practice for pediatric-oncology patients.An electronic literature search of three databases, EBSCOhost, GoogleScholar, and PubMed was carried out.Studies were classified by study design and then assigned a quality rating using standardized criteria research which included items such as potential sources of bias, the research question, variables, study groups, blinding, methods, outcomes, and the validity and reliability of the results.A conclusion statement was then assigned for each evidence-analysis question based on the results of the review.An evidence grade of I (strong), II (fair), III (weak), IV (expert opinion only), or V (no evidence) was assigned to each statement indicating the strength of the evidence. Results.Two non-randomized control trials, two non-randomized control/cohort studies, and one cohort study were evaluated to determine the impact of enteral and/or parenteral nutrition support on nutrition status of pediatric oncology patients with solid malignancies.One nonrandomized control trial found that 40% of patients (N = 46) receiving gastrostomy tube feedings reached >95% of their desirable body weight after a mean of 4.9 months.One non-randomized control/cohort study (N = 24) found that patients receiving total parenteral nutrition (TPN) increased their weight by 17 ± 2%, and patients receiving peripheral parenteral nutrition plus enteral nutrition (PPN + EN) increased their weight by 11 ± 2% (p < 0.05).One non-randomized control/cohort study found that TPN for 9-14 days did not improve nutritional status, but TPN guidance in the development and completion of my thesis.I have the most sincere gratitude for Mary Jo Frost for helping with the administrative aspect of completing my degree and thesis in the Nutrition Sciences department.Many thanks to Lauren Fischer RD, LD for keeping me on track and going through the thesis writing process with me.Lastly, thank you to Michelle Esposito RD, LD, CNSC and all my co-workers in the Cancer and Blood Diseases Institute at Cincinnati Children's Hospital Medical Center who gave me the idea for this thesis and who's work changes the outcome for pediatric oncology patients every day.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.041 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.005 |
| Bibliometrics | 0.007 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".