Nausea and vomiting in children and adolescents receiving intrathecal methotrexate: A prospective, observational study
Bibliographic record
Abstract
BACKGROUND: The prevalence of nausea and vomiting after receipt of intrathecal methotrexate (IT-MTX) in pediatric oncology patients is unknown. METHODS: Patients (4-18 years) about to receive IT-MTX were eligible to participate in this prospective, observational study. Patients received antiemetics as prescribed by their clinical team. Nausea severity (patient-assessed), timing of emetic episodes, and administration of antiemetics were recorded beginning immediately prior to IT-MTX administration, for the next 24 hr (acute phase), and for a maximum of 7 additional days (delayed phase). Complete chemotherapy-induced nausea and vomiting (CINV) control was defined as no emetic episodes and no nausea. RESULTS: One hundred patients consented to participate in this study; 70 provided evaluable data (mean age: 8.3 years; range: 4.1-17.6). Most (94%) received propofol-containing anesthesia for IT-MTX administration. Most (89%) received a 5-HT3 antagonist prior to IT-MTX. During the acute phase, 36 children (51%) experienced complete CINV control, 67 (96%) complete vomiting control, and 36 (51%) complete nausea control. Severe acute phase nausea was reported by 12 children (17%). During the delayed phase, 35 patients (50%) experienced complete CINV control, 60 (86%) complete vomiting control, and 36 (51%) complete nausea control. Severe nausea was reported in the delayed phase by 27 (39%) patients. CONCLUSIONS: Most pediatric patients who received IT-MTX and prophylaxis with ondansetron or granisetron experienced complete acute and delayed vomiting control. However, nausea control was poor and severe nausea was reported by many children. Effective interventions to control nausea are needed.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".