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Cochrane Database of Systematic Reviews

Low bacterial diet to prevent infection in neutropenic patients

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Information

DOI:
https://doi.org/10.1002/14651858.CD006247Copy DOI
Database:
  1. Cochrane Database of Systematic Reviews
Version published:
  1. 18 October 2006see what's new
Type:
  1. Intervention
Stage:
  1. Protocol
Cochrane Editorial Group:
  1. Cochrane Childhood Cancer Group

Copyright:
  1. Copyright © 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Authors

  • Arno Mank

    Correspondence to: Department of Haematology F6 155, Emma Children's Hospital / Academic Medical Centre, Amsterdam, Netherlands

    [email protected]

  • Michelle Davies

    ALU, Christie Hospital, Manchester, UK

  • Nelia Langeveld

    Dept of Paediatric Onocology F8 257, Emma Children's Hospital / Academic Medical Centre, Amsterdam, Netherlands

  • Marianne D van de Wetering

    Pediatrics, Emma Children's Hospital / Academic Medical Centre, Amsterdam, Netherlands

  • Hans van der Lelie

    Dept of Haematology F6 154, Emma Children's Hospital / Academic Medical Centre, Amsterdam, Netherlands

Contributions of authors

AM, NL protocol development, MD protocol development advisor. MvdW, HvdL protocol development advisor and review of manuscript.

Declarations of interest

None known.

Version history

Published

Title

Stage

Authors

Version

2016 Apr 24

Low bacterial diet versus control diet to prevent infection in cancer patients treated with chemotherapy causing episodes of neutropenia

Review

Elvira C van Dalen, Arno Mank, Edith Leclercq, Renée L Mulder, Michelle Davies, Marie José Kersten, Marianne D van de Wetering

https://doi.org/10.1002/14651858.CD006247.pub3

2012 Sep 12

Low bacterial diet versus control diet to prevent infection in cancer patients treated with chemotherapy causing episodes of neutropenia

Review

Elvira C van Dalen, Arno Mank, Edith Leclercq, Renée L Mulder, Michelle Davies, Marie José Kersten, Marianne D van de Wetering

https://doi.org/10.1002/14651858.CD006247.pub2

2006 Oct 18

Low bacterial diet to prevent infection in neutropenic patients

Protocol

Arno Mank, Michelle Davies, Nelia Langeveld, Marianne D van de Wetering, Hans van der Lelie

https://doi.org/10.1002/14651858.CD006247

Keywords

MeSH

PICOs

Population
Intervention
Comparison
Outcome

The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.

See more on using PICO in the Cochrane Handbook.

Table 1. Definitions

Infection is defined as:
1) Fever of unknown origin (FUO): New onset of fever without clear clinical or microbiological evidence; Fever is defined as: a single oral temperature of = 38.3°C or = 38.0° C, over at least 1 hour or twice within 12 hours without evident cause (Hughes, 2002).

2) Clinically documented infection (CDI): Fever in connection with unambiguous diagnostic signs of localized infection, e.g. pneumonia or skin/soft tissue inflammation without microbiological proof or if not accessible for examination.

3) Micro‐biologically documented infection (MDI): Fever with plausible pathogenic evidence (in the microbiological / time context) in addition to identified localized infection, or pathogenic agents found in blood culture without localized infection.

Fungaemia/ Proven Fungal infection is defined as:
1) Microbiological cultures of specimens from normally sterile but clinically abnormal sites with positive results from blood, sputum, urine, cerebrospinal fluid, bone or joint, peritoneum, bronchoalveolar lavage, sinus aspirate specimen or any other sterile body fluid samples.

2) Clinical criteria: findings from radiological or other imaging examination to distinguish between evidence of abnormality of an organ or organ system like ophthalmologic examination, ultrasound examination, HRCT scan of the lungs (Ascioglu, 2002).

Neutropenia is defined as:
Absolute Neutrophil Count (ANC) (the total white blood cell count multiplied by the combined percentage of segmented neutrophils and band cells) is < 0.5 x 109 /L for an episode of at least 7 days

Figures and Tables -
Table 1. Definitions
Table 2. Assessment of methodological quality of randomised controlled trials

Selection bias
Allocation concealment:
A.Adequate: Use of randomisation method that did not allow investigator and participant to know or influence the allocation of treatment before eligible participants entered the study.
B.Unclear: Randomisation stated but no information on method used in available.
C.Inadequate: Use of alternate medical record numbers or unsealed envelopes as randomisation method, and/or there is information in the study indicating that investigators or participants could have influenced the allocation of treatment.

Performance bias
Blinding of care providers: Yes/ No/ Unclear
Blinding of participants: Yes/ No/ Unclear
Care providers and patients are considered not blinded if the intervention group can be identified in >20% of participants because of side‐effects of treatment.

Detection bias
Blinding of outcome assessors: Yes/ No/ Unclear

Attrition bias
Intention to treat analysis:
A.Yes: All participants are analysed in the treatment group to which they were allocated, regardless of whether or not they received the allocated intervention.
B.No: Some participants (<5%, 5‐10%, 10‐20%, >20%) are not analysed in the treatment group to which they were randomised because they did not receive study intervention, they withdrew from the study, or because of protocol violation.
C.Unclear: Inability to determine if patients were analysed according to the intention to treat principle after contact with the authors.

Completeness of follow‐up
Percentage of participants excluded or lost to follow‐up for the different treatment groups for the primary and secondary outcomes (<5%, 5‐10%, 10‐20%, >20%).

Figures and Tables -
Table 2. Assessment of methodological quality of randomised controlled trials
Table 3. Assessment of methodological quality of non‐randomised studies

NEWCASTLE ‐ OTTAWA QUALITY ASSESSMENT SCALE

Note: A study can be awarded a maximum of one star for each numbered item within the Selection and Outcome categories. A maximum of two stars can be given for Comparability

Selection
1. Representativeness of the exposed cohort
a)Truly representative of the average _______________ (describe) in the community
b)Somewhat representative of the average ______________ in the community
c)Selected group of users e.g. nurses, volunteers
d)No description of the derivation of the cohort

2. Selection of the non exposed cohort
a)Drawn from the same community as the exposed cohort
b)Drawn from a different source
c)No description of the derivation of the non exposed cohort

3. Ascertainment of exposure
a)Secure record (e.g. surgical records)
b)Structured interview
c)Written self report
d)No description

4. Demonstration that outcome of interest was not present at start of study
a)Yes
b)No

Comparability
1. Comparability of cohorts on the basis of the design or analysis
a)Study controls for _____________ (select the most important factor)
b)Study controls for any additional factor (This criteria could be modified to indicate specific control for a second important factor.)

Outcome
1. Assessment of outcome
a)Independent blind assessment
b)Record linkage
c)Self report
d)No description

2. Was follow‐up long enough for outcomes to occur
a)Yes (select an adequate follow up period for outcome of interest)
b)No

3. Adequacy of follow up of cohorts
a)Complete follow up ‐ all subjects accounted for
b)Subjects lost to follow up unlikely to introduce bias ‐ small number lost ‐ > ____ % (select an adequate %) follow up, or description provided of those lost)
c)Follow‐up rate < ____% (select an adequate %) and no description of those lost
d)No statement

Figures and Tables -
Table 3. Assessment of methodological quality of non‐randomised studies