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An international multicenter survey reveals health care providers’ knowledge gap in childhood central nervous system tumors

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Abstract

Childhood central nervous system (CNS) tumors have longer delays in diagnosis than do other pediatric malignancies because health care providers (HCPs) lack awareness about clinical presentation of these tumors. To evaluate the knowledge gap among HCPs, we conducted a global cross-sectional survey. The survey consisted of a set of CNS tumor knowledge questions focused on symptoms, signs, and imaging indications. The survey was disseminated to HCPs via email (November 2018–March 2020). Participants had to complete a pre-test survey, attend an education seminar on CNS tumors, and complete a post-test survey. The knowledge gap was evaluated using pre-test and post-test scores. We received 889 pre-test and 392 post-test responses. Most respondents were from Asia (73.1% of pre-test responses; 87.5% of post-test responses). The median pre-test score was 40.0% (range: 13.1–92.9%). A high percentage of correct answers were given in post-test responses (median score: 77.1%, range: 14.9–98.2%). In the pre-test, 18.7% of participants accurately responded that Cushing’s triad was a less common symptom, and 15.0% recognized that children aged > 10 years are at risk of late diagnosis. Surprisingly, 21.9% falsely reported that patients with malignancy experienced the longest pre-diagnostic symptom interval, and 54.5% of respondents wrongly selected medulloblastoma as the most common CNS tumor. Overall, pediatricians demonstrated a greater knowledge gap on both surveys than did other specialties.

  Conclusion: Pre- and post-test surveys revealed significant knowledge gaps in childhood CNS tumors among HCPs. Thus, raising professional awareness on clinical presentations of CNS tumors through educational strategies is important to address this knowledge deficit.

What is Known:

• Diagnostic delay in childhood central nervous system (CNS) tumors continues to be a significant problem that negatively impacts the quality of life and treatment sequelae.

• Lack of medical education on CNS tumors is a contributing factor to this problem.

What is New:

• Most health care providers do not realize that low-grade tumors are the most common neoplasm in children.

• Health care providers fail to recognize that teenagers and adolescents are a vulnerable age group for diagnostic delays, with the longest pre-diagnostic symptom interval.

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Data availability

Data are available on request from the corresponding author.

Abbreviations

CNS:

Central nervous system

CT:

Computed tomography

HCPs:

Health care providers

ICP:

Intracranial pressure

LGG:

Low-grade glioma

MRI:

Magnetic resonance imaging

PSI:

Pre-diagnostic symptom interval

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Acknowledgements

We thank all the health care providers who participated in the survey. We also thank Vani Shanker, PhD, ELS, and Cherise Guess, PhD, ELS, from St. Jude Children’s Research Hospital for editing the article.

Funding

This work was funded by the American Lebanese Syrian Associated Charities (ALSAC). The funder/sponsor did not participate in the work.

Author information

Authors and Affiliations

  1. Department of Global Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Revathi Rajagopal, Daniel C. Moreira, Lane Faughnan, Huiqi Wang, Lisa Krull, Meenakshi Devidas & Ibrahim Qaddoumi

  2. Department of Pediatrics, Hospital Raja Permaisuri Bainun, Ipoh, Malaysia

    Revathi Rajagopal

  3. Department of Pediatrics, Hematology, and Oncology, MedStar Georgetown University Hospital, Washington, DC, USA

    Sameen Naqvi

  4. Centro de Investigación de Medicina de Precision, Universidad de San Martín de Porres, Facultad de Medicina, Lima, Peru

    Liliana Vasquez

  5. Unit of Non-Communicable Diseases, Pan American Health Organization, Washington, DC, USA

    Liliana Vasquez

  6. Department of Pediatric Oncology, Instituto Nacional de Enfermedades Neoplásicas (INEN), Lima, Peru

    Rosdali Diaz-Coronado

  7. Office of Student Learning, Georgetown University School of Medicine, Washington, DC, USA

    Michael Terao

Authors
  1. Revathi Rajagopal
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  2. Daniel C. Moreira
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  11. Ibrahim Qaddoumi
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Contributions

Ibrahim Qaddoumi conceptualized and designed the study, collected the data, drafted the initial manuscript, and reviewed and revised the manuscript. Lane Faughnan and Lisa Krull designed the data collection instruments, collected the data, and reviewed and revised the manuscript. Revathi Rajagopal, Daniel C Moreira, and Sameen Naqvi drafted the initial manuscript and reviewed and revised the manuscript. Huiqi Wang and Meenakshi Devidas carried out the initial analysis and reviewed and revised the manuscript. Liliana Vasquez, Rosdali Diaz-Coronado, and Michael Terao conceptualized and designed the study and reviewed and revised the manuscript.

Corresponding author

Correspondence to Ibrahim Qaddoumi.

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Ethical approval

All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work. There has been no honorarium, grant, or other forms of payment to the authors to produce the manuscript.

Conflict of interest

Michael Terao is a Pre-Submission Peer Reviewer for Enago and the Pediatric Hematology Section Editor for MedStudy. The other authors have no relevant conflicts of interest to disclose.

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Communicated by Peter de Winter

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Rajagopal, R., Moreira, D.C., Faughnan, L. et al. An international multicenter survey reveals health care providers’ knowledge gap in childhood central nervous system tumors. Eur J Pediatr 182, 557–565 (2023). https://doi.org/10.1007/s00431-022-04712-4

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  • DOI: https://doi.org/10.1007/s00431-022-04712-4

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