Clinical verifications of feasibility evaluation system for vaccination in convalescent children with hematologic malignancies in a hospital in Shanghai

Abstract

Abstract: Objective To analyze the clinical verifications of the feasibility evaluation system for vaccination of convalescent children with hematologic malignancies,and provide reference for vaccination of convalescent children with hematologic malignancies. Methods A modified Delphi and analytic hierarchy process were used to construct a feasibility evaluation system for vaccination of convalescent children with hematologic malignancies. Clinical demonstration was carried out by randomly select convalescent children with hematologic malignancies who visited the vaccine evaluation clinic of Shanghai Children's Medical Center from December 2022 to July 2023. The consistency between the evaluation opinions of clinical medical staff and the feasibility evaluation system for vaccination was analyzed. Results After two rounds of Delphi expert consultation,the expert authority degree（Cr） in both rounds was ≥0.70,the positive coefficient of experts was 100%,and the consistency of expert opinions was good（P<0.01）.The final determination of the feasibility evaluation system for vaccination includes 56 items,including 3 dimensions（clinical laboratory,physiological and basic information indicators,and disease recovery status）,15 aspects and 38 indicators,and the normalized weight coefficients of the 3 dimensions were 0.405,0.114 and 0.481,respectively.A total of 106 convalescent children with hematologic malignancies who visited the vaccine evaluation clinic were randomly selected for clinical verification,the overall reliability（Cronbach's α=0.840） and validity（CVI=0.829,KMO=0.839） of the vaccination feasibility evaluation system were high. Among them,76 children were recommended for vaccination after evaluation by clinical medical personnel,and 78 children were recommended for vaccination after evaluation by the vaccine feasibility evaluation system. The consistency test between the two was strong（Kappa=0.858,P<0.01）. Conclusion The feasibility evaluation system of vaccination in convalescent children with hematologic malignancies by modified Delphi Method is relatively complete,and preliminary clinical evidence was good,which can provide new ideas and reference for the vaccination evaluation in convalescent children with hematologic malignancies.

Key words: Hematologic malignancies, Children, Vaccination, Evaluation

CLC Number:

R186

YANG Dandan, LIU Wenmin, YANG Laibao, XUE Caoyi, GAO Yijin, DENG Pengfei. Clinical verifications of feasibility evaluation system for vaccination in convalescent children with hematologic malignancies in a hospital in Shanghai. [J]OCCUPATION AND HEALTH, 2025, 41(8): 1050-1054.

References

[1] PULTE D,GONDOS A,BRENNER H.Trends in survival after diagnosis with hematologic malignancy in adolescence or young adulthood in the United States,1981-2005[J].Cancer,2009,115(21):4973-4979.
[2] PULTE D,GONDOS A,BRENNER H.Trends in 5-and 10-year Survival After Diagnosis with Childhood Hematologic Malignancies in the United States,1990-2004[J].JNCI,2008,100(18):1301-1309.
[3] NEAGA A,JIMBU L,MESAROS O,et al.Why do children with acute lymphoblastic leukemia fare better than adults?[J].Cancers(Basel),2021,13(15):3886.
[4] PULTE D,JANSEN L,BRENNER H.Changes in long term survival after diagnosis with common hematologic malignancies in the early 21st century[J].Blood cancer journal(New York),2020,10(5):56.
[5] DENG P,YANG T,ZHANG H,et al.Prospective clinical trial of hepatitis B vaccination for children with hematological malignancies:a study on the safety and immunogenicity efficacy[J].Hum Vaccin Immunother,2021,17(11):4578-4586.
[6] 韩英,胡丹丹,韦茹,等.广东省特需人群接种门诊特殊健康状态儿童预防接种探索[J].中国疫苗和免疫,2021,27(6):678-683.
[7] PIETRAS W,CHABER R,PELA H,et al.The recovery of immune system parameters in children following lymphoblastic leukemia therapy- preliminary report[J].Adv Clin Exp Med,2014,23(1):97-102.
[8] WU C,WU P,LI P,et al.Construction of an index system of core competence assessment for infectious disease specialist nurse in China:a Delphi study[J].BMC Infectious Diseases,2021,21(1):791.
[9] BAI X,GAN X,YANG R,et al.Construction of a competency evaluation index system for front-line nurses during the outbreak of major infectious diseases:A Delphi study[J].PLoS One,2022,17(7):e270902.
[10] Q L.A novel Likert scale based on fuzzy sets theory[J].Expert Syst Appl,2013,5(40):1609-1618.
[11] SATTY A M H.A review of Methods for handling missing data in the form of dropouts in longitudinal clinical trials[J].BOPAMS,2014, 3(2):2310-2331.
[12] 刘伟涛,顾鸿,李春洪.基于德尔菲法的专家评估方法[J].计算机工程,2011,37(S1):189-191.
[13] 柯雄,陈英耀,胡献之,等.公立医疗机构公益性指标赋权中的方法比较与权重优化[J].中国卫生经济,2013,32(8):68-70.
[14] 龙耀,周璇,邓鹏飞,等.基于改良德尔菲法的健康人生理性衰老量表构建[J].中南大学学报(医学版),2016,41(4):422-426.
[15] 平卫伟. Delphi法的研究进展及其在医学中的应用[J].疾病控制杂志,2003,7(3):243-246.
[16] 朱梦,龚磊,宋丹丹,等.应用德尔菲法构建流感与新型流感暴发早期预警指标体系[J].安徽医科大学学报,2018,53(9):1403-1406.
[17] 常骁毅,白婷,段雨超,等.基于德尔菲法与层次分析法构建大型医用设备维修保养服务评价体系的研究[J].中国医学装备,2020,17(7):122-127.
[18] HOFMANN G,ZIERK J,SOBIK B,et al.Temporal evolution and differential patterns of cellular reconstitution after therapy for childhood cancers[J].Sci Rep,2023,13(1):4022.
[19] WILLIAMS A P,BATE J,BROOKS R,et al.Immune reconstitution in children following chemotherapy for acute leukemia[J].eJHaem,2020,1(1):142-151.
[20] KOVACS G T,BARANY O,SCHLICK B,et al.Late immune recovery in children treated for malignant diseases[J].Pathol Oncol Res,2008,14(4):391-397.
[21] CESARO S,GIACCHINO M,FIOREDDA F,et al.Guidelines on vaccinations in paediatric haematology and oncology patients[J].Biomed Res Int,2014,2014:1-10.
[22] ZIGNOL M,PERACCHI M,TRIDELLO G,et al.Assessment of humoral immunity to poliomyelitis,tetanus,hepatitis B,measles,rubella,and mumps in children after chemotherapy[J].Cancer,2004,101(3):635-641.
[23] ONORATELI M,BOTANA C,PERALTA L,et al.Humoral immunity to tetanus,measles and rubella in children with acute lymphoblastic leukemia after chemotherapy[J].Arch Argent Pediatr,2016,114(6):549-552.