Comprehensive global collaboration in the care of 1182 pediatric oncology patients over 12 years: The Iraqi–Italian experience
Abstract Background Iraq's health care system has gradually declined after several decades of wars, terrorism, and UN economic sanctions. The Oncology Unit at Children's Welfare Teaching Hospital (CWTH) in Baghdad was lacking basic facilities and support. To address this shortcoming, a hum...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-01-01
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| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.4892 |
| _version_ | 1797950906808926208 |
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| author | Mazin Faisal Al‐Jadiry Stefania Uccini Anna Maria Testi Maria Luisa Moleti Adil Rabeea Alsaadawi Amir Fadhil Al‐Darraji Raghad Majid Al‐Saeed Safaa A. Faraj Al‐Badri Ahmed Hatem Sabhan Hasanein Habeeb Ghali Samaher Abdulrazzaq Fadhil Wisam Majeed Abed Najiha Ahmed Ameen Yasir Saadoon Abed Fawaz Salim Yousif Aseel Rashid Abed Hanadi Munaf Hussein Ahmed Mudhafar Shkara Alfonso Piciocchi Sara Mohamed Luigi Ruco Ibrahim Qaddoumi Salma Abbas Al‐Hadad |
| author_facet | Mazin Faisal Al‐Jadiry Stefania Uccini Anna Maria Testi Maria Luisa Moleti Adil Rabeea Alsaadawi Amir Fadhil Al‐Darraji Raghad Majid Al‐Saeed Safaa A. Faraj Al‐Badri Ahmed Hatem Sabhan Hasanein Habeeb Ghali Samaher Abdulrazzaq Fadhil Wisam Majeed Abed Najiha Ahmed Ameen Yasir Saadoon Abed Fawaz Salim Yousif Aseel Rashid Abed Hanadi Munaf Hussein Ahmed Mudhafar Shkara Alfonso Piciocchi Sara Mohamed Luigi Ruco Ibrahim Qaddoumi Salma Abbas Al‐Hadad |
| author_sort | Mazin Faisal Al‐Jadiry |
| collection | DOAJ |
| description | Abstract Background Iraq's health care system has gradually declined after several decades of wars, terrorism, and UN economic sanctions. The Oncology Unit at Children's Welfare Teaching Hospital (CWTH) in Baghdad was lacking basic facilities and support. To address this shortcoming, a humanitarian and educational partnership was established between CWTH and Sapienza University of Rome (SUR). Methods We investigated the outcomes of 80 online and 16 onsite educational sessions and 142 teleconsultation sessions from 2006 to 2014. We also determined the outcomes of pathology reviews by SUR of 1216 tissue specimens submitted by CWTH from 2007 until 2019 for second opinions. The primary outcomes were discordance, concordance, and changes among clinical diagnoses and pathology review findings. The measures included the frequency of teleconsultation and tele‐education sessions, the topics discussed in these sessions, and the number of pathology samples requiring second opinions. Findings A total of 500 cases were discussed via teleconsultations during the study period. The median patient age was 7 years (range, 24 days to 16·4 years), and the cases comprised 79 benign tumors, 299 leukemias, 120 lymphomas, and 97 solid tumors. The teleconsultation sessions yielded 27 diagnostic changes, 123 confirmed diagnoses, and 13 equivocal impacts. The pathology reviews by SUR were concordant for 996 (81·9%) cases, discordant for 186 (15·3%), and inconclusive for 34 (2·8%). The major cause of discordance was inadequate immunohistochemical staining. The percentage of discordance markedly decreased over time (from 40% to 10%). The cause of the improvement is multifactorial: training of two CWTH pathologists at SUR, better immunohistochemical staining, and the ongoing clinical and pathologic telemedicine activities. The partnership yielded 12 publications, six posters, and three oral presentations by CWTH investigators. Interpretation The exchange of knowledge and expertise across continental boundaries meaningfully improved the diagnoses and management of pediatric cancer at CWTH. |
| first_indexed | 2024-04-10T22:22:26Z |
| format | Article |
| id | doaj.art-daec27a67e8c4947b8fcb2019988af90 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-04-10T22:22:26Z |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-daec27a67e8c4947b8fcb2019988af902023-01-17T17:10:24ZengWileyCancer Medicine2045-76342023-01-0112125626510.1002/cam4.4892Comprehensive global collaboration in the care of 1182 pediatric oncology patients over 12 years: The Iraqi–Italian experienceMazin Faisal Al‐Jadiry0Stefania Uccini1Anna Maria Testi2Maria Luisa Moleti3Adil Rabeea Alsaadawi4Amir Fadhil Al‐Darraji5Raghad Majid Al‐Saeed6Safaa A. Faraj Al‐Badri7Ahmed Hatem Sabhan8Hasanein Habeeb Ghali9Samaher Abdulrazzaq Fadhil10Wisam Majeed Abed11Najiha Ahmed Ameen12Yasir Saadoon Abed13Fawaz Salim Yousif14Aseel Rashid Abed15Hanadi Munaf Hussein16Ahmed Mudhafar Shkara17Alfonso Piciocchi18Sara Mohamed19Luigi Ruco20Ibrahim Qaddoumi21Salma Abbas Al‐Hadad22Department of Pediatrics, College of Medicine University of Baghdad, Oncology Unit‐Children Welfare Teaching Hospital‐Medical City Baghdad IraqClinical and Molecular Medicine Sapienza University Rome ItalyHematology, Department of Translational and Precision Medicine Sapienza University Rome ItalyHematology, Department of Translational and Precision Medicine Sapienza University Rome ItalyCentral Teaching Laboratory Medical City Pathology Baghdad IraqOncology Unit Children Welfare Teaching Hospital‐Medical City Baghdad IraqOncology Unit Children Welfare Teaching Hospital‐Medical City Baghdad IraqCollege of Medicine‐ Wasit University Children's Welfare Teaching Hospital‐Pediatric Oncology Unit, Medical City Baghdad IraqOncology Unit Children Welfare Teaching Hospital‐Medical City Baghdad IraqDepartment of Pediatrics, College of Medicine University of Baghdad, Oncology Unit‐Children Welfare Teaching Hospital‐Medical City Baghdad IraqOncology Unit Children Welfare Teaching Hospital‐Medical City Baghdad IraqHematology Laboratory Department Children Welfare Teaching Hospital‐Medical City Baghdad IraqHematology Laboratory Department Children Welfare Teaching Hospital‐Medical City Baghdad IraqOncology Unit Children Welfare Teaching Hospital‐Medical City Baghdad IraqOncology Unit Children Welfare Teaching Hospital‐Medical City Baghdad IraqOncology Unit Children Welfare Teaching Hospital‐Medical City Baghdad IraqOncology Unit Children Welfare Teaching Hospital‐Medical City Baghdad IraqDepartment of Pharmaceutics‐College of Pharmacy University of Baghdad Baghdad IraqGIMEMA Data Center GIMEMA Foundation Rome ItalyHematology, Department of Translational and Precision Medicine Sapienza University Rome ItalyClinical and Molecular Medicine Sapienza University Rome ItalyDepartment of Global Pediatric Medicine St. Jude Children's Research Hospital Memphis Tennessee USADepartment of Pediatrics, College of Medicine University of Baghdad, Oncology Unit‐Children Welfare Teaching Hospital‐Medical City Baghdad IraqAbstract Background Iraq's health care system has gradually declined after several decades of wars, terrorism, and UN economic sanctions. The Oncology Unit at Children's Welfare Teaching Hospital (CWTH) in Baghdad was lacking basic facilities and support. To address this shortcoming, a humanitarian and educational partnership was established between CWTH and Sapienza University of Rome (SUR). Methods We investigated the outcomes of 80 online and 16 onsite educational sessions and 142 teleconsultation sessions from 2006 to 2014. We also determined the outcomes of pathology reviews by SUR of 1216 tissue specimens submitted by CWTH from 2007 until 2019 for second opinions. The primary outcomes were discordance, concordance, and changes among clinical diagnoses and pathology review findings. The measures included the frequency of teleconsultation and tele‐education sessions, the topics discussed in these sessions, and the number of pathology samples requiring second opinions. Findings A total of 500 cases were discussed via teleconsultations during the study period. The median patient age was 7 years (range, 24 days to 16·4 years), and the cases comprised 79 benign tumors, 299 leukemias, 120 lymphomas, and 97 solid tumors. The teleconsultation sessions yielded 27 diagnostic changes, 123 confirmed diagnoses, and 13 equivocal impacts. The pathology reviews by SUR were concordant for 996 (81·9%) cases, discordant for 186 (15·3%), and inconclusive for 34 (2·8%). The major cause of discordance was inadequate immunohistochemical staining. The percentage of discordance markedly decreased over time (from 40% to 10%). The cause of the improvement is multifactorial: training of two CWTH pathologists at SUR, better immunohistochemical staining, and the ongoing clinical and pathologic telemedicine activities. The partnership yielded 12 publications, six posters, and three oral presentations by CWTH investigators. Interpretation The exchange of knowledge and expertise across continental boundaries meaningfully improved the diagnoses and management of pediatric cancer at CWTH.https://doi.org/10.1002/cam4.4892cancerchildrendeveloping countriespathology reviewpediatric oncologypediatric pathology |
| spellingShingle | Mazin Faisal Al‐Jadiry Stefania Uccini Anna Maria Testi Maria Luisa Moleti Adil Rabeea Alsaadawi Amir Fadhil Al‐Darraji Raghad Majid Al‐Saeed Safaa A. Faraj Al‐Badri Ahmed Hatem Sabhan Hasanein Habeeb Ghali Samaher Abdulrazzaq Fadhil Wisam Majeed Abed Najiha Ahmed Ameen Yasir Saadoon Abed Fawaz Salim Yousif Aseel Rashid Abed Hanadi Munaf Hussein Ahmed Mudhafar Shkara Alfonso Piciocchi Sara Mohamed Luigi Ruco Ibrahim Qaddoumi Salma Abbas Al‐Hadad Comprehensive global collaboration in the care of 1182 pediatric oncology patients over 12 years: The Iraqi–Italian experience Cancer Medicine cancer children developing countries pathology review pediatric oncology pediatric pathology |
| title | Comprehensive global collaboration in the care of 1182 pediatric oncology patients over 12 years: The Iraqi–Italian experience |
| title_full | Comprehensive global collaboration in the care of 1182 pediatric oncology patients over 12 years: The Iraqi–Italian experience |
| title_fullStr | Comprehensive global collaboration in the care of 1182 pediatric oncology patients over 12 years: The Iraqi–Italian experience |
| title_full_unstemmed | Comprehensive global collaboration in the care of 1182 pediatric oncology patients over 12 years: The Iraqi–Italian experience |
| title_short | Comprehensive global collaboration in the care of 1182 pediatric oncology patients over 12 years: The Iraqi–Italian experience |
| title_sort | comprehensive global collaboration in the care of 1182 pediatric oncology patients over 12 years the iraqi italian experience |
| topic | cancer children developing countries pathology review pediatric oncology pediatric pathology |
| url | https://doi.org/10.1002/cam4.4892 |
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