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Common misconceptions in the prognostic evaluation of clinically stable patients with febrile neutropenia and solid tumors

  • A. Carmona-BayonasEmail author
  • P. Jiménez-Fonseca
Correspondence
SEOM has recently updated its clinical guidelines for febrile neutropenia (FN) [ 1]. However, as surprising as it may seem, the usefulness of clinical judgment as a guarantee and central axis of decision-making in FN is being questioned by some experts [ 2]. In light of this, the following ten clarifications highlight the importance of starting with clinical evaluation, as per SEOM and ASCO 2018 guidelines [ 1, 3], using scales solely as a complement when confronting doubts whether to intensify care:
  1. 1.

    Most prognostic scales are designed to inform clinical judgment, but in no way supersede it. In the event of contradiction, the experienced clinician’s opinion should prevail [4]. As George Box said, “Essentially all models are wrong, but some are useful.”

     
  2. 2.

    To base decision-making merely on summative models flies in the face of clinical guideline consensus [1, 3], and of the general principles governing evaluation of sepsis.

     
  3. 3.

    The uncertainty of each FN episode is inversely...

Notes

Acknowledgements

Priscilla Chase Duran for editing and improving this manuscript.

Funding

None.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The current study has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study, no informed consent is required.

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Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2019

Authors and Affiliations

  1. 1.Hematology and Medical Oncology DepartmentHospital Universitario Morales MeseguerMurciaSpain
  2. 2.Medical Oncology DepartmentHospital Universitario Central de AsturiasOviedoSpain

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