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the2269146001072876120
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administration659174001074088159177223241272300326366392410456503
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nature1481188001074786113159185226
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thus1249202001072875122154
requiring1419202001072769118165184209228275324
external1759202001074383113155181229269287
validation.2062202001074182100118167207233252299347363
Furthermore,2441202001074186112143190234260333381408450464
the425216001072775118
authors558216001074187115162209235269
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Unfortunately,8572440010757104128175202233281329370397440459499511
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CR1046328001075196
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cancer1279328001074182130171213240
patients.1538328001075092119137181229256291308
Discussion4253520015382123178237310363418459524597
The425370001074291135
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an1133370001074188
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predictive621384001075077119169188228259277318362
tools999384001072875124143176
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DIVA1914384001075877124172
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clinical78039800107405876123141181221240
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The1347398001074291134
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the425412001072876120
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evidence,906412001074485104153197246286329343
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evaluate1686412001074485126145192233260303
the2013412001072876120
application2157412001074190140160178219260287306354403
potential2584412001074998126168216243262302321
within425426001076685114163182230
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Czech831426001075191134176225
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The425454001074292136
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environment1672524001074391131150177224272346390438465
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about2689622001074191140188216
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a9797060010740
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The1696748001074292136
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the354762001072876120
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The504376001074293138
study520776001073464112163203
by543776001075090
Pinkham304790001074563110148198238311
et337590001074371
al.34629000107416076
confirms355490001074086135158178204278311
that388190001072876117144
A‑DICAVE404190001075379139158209263305348
is440590001071952
an447390001074189
easy‑to‑use457890001074484117158185213259288337370414
predictive500890001075077119169188228258277317360
tool538590001072874123142
that3047104001072876117144
strengthens321510400107346389132181230258306351399432
the3671104001072876120
rationale381510400107276996115163211252271315
for415410400107247198
using427610400107488199147197
ultrasound449710400107486694121163196244293341390
in4911104001071967
at‑risk500210400107416893121140173210
patients5236104001075092119138181230256291
[12].304711800109266910913231781180010716
The3216118001074292136
SAFE33741170011047103149195
Rule35901170011051103126173
is3786118001071952
a38601180010741
synthetic3923118001073475124151199243271290330
screening4275118001073474101144189237255303353
rule465011800107267594138
(not4810118001072470118145
a49781180010741
scoring5041118001073374121148167215264
scale)5328118001073374115134178200
created3047132001074067110150177219269
from333713200107245299173
meta‑analytical35311320010773118145187215256304344363403434453494535554
findings.410613200107234391140159207256289306
The4433132001074291135
benefit4589132001075095143187211231259
of4869132001074872
the4961132001072876121
SAFE5102132001074294135176
Rule5299132001074593112156
is5476132001071951
its304714600107194782
simplicity3145146001073452125175195213253272300342
and3504146001074189138
universal3659146001074896114155199225259301320
applicability;3996146001074190140160178218260309329347366394436452
a44651460010741
disadvantage4523146001074967100142191232274322349390439483
is5023146001071952
the5091146001072876121
absence5228146001074191124168216257299
of3047160001074872
weighted31351600010765108127176224250293343
scoring3494160001073474121147167214263
and,3774160001074189138153
therefore,3944160001072776120146189212260287329344
formal430416000107247198172213232
stratification.455216000107346389131158176200220260301328347395443459
The5028160001074291135
SAFE5180160001074293134175
Rule5371160001074693112156
has3047174001074888122
not3185174001074896123
yet3325174001073982110
been3451174001075094139187
independently3654174001071967116159209253301350394442469487527
validated4198174001074081100118167208235277327
in4541174001071966
clinical462417400107405877124143183224243
practice;4883174001075076118158188207247289303
however,5203174001074896160204244287313325
its304718800107194782
principle315118800107507796144184203252272316
of3489188001074872
early3584188001074383110129169
identification3776188001071868112160187205229249289331358377425473
of4272188001074872
at‑risk436618800107416892120139172209
patients4598188001074991118137181229256291
and4911188001074189138
escalation5072188001074377118159178218246264312361
of5455188001074872
care3047202001073980105147
is3209202001071950
consistent3275202001073984132164181213241282329355
with3645202001076482109156
the3817202001072774117
expert3949202001074382130174200230
position4194202001074997129147174192238286
of4495202001074770
the4580202001072875118
Infusion471320200107196588136167185232279
Nurses50072020010757103129162205237
Society,5260202001074188128146188215256267
which30472160010765113131171219
in3282216001071966
its336421600107194781
Infusion346221600107196689138171189236284
Therapy3763216001074191134161202251290
Standards4069216001074268109157206246272320352
of4438216001074771
Practice4525216001074571112152182201241283
(2024)4824216001072466109150189211
recommends5051216001072669110156230303347394443476
early3047230001074484110130170
recognition3241230001072770111158208256274302321369418
of3684230001074771
difficult378023000107496892119139179227246274
venous4078230001074184132181229262
access4365230001074081120162196229
and4619230001074189138
the4782230001072876120
use4927230001074881125
of5076230001074872
advanced5173230001074190131173221262304354
techniques3047244001072870112160208226275323367400
before3467244001075095118166193236
repeated3723244001072669119164204231273324
failed406624400107246685103147197
cannulation4283244001074082130178225244285312331379427
attempts473024400107416898141215264292327
[13].507624400109266910913252072440010716
The3187258001074292136
last334425800107195993122
scale3487258001073374115134178
analysed3686258001074189130149189223267317
in4024258001071967
this411225800107277694127
study4260258001073362110160200
is4481258001071952
DIVA‑CP,455425700110618614119522327932948732580010716
which49102580010765113132172220
represents5151258001072770119146189223267315342377
a30472720010740
specifically3104272001073381126166184208227267308326344384
oncology‑focused3504272001074795135181200248297337364388435475522555598648
tool4168272001072773122141
that4325272001072775115142
integrates448327200107186692134183209250277319352
patient4851272001074990117135178226252
characteristics5119272001074087127153194234264306332350383304728600107284685120
and3183286001074087136
their3335286001072875119137162
peripheral3514286001074993119138186234278304345363
venous3893286001074083130178225258
system4167286001073373106135177249
and4432286001074188137
reflects458528600107266891113157197227261
cumulative4862286001074087159206224264291309350392
venous5270286001074083130178225258
strain304730000107336289130148196
during3259300001074996122141188237
chemotherapy.3513300001074087131204252279327371397439488527539
Pilot406830000107456281129156
validation4240300001074182100119167208235253301349
identified4605300001071968111159186204228248291341
ten4962300001072870118
items509630000107194689162195
across5307300001074181107154187220
four3047314001072369116141
factors3203314001072364103132177203236
and3454314001074087134
showed3603314001073380126189231280
significant389831400107335098144162185203242282329354
inter‑rater426731400107196591132157181207247273314340
agreement4622314001074088113154198269312359384
for502131400107236995
most51313140010773120152180
of5326314001074770
the5411314001072774116
items.304732800107194789163196213
The3277328001074292136
score3430328001073474121148191
range3638328001072768116166210
of3865328001074872
0–113954328001074492131166
quantifies4137328001074996137185212231255274318352
the4506328001072876120
risk464432800107264578116
of4777328001074872
difficult486632800107496892119139179227246274
peripheral5157328001075095121140190239283309351370
access,3047342001074080118159192224240
albeit3302342001074159107151169196
without3514342001076482110157204251279
established3808342001074376104145193212230262309352401
cut‑off4224342001074087114138187210237
values447634200107408199145188221
for471334200107237096
clinical482534200107395775122140179219238
stratification.507834200107336288128155173196215254295321339386434449
In3047356001071966
the3128356001072875118
context3261356001074085133159200239269
of3545356001074771
outpatient3631356001074794122170211237255298345371
chemotherapy,4018356001073986129201248275322365391431479518529
DIVA‑CP4562356001075877122169195248292
thus4869356001072875121153
complements5038356001073985157206224267339383430456489
more30473700010774122149192
generally3257370001074993141185212254273291331
focused3606370001072471113160193237287
tools3911370001072875124144176
and4105370001074189138
can4261370001074182130
aid4409370001074160109
in4536370001071966
protecting4620370001075077124151194235265284332382
the5020370001072776120
peripheral5158370001074994121140190238283309351370
venous3047384001074184132180229262
bed3328384001075095145
through3493384001072776102149197247295
timely3807384001072847120164184224
consideration4050384001074087136169187236280307348375394442491
of4560384001074872
ultrasound‑assisted465238400107486795121163196245293341390418459492525544576605648698
cannulation53703840010740811293047398001074895114155182200248297
or3360398001074875
early3451398001074484110130169
indication3637398001071966116134174216243261309358
of4011398001074872
central4099398001074083131157184226244
venous4360398001074084132180228261
access4637398001074181120162196229
in4883398001071866
cancer4966398001074081129169211238
patients.5220398001075091118137181229255290307
External3047412001074283114156183231272291
validation3361412001074182101119169209236255303352
of3736412001074772
the3830412001072876121
tool3973412001072875124143
is4139412001071952
also421341200107416093141
required4377412001072770119167186212255305
here.4705412001074892119162176
The4904412001074292136
DIVA‑CP5063412001075877124172199254298
tool5384412001072875124143
has3047426001074889122
so3188426001073482
far328942600107236692
been3400426001074994139187
evaluated3606426001074484126145192233260303353
only3977426001074897116156
within4152426001076584112160179227
the4397426001072877121
authors’4537426001074088116164213240274290
original484542600107487595144162210251270
pilot513442600107496987136163
study,5316426001073362110160200211
and3047440001074189138
no3207440001074897
independent3325440001071967116161210255303353397445472
external3818440001074484114157183232273292
validation4132440001074082101119168209236255303352
or4505440001074875
confirmation4602440001074086135159178205279320347366414462
of5086440001074872
its518044000107184681
clinical528344000107405977125144184226244
utility304745400107487695114132160203
by3269454001075089
other3378454001074875123168194
research3592454001072669103147187214253301
groups3913454001074875122170220253
is4186454001071951
currently4257454001074088114142184233259279319
available.4595454001074181122141160200250270314328
From3187468001074166112186
a33894680010741
methodological34464670011076123155206257310361385436488512552598622
standpoint,408346700110377011616822027332434839943145154680010716
the4547468001072875119
compared4683468001073986159208250276318368
tools5067468001072874123142175
differ525846800107496791118161187
in5461468001071967
item304748200107194789163
construction3232482001074187136169198225273314344363411459
(binary371448200107247493141181208251
vs.398748200107417592
multi‑level/ordinal)41014820010774121140168187215235279320363382414458485533552600640659684
as4807482001074174
well49044820010764108127146
as5072482001074174
the5169482001072876120
scope5311482001073475121171216
and3047496001074189138
quality3209496001074996137156174202245
of3478496001074872
validation3573496001074183102120169210237256304352
(internal394949600107244290117159186235275294
vs.426749600107417591
external;4382496001074483114157183232273292306
single4711496001073452100149168212
centre4947496001074082131157184227
vs.519849600107417491
multicentre).531349600107741211401681873047510001074083131158184227249262
For3334510001074188115
DIVA‑CP,3474510001075878124173199254298303
the3802510001072776120
authors3947510001074088116164213240274
point4246510001074998118165192
out4463510001074896124
the4612510001072876120
limitation4757510001071937111129157199226244292341
of5123510001074872
the5219510001072876121
pilot536451000107506988136163
phase,3047524001075098139172217231
high3298524001074867116164
inter‑rater348252400107196693136162187214256283326352
agreement,3854524001074190117160204278322370397413
and4287524001074189139
the4446524001072776120
mixed4586524001077392131174224
nature4830524001074889116164190233
of5083524001074872
the5175524001072876120
items,531552400107194789163196212
which30475380010765114133174222
complicates3296538001074087162212232250291333360403437
factor3760538001072366107137184212
analysis.3998538001074190131150190225243276293
They4318538001074292136176
emphasize45215380010744118168217258292310347391
that4938538001072877118145
exploratory5110538001074484134154203230272299346374417
factor3047552001072467109140188216
analysis3290552001074191132152193228247281
should3598552001073483133182202252
be3877552001075197
primarily400155200107517898173215242262282323
applied4351552001074292144164183228279
to4658552001072876
continuous4761552001074189138166186235283333382416
variables5204552001074284111131173224244289324
and3047566001074189138
that3208566001072876117144
tetrachoric337556600107287098125167207255304331350390
correlations3788566001074087114141184203244271290338386419
are4230566001074167110
more43635660010774123150192
adequate4578566001074191135185232273300343
for494456600107237198
binary5065566001074969116157183227
items.531456600107194790163197213
For3047580001074289116
follow‑up318858000107247191110158223250300349
research,3562580001072770104148188214253301317
they3904580001072876121160
recommend4090580001072669111157231305349397447
converting4562580001074087135175218245275294342392
binary4979580001075069117157184227
items523158000107194790163196
to5453580001072874
ordinal3047594001074874122140188228246
scales3310594001073373114133176210
(e.g.,353659400107246579128143159
“37115940010726
very3753594001074184110152
well39225940010764107126144
visible/partially408359400107405992109158178221254301342368398417457475494533
visible/non‑visible463259400107416092110159179222254300348396424464484516534583602646
veins”)5294594001074083101149181208233
to3047608001072874
improve3141608001071992142169216256299
the3460608001072876120
psychometric3600608001075083124164212260334379407433453493
properties4113608001074976123173218245276295338372
of4505608001074872
the4596608001072876121
tool.4736608001072875124143159
This3187622001074393113146
consideration3360622001074189139173192242287314357385404453503
is3890622001072053
generally3970622001075095145190217260279299340
relevant433762200107277191136178220269297
for4661622001072473101
other4789622001074977126171199
scales5015622001073476118138183217
as5260622001074175
well,53636220010766110130149165
where30476360010765114158184227
the3294636001072876120
subjective3434636001073481130150193235265284325368
assessment3822636001074174107152185219292336384411
of4253636001074872
vein4345636001074184103150
visibility451563600107416193111161180199217245288
and4823636001074189138
palpability4981636001075091110160201251270289307335378
represents53796360010726691193047650001072770103147196222257
a33226500010740
potential3380650001074999126168217243262302321
source3719650001073382130156195238
of3974650001074872
inter‑rater406365000107196794136163187215256284326353
variability.4433650001074182108128168218237256274302345357
Formal4807650001074189116190231250
anchoring5074650001074189129177226253272320369
in5461650001071866
clearly3047664001074059103143169189229
defined3297664001074993117137185229279
levels3597664001071963104147166199
could3817664001074087135154203
increase4042664001071866107133176216250294
tool4357664001072875124143
reliability.452266400107266988107147197216235253281324336
Another48796640010753101149177225269295
common5196664001074086161234283331
theme3047678001072775118190233
is3296678001071850
the3362678001072774118
degree3495678001074891140166208252
of3762678001074771
subjectivity3848678001073379128146189229259277317336363404
for426867800107237096
items438067800107184587159191
requiring4587678001072668117163181207225272321
clinical492367800107405876122140180220238
judgment5177678001071965113162234277324350
(e.g.,304769200107246682132148164
“expected3238692001072769109160206248279323374
difficult363969200107506993121142183232251280
cannulation”3946692001074183132181229249290318337386436462
in4435692001071968
A‑DIVA4530692001075381142162210259
or4816692001074976
“rolling/tortuous4919692001072752100121140159207258291320368395427476525575608
vein”3047706001074184103150176
in3245706001071967
EA‑DIVA).3335706001074296123183202248297321334
To3691706001074285
maintain37997060010773114133181207249267315
the4137706001072876120
predictive4280706001074976119169188228259277319362
capability4664706001074182131173223242261279307350
of5036706001074872
these5131706001072876120154198
tools5352706001072774123143175
in3047720001071966
routine3130720001072673121149168216260
operations,3406720001074898143169210237256304352385401
it3824720001071846
is3887720001071951
essential3955720001074377110154202229247287306
to4278720001072774
ensure4368720001074492125172198241
high‑quality4625720001074867116163192243290330349368395438
staff5079720001073463104127155
training525072000107285496114162180228277
and3047734001074189139
unify3213734001074896115139182
the3422734001072876121
assessment3569734001074175108153187220294339387414
method.40097340010774119147196244295311
Regular4346734001074690141189208248275
verification4647734001074185111131155175215257284303352401
of5074734001074872
inter‑rater517373400107196794137163188216258285328354
reliability304774800107277089107147197216235253281324
is3391748001071951
also346274800107416092141
ideal.3623748001071867112152171186
From3187762001074266113187
a33987620010741
practical3464761001105385132172206230270317341
perspective38277610011053100133172225272314348371417463
regarding4314762001072770120160187235253301351
tool4689762001072874123143
utilization,485676200107487695114132169211238257305353369
a52497620010741
differentiated5314762001074968921191621893047776001074492119137178205247297
approach3368776001074191141168215257297345
is3737776001071952
suggested:3813776001073380130179223257286328378393
(i)423077600107244366
rapid4320776001072768118137186
and4530776001074189138
simple4692776001073452126175195239
screening4955776001073374100143188236255303352
using533177600107488199147196