Clinical calculator summary
Febrile Neutropenia Triage Panel
Clinical calculator summary
Febrile Neutropenia Triage Panel
A combined view of MASCC and CISNE for urgent febrile-neutropenia risk assessment.
Evidence-based context for fast calculator use
- Purpose:
- Expose agreement or discordance between complementary febrile-neutropenia tools
- Population:
- Adults with treatment-related febrile neutropenia after immediate stabilization and empiric-treatment planning
- Factors:
- MASCC low-risk features, CISNE stability criteria, Sepsis physiology, Logistical safety
- Reference:
- Klastersky et al., JCO 2000; Carmona-Bayonas et al., JCO 2015
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Febrile Neutropenia Triage
years
mmHg
cells/µL
mg/dL
Clinical Context & Background
This panel presents the validated MASCC and CISNE scores together without turning either score into an automatic disposition decision.
Clinical workflow:
1. Confirm febrile neutropenia and assess urgently for instability, sepsis, organ dysfunction, focal infection, and other admission-requiring features.
2. Use MASCC to stratify complication risk in its eligible adult chemotherapy-related population. A score of 21 or more is the published lower-risk group.
3. Use CISNE only after apparent stability is established in an adult outpatient with a solid tumor receiving an eligible mild-to-moderate-intensity cytotoxic regimen. CISNE was designed to detect serious-complication risk, not to authorize discharge.
4. Apply the current clinical pathway, local antimicrobial guidance, observation, social/logistical criteria, and clinician judgment. Empiric treatment must not be delayed for score calculation.
Formula Logic
MASCC is calculated for eligible adult chemotherapy-related febrile neutropenia; CISNE is additionally calculated only for apparently stable adult outpatients with solid tumors in its validated chemotherapy context.Reference Data
| Tool | Score | Published interpretation |
|---|---|---|
| MASCC | ≥21 | Lower risk; complete outpatient-eligibility assessment still required |
| MASCC | <21 | High/not-low risk |
| CISNE | 0 | Low serious-complication risk |
| CISNE | 1-2 | Intermediate serious-complication risk |
| CISNE | 3-8 | High serious-complication risk; early discharge should be avoided |
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
When To Use
- Use after urgent assessment to compare MASCC and CISNE in an apparently stable adult with treatment-related febrile neutropenia.
- Use only when the patient and clinical setting match the population described for Febrile Neutropenia Triage Panel.
How To Interpret
- Discordant results should favor the more cautious pathway and direct clinical review rather than score averaging.
- Interpret thresholds with the entered units, current clinical status, and local guideline context.
What To Do Next
- Confirm antibiotics, cultures, stability, observation needs, oral tolerance, support, transport, and follow-up before disposition.
- Document the inputs, result, clinical judgment, and any reason for deviating from the model-guided pathway.
Limitations
- The panel must never delay sepsis treatment or be used to discharge an unstable patient.
- This calculator supports clinical assessment and does not independently prescribe treatment.
Validated Population
Adults with treatment-related febrile neutropenia after immediate stabilization and empiric-treatment planning
Clinical example
A favorable MASCC score with an elevated CISNE score is discordant and should prompt caution rather than automatic outpatient management.
Calculation verification history
Verified
Calculation verification history
Verified: Production browser revalidation
- Three source-backed production cases passed through visible controls across the age-60 MASCC transition and the maximum CISNE predictor profile.
- Observed independent results matched exactly: MASCC 26 / CISNE 0, MASCC 24 / CISNE 0, and MASCC 22 / CISNE 8 with the expected Low/Low, Low/Low, and Low/High classifications.
- The published panel presents MASCC and CISNE separately with no agreement/discordance synthesis, combined score, stale controls, literal undefined/null values, or visible error boundary.
Case-level production evidence is retained in validation/browser-revalidation/panel-neutropenia-production-closure-2026-08-03.json.
: Local independent-component summary remediation
- Three visible-control cases covered the baseline, exact age-60 MASCC boundary, and maximum CISNE profile.
- The concise receipt now labels the second column `Independent result` and keeps MASCC and CISNE separate without a cross-score synthesis instruction.
- All scores and classifications matched; 65/65 panel assertions passed, both child regression gates remain green, and the browser console was clean.
Case evidence is retained in validation/browser-revalidation/panel-neutropenia-local-remediation-2026-08-03.json.
: Production browser revalidation — calculation fixed; UI finding retained
- Three source-backed cases produced the expected independent MASCC/CISNE pairs 26/0, 24/0, and 22/8; the former unsupported-field CISNE adapter failure did not recur.
- Production still labels the panel summary `RESULT / AGREEMENT` and instructs users to `review agreement or discordance clinically`, outside the neutral parallel-results contract.
- Overall production status remains failed-ui-safety until that residual synthesis wording is removed and revalidated; no browser-console error was observed.
Case-level evidence and reproduction are retained in validation/browser-revalidation/panel-neutropenia-2026-08-03.json.
: Local browser remediation verified; production retest pending
- Ten source-backed cases passed through visible controls on the corrected local route across 12 submissions.
- The CISNE child now receives only its seven standalone predictor fields; the prior unsupported-field result is absent across CISNE scores 0 through 8.
- MASCC and CISNE render as independent parallel results, MASCC-only skipping is preserved, and a missing MASCC-specific field no longer suppresses valid CISNE evidence. The original production findings remain open until deployment and public revalidation.
Case-level local remediation evidence is retained in validation/browser-production/panel-neutropenia.local-remediation.json.
: Production browser validation
- Ten source-backed cases were exercised on the public production route through visible browser controls; 0/10 case records passed their expected-versus-observed assertions across 12 visible submissions.
- Overall browser status: failed-calculation-ui-and-console. critical: Every fully completed CISNE branch renders N/A / Invalid Input with `The public form contains an unsupported field.` MASCC remains correct, but CISNE never produces its expected score. | high: The production panel renders `Unified Panel Results`, `Combined assessment from multiple tools`, and agreement/discordance wording despite the source contract defining independent parallel risk evidence. | medium: Production emitted minified React error #418 during route loads/reloads used by this run.
- Case-level inputs, expected and observed results, reset/repeat behavior, failure reproductions, and console evidence are retained in the production-browser evidence record.
Case-level production evidence is retained in validation/browser-production/panel-neutropenia.json.
: Exact input guidance for unavailable components
- MASCC and CISNE corrective explanations now expand each model name, use "Please review", and identify the exact visible entries in parentheses.
- No score, safety gate, population rule, threshold, or component-isolation behavior changed.
All 65 existing panel assertions pass; current report remains applicable.
: Component-specific input and partial-completion correction
- Added required shared-field and optional component-field labels for all 17 inputs, identifying exact MASCC and CISNE dependencies.
- Separated intentionally skipped, partially invalid, outside-scope, and calculated component states so one incomplete score no longer suppresses its valid sibling.
- Moved CISNE population and stability gates before its predictor requirements, guarded blank numeric serialization from becoming zero, and removed the unsupported whole-number restriction from glucose.
- Passed 65/65 deterministic score, boundary, applicability, malformed, partial-completion, and sibling-isolation checks without changing either published scoring formula.
: Full validation test
- Passed 59/59 score-parity, cutoff, predictor, applicability, population, missing-input, and malformed-input checks.
- Confirmed parity with the independently validated MASCC and CISNE calculators.
: Correction
- Removed favorable preselected answers and required the raw clinical inputs used by both models.
- Restricted CISNE to apparently stable adult outpatients with solid tumors in its validated chemotherapy context.
- Corrected CISNE stress hyperglycemia to 2 points and enforced exact threshold and score boundaries through the shared model.
- Removed automatic discharge, observation, admission, antibiotic-route, and treatment directives; added explicit emergency and clinical-pathway safeguards.
Included in the current validation report.
Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.
Frequently Asked Questions
What is Febrile Neutropenia Triage Panel used for?
Expose agreement or discordance between complementary febrile-neutropenia tools. It is intended for adults with treatment-related febrile neutropenia after immediate stabilization and empiric-treatment planning.
Does Febrile Neutropenia Triage Panel determine treatment by itself?
No. Confirm the population, inputs, contraindications, competing risks, and current guideline recommendations before acting on the result.
Evidence-based oncology decision support. Verify with clinical guidelines.