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Gisslander K, Rutherford M, Aslett L, Basu N, Dradin F, Hederman L, Hruskova Z, Kardaoui H, Lamprecht P, Lichołai S, Musial J, O'Sullivan D, Puechal X, Scott J, Segelmark M, Straka R, Terrier B, Tesar V, Tesi M, Vaglio A, Wandrei D, White A, Wójcik K, Yaman B, Little MA, Mohammad AJ. Data quality and patient characteristics in European ANCA-associated vasculitis registries: data retrieval by federated querying. Ann Rheum Dis 2024; 83:112-120. [PMID: 37907255 PMCID: PMC10804071 DOI: 10.1136/ard-2023-224571] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/16/2023] [Indexed: 11/02/2023]
Abstract
OBJECTIVES This study aims to describe the data structure and harmonisation process, explore data quality and define characteristics, treatment, and outcomes of patients across six federated antineutrophil cytoplasmic antibody-associated vasculitis (AAV) registries. METHODS Through creation of the vasculitis-specific Findable, Accessible, Interoperable, Reusable, VASCulitis ontology, we harmonised the registries and enabled semantic interoperability. We assessed data quality across the domains of uniqueness, consistency, completeness and correctness. Aggregated data were retrieved using the semantic query language SPARQL Protocol and Resource Description Framework Query Language (SPARQL) and outcome rates were assessed through random effects meta-analysis. RESULTS A total of 5282 cases of AAV were identified. Uniqueness and data-type consistency were 100% across all assessed variables. Completeness and correctness varied from 49%-100% to 60%-100%, respectively. There were 2754 (52.1%) cases classified as granulomatosis with polyangiitis (GPA), 1580 (29.9%) as microscopic polyangiitis and 937 (17.7%) as eosinophilic GPA. The pattern of organ involvement included: lung in 3281 (65.1%), ear-nose-throat in 2860 (56.7%) and kidney in 2534 (50.2%). Intravenous cyclophosphamide was used as remission induction therapy in 982 (50.7%), rituximab in 505 (17.7%) and pulsed intravenous glucocorticoid use was highly variable (11%-91%). Overall mortality and incidence rates of end-stage kidney disease were 28.8 (95% CI 19.7 to 42.2) and 24.8 (95% CI 19.7 to 31.1) per 1000 patient-years, respectively. CONCLUSIONS In the largest reported AAV cohort-study, we federated patient registries using semantic web technologies and highlighted concerns about data quality. The comparison of patient characteristics, treatment and outcomes was hampered by heterogeneous recruitment settings.
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Affiliation(s)
- Karl Gisslander
- Clinical Sciences, Rheumatology, Lund University, Lund, Sweden
| | | | - Louis Aslett
- Department of Mathematical Science, University of Durham, Durham, UK
| | - Neil Basu
- School of Infection and Immunity, University of Glasgow, Glasgow, UK
| | | | - Lucy Hederman
- ADAPT SFI Centre, School of Computer Science and Statistics, Trinity College Dublin, Dublin, Ireland
| | - Zdenka Hruskova
- Department of Nephrology, General University Hospital, Prague, Czech Republic
- First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Hicham Kardaoui
- National Referral Center for Rare Systemic Autoimmune Diseases, Hospital Cochin, Paris, France
- Université Paris Cité, Paris, France
| | - Peter Lamprecht
- Department of Rheumatology and Clinical Immunology, Universitat zu Lubeck, Lubeck, Germany
| | - Sabina Lichołai
- Division of Molecular Biology and Clinical Genetics, Jagiellonian University Medical College, Krakow, Poland
| | - Jacek Musial
- 2nd Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Declan O'Sullivan
- ADAPT SFI Centre, School of Computer Science and Statistics, Trinity College Dublin, Dublin, Ireland
| | - Xavier Puechal
- National Referral Center for Rare Systemic Autoimmune Diseases, Hospital Cochin, Paris, France
- French Vasculitis Study Group, Paris, France
| | - Jennifer Scott
- ADAPT SFI Centre, School of Computer Science and Statistics, Trinity College Dublin, Dublin, Ireland
- Trinity Kidney Centre, Trinity Translational Medicine Institute, Trinity College Dublin, Dublin, Ireland
| | - Mårten Segelmark
- Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Endocrinology, Nephrology and Rheumatology, Skåne University Hospital, Lund, Sweden
| | - Richard Straka
- General University Hospital in Prague, Praha, Czech Republic
| | - Benjamin Terrier
- National Referral Center for Rare Systemic Autoimmune Diseases, Hospital Cochin, Paris, France
- French Vasculitis Study Group, Paris, France
| | - Vladimir Tesar
- Department of Nephrology, General University Hospital, Prague, Czech Republic
- First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Michelangelo Tesi
- Nephrology and Dialysis Unit, Meyer Children's Hospital IRCCS, Firenze, Italy
| | - Augusto Vaglio
- Nephrology and Dialysis Unit, Meyer Children's Hospital IRCCS, Firenze, Italy
| | - Dagmar Wandrei
- Clinical Trials Unit, Medical Center, University of Freiburg Faculty of Medicine, Freiburg, Germany
| | - Arthur White
- School of Computer Science and Statistics, Trinity College Dublin, Dublin, Ireland
| | - Krzysztof Wójcik
- 2nd Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Beyza Yaman
- ADAPT SFI Centre, School of Computer Science and Statistics, Trinity College Dublin, Dublin, Ireland
| | - Mark A Little
- ADAPT SFI Centre, School of Computer Science and Statistics, Trinity College Dublin, Dublin, Ireland
- Trinity Kidney Centre, Trinity Translational Medicine Institute, Trinity College Dublin, Dublin, Ireland
| | - Aladdin J Mohammad
- Clinical Sciences, Rheumatology, Lund University, Lund, Sweden
- Department of Medicine, University of Cambridge, Cambridge, UK
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Ponte C, Khmelinskii N, Teixeira V, Luz K, Peixoto D, Rodrigues M, Luís M, Teixeira L, Sousa S, Madeira N, Aleixo JA, Pedrosa T, Serra S, Campanilho-Marques R, Castelão W, Cordeiro A, Cordeiro I, Fernandes S, Macieira C, Madureira P, Malcata A, Vieira R, Martins F, Sequeira G, Branco JC, Costa L, Patto JV, da Silva JC, Pereira da Silva JA, Afonso C, Canhão H, Santos MJ, Luqmani RA, Fonseca JE. Reuma.pt/vasculitis - the Portuguese vasculitis registry. Orphanet J Rare Dis 2020; 15:110. [PMID: 32370776 PMCID: PMC7201571 DOI: 10.1186/s13023-020-01381-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 04/07/2020] [Indexed: 11/26/2022] Open
Abstract
Background The vasculitides are a group of rare diseases with different manifestations and outcomes. New therapeutic options have led to the need for long-term registries. The Rheumatic Diseases Portuguese Register, Reuma.pt, is a web-based electronic clinical record, created in 2008, which currently includes specific modules for 12 diseases and > 20,000 patients registered from 79 rheumatology centres. On October 2014, a dedicated module for vasculitis was created as part of the European Vasculitis Society collaborative network, enabling prospective collection and central storage of encrypted data from patients with this condition. All Portuguese rheumatology centres were invited to participate. Data regarding demographics, diagnosis, classification criteria, assessment tools, and treatment were collected. We aim to describe the structure of Reuma.pt/vasculitis and characterize the patients registered since its development. Results A total of 687 patients, with 1945 visits, from 13 centres were registered; mean age was 53.4 ± 19.3 years at last visit and 68.7% were females. The most common diagnoses were Behçet’s disease (BD) (42.5%) and giant cell arteritis (GCA) (17.8%). Patients with BD met the International Study Group criteria and the International Criteria for BD in 85.3 and 97.2% of cases, respectively. Within the most common small- and medium-vessel vasculitides registered, median [interquartile range] Birmingham Vasculitis Activity Score (BVAS) at first visit was highest in patients with ANCA-associated vasculitis (AAV) (17.0 [12.0]); there were no differences in the proportion of patients with AAV or polyarteritis nodosa who relapsed (BVAS≥1) or had a major relapse (≥1 major BVAS item) during prospective assessment (p = 1.00, p = 0.479). Biologic treatment was prescribed in 0.8% of patients with GCA, 26.7% of patients with AAV, and 7.6% of patients with BD. There were 34 (4.9%) deaths reported. Conclusions Reuma.pt/vasculitis is a bespoke web-based registry adapted for routine care of patients with this form of rare and complex diseases, allowing an efficient data-repository at a national level with the potential to link with other international databases. It facilitates research, trials recruitment, service planning and benchmarking.
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Affiliation(s)
- Cristina Ponte
- Rheumatology Department, Hospital de Santa Maria - Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal. .,Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
| | - Nikita Khmelinskii
- Rheumatology Department, Hospital de Santa Maria - Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.,Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Vítor Teixeira
- Rheumatology Department, Hospital de Santa Maria - Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.,Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Karine Luz
- Rheumatology Department, Hospital de Santa Maria - Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.,Rheumatology Department, Universidade Federal do Estado de São Paulo, São Paulo, Brazil
| | - Daniela Peixoto
- Rheumatology Department, Unidade Local de Saúde do Alto Minho, Ponte de Lima, Portugal
| | - Marília Rodrigues
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Rheumatology Department, Hospital de Santo André - Centro Hospitalar de Leiria, Leiria, Portugal
| | - Mariana Luís
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Lídia Teixeira
- Rheumatology Department, Hospital Garcia de Orta, Almada, Portugal.,Rheumatology Department, Hospital Dr. Nélio Mendonça, Funchal, Portugal
| | - Sandra Sousa
- Rheumatology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Nathalie Madeira
- Rheumatology Department, Instituto Português de Reumatologia, Lisbon, Portugal
| | - Joana A Aleixo
- Rheumatology Department, Centro Hospitalar de São João, Porto, Portugal.,Rheumatology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Gaia, Portugal
| | - Teresa Pedrosa
- Rheumatology Department, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.,Multidisciplinary Unit of Chronic Pain, Centro Hospitalar de Setúbal, Setúbal, Portugal
| | - Sofia Serra
- Rheumatology Department, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - Raquel Campanilho-Marques
- Rheumatology Department, Hospital de Santa Maria - Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.,Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Rheumatology Department, Instituto Português de Reumatologia, Lisbon, Portugal
| | - Walter Castelão
- Rheumatology Department, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - Ana Cordeiro
- Rheumatology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Inês Cordeiro
- Rheumatology Department, Hospital de Santa Maria - Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.,Rheumatology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Sílvia Fernandes
- Rheumatology Department, Hospital de Santa Maria - Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.,Rheumatology Department, Centro Hospitalar Barreiro Montijo, Barreiro, Portugal
| | - Carla Macieira
- Rheumatology Department, Hospital de Santa Maria - Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | - Pedro Madureira
- Rheumatology Department, Centro Hospitalar de São João, Porto, Portugal
| | - Armando Malcata
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Romana Vieira
- Rheumatology Department, Centro Hospitalar de São João, Porto, Portugal.,Rheumatology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Gaia, Portugal
| | | | - Graça Sequeira
- Rheumatology Department, Hospital de Faro, Centro Hospitalar do Algarve, Faro, Portugal
| | - Jaime C Branco
- Rheumatology Department, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - Lúcia Costa
- Rheumatology Department, Centro Hospitalar de São João, Porto, Portugal
| | - José Vaz Patto
- Rheumatology Department, Instituto Português de Reumatologia, Lisbon, Portugal
| | | | | | - Carmo Afonso
- Rheumatology Department, Unidade Local de Saúde do Alto Minho, Ponte de Lima, Portugal
| | - Helena Canhão
- Sociedade Portuguesa de Reumatologia, Lisbon, Portugal.,CEDOC, EpiDoC Unit, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Maria J Santos
- Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Rheumatology Department, Hospital Garcia de Orta, Almada, Portugal.,Sociedade Portuguesa de Reumatologia, Lisbon, Portugal
| | - Raashid A Luqmani
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - João E Fonseca
- Rheumatology Department, Hospital de Santa Maria - Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa, Lisbon, Portugal.,Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
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