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Tones M, Zeps N, Wyborn Y, Smith A, Barrero RA, Heussler H, Cross M, McGree J, Bellgard M. Does the registry speak your language? A case study of the Global Angelman Syndrome Registry. Orphanet J Rare Dis 2023; 18:330. [PMID: 37858180 PMCID: PMC10588126 DOI: 10.1186/s13023-023-02904-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 08/31/2023] [Indexed: 10/21/2023] Open
Abstract
Global disease registries are critical to capturing common patient related information on rare illnesses, allowing patients and their families to provide information about their condition in a safe, accessible, and engaging manner that enables researchers to undertake critical research aimed at improving outcomes. Typically, English is the default language of choice for these global digital health platforms. Unfortunately, language barriers can significantly inhibit participation from non-English speaking participants. In addition, there is potential for compromises in data quality and completeness. In contrast, multinational commercial entities provide access to their websites in the local language of the country they are operating in, and often provide multiple options reflecting ethnic diversity. This paper presents a case study of how the Global Angelman Syndrome Registry (GASR) has used a novel approach to enable multiple language translations for its website. Using a "semi-automated language translation" approach, the GASR, which was originally launched in English in September 2016, is now available in several other languages. In 2020, the GASR adopted a novel approach using crowd-sourcing and machine translation tools leading to the availability of the GASR in Spanish, Traditional Chinese, Italian, and Hindi. As a result, enrolments increased by 124% percent for Spain, 67% percent for Latin America, 46% percent for Asia, 24% for Italy, and 43% for India. We describe our approach here, which we believe presents an opportunity for cost-effective and timely translations responsive to changes to the registry and helps build and maintain engagement with global disease communities.
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Affiliation(s)
- Megan Tones
- Office of eResearch, Queensland University of Technology, Brisbane, QLD, 4000, Australia.
| | - Nikolajs Zeps
- Office of eResearch, Queensland University of Technology, Brisbane, QLD, 4000, Australia
| | - Yvette Wyborn
- Office of eResearch, Queensland University of Technology, Brisbane, QLD, 4000, Australia
| | - Adam Smith
- Office of eResearch, Queensland University of Technology, Brisbane, QLD, 4000, Australia
| | - Roberto A Barrero
- Office of eResearch, Queensland University of Technology, Brisbane, QLD, 4000, Australia
| | - Helen Heussler
- Centre for Clinical Trials in Rare Neurodevelopmental Disorders, Child Development Program, Children's Health Queensland, Child Health Research Centre University of Queensland, Brisbane, QLD, 4101, Australia
| | - Meagan Cross
- Foundation for Angelman Syndrome Therapeutics Australia, Salisbury, QLD, 4107, Australia
| | - James McGree
- School of Mathematical Sciences, Queensland University of Technology, Brisbane, Australia
| | - Matthew Bellgard
- Office of eResearch, Queensland University of Technology, Brisbane, QLD, 4000, Australia.
- University of East London, London, UK.
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Haymond MW, Araújo-Vilar D, Balser J, Lewis JH, Louzado R, Musso C, von Schnurbein J, Wabitsch M. The Metreleptin Effectiveness and Safety Registry (MEASuRE): concept, design and challenges. Orphanet J Rare Dis 2023; 18:127. [PMID: 37237416 DOI: 10.1186/s13023-023-02714-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 04/30/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Metreleptin, a recombinant analog of human leptin, is an approved therapy, adjunct to diet, to treat the metabolic complications of leptin deficiency in patients with lipodystrophy - a group of rare diseases characterized by a paucity of adipose tissue. MEASuRE (Metreleptin Effectiveness And Safety Registry) is a post-authorization, voluntary registry that gathers long-term safety and effectiveness data on metreleptin. Here, we present the aims and evolution of MEASuRE. METHODS MEASuRE was established to collect data from patients receiving commercially supplied metreleptin in the United States (US) and European Union (EU). MEASuRE aims to determine the incidence and severity of safety events and describe the clinical characteristics and therapeutic outcomes in the metreleptin-treated population. A key feature of MEASuRE is that it accumulates data from different sources to meet post-authorization objectives. US data are received directly from treating physicians via a contract research organization-mediated electronic data capture system. In the EU, data are received via the European Registry of Lipodystrophies managed by the European Consortium of Lipodystrophies (ECLip), a platform established by researchers and physicians to advance the knowledge of lipodystrophy. MEASuRE complies with applicable regulatory requirements governing privacy, and the storage, management, and access of data. RESULTS Leveraging processes, infrastructure, and data from the ECLip registry presented several challenges that were addressed during MEASuRE's development, including the expansion of the ECLip registry to accommodate MEASuRE-specific data elements, extensive data matching processes to ensure data consistency regardless of source, and rigorous data validation following the amalgamation of global data. Through the support of ECLip, MEASuRE is now a fully operational registry with the capacity for gathering and integrating standardized US- and EU-derived data. As of 31st October 2022, 15 US and four EU sites have participated in the MEASuRE, enrolling 85 patients globally. CONCLUSIONS Our experiences show that a post-authorization product registry can be successfully integrated into an existing patient registry. We propose that, through collaboration with existing registries and use of their established resources, patient enrolment timelines and data collection for new registries can be expedited. The learnings presented here may be applicable to other registries with similar objectives. TRIAL REGISTRATION NCT02325674; Registered 25 December 2014 - Retrospectively registered'. https://clinicaltrials.gov/ct2/show/NCT02325674 .
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Affiliation(s)
- Morey W Haymond
- Clinical Care Center, Texas Children's Hospital, Baylor College of Medicine, 6701 Fannin St., 11th floor, Houston, TX, 77030, USA.
| | - David Araújo-Vilar
- Thyroid and Metabolic Diseases Unit, Centro de Investigación en Medicina Molecular y Enfermedades Crónicas (CIMUS)-IDIS, School of Medicine, Universidade de Santiago de Compostela, Avda. Barcelona 3, Santiago de Compostela, 15707, Spain
| | - John Balser
- Veristat LLC, 134 Turnpike Rd #200, Southborough, MA, 01772, USA
| | - James H Lewis
- MedStar Georgetown University Hospital, Washington, DC, USA
| | - Ruth Louzado
- Amryt Pharmaceuticals DAC, 45 Mespil Road, Dublin 4, Ireland
| | - Carla Musso
- Diabetes section, Fundacion Favaloro, Buenos Aires, Argentina
| | - Julia von Schnurbein
- Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics and Adolescent Medicine, Centre for Rare Endocrine Disorders, Ulm University Medical Centre, Eythstraße 24, 89075, Ulm, Germany
| | - Martin Wabitsch
- Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics and Adolescent Medicine, Centre for Rare Endocrine Disorders, Ulm University Medical Centre, Eythstraße 24, 89075, Ulm, Germany
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Scarlat MM, Mavrogenis A, Hernigou P, Waddell JP. New surgical techniques and social media in orthopaedics. Is a scientific peer-reviewed journal assimilated to a social media platform? INTERNATIONAL ORTHOPAEDICS 2023; 47:1-4. [PMID: 36534163 PMCID: PMC9761020 DOI: 10.1007/s00264-022-05656-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Marius M. Scarlat
- Clinique Chirurgicale St Michel, Toulon, France and Group ELSAN, Paris, France
| | - Andreas Mavrogenis
- The Orthopaedic Department, Kapadostrian University of Athens, Athens, Greece
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Schoenmakers DH, Beerepoot S, van den Berg S, Adang L, Bley A, Boelens JJ, Fumagalli F, Goettsch WG, Grønborg S, Groeschel S, van Hasselt PM, Hollak CEM, Lindemans C, Mochel F, Mol PGM, Sevin C, Zerem A, Schöls L, Wolf NI. Modified Delphi procedure-based expert consensus on endpoints for an international disease registry for Metachromatic Leukodystrophy: The European Metachromatic Leukodystrophy initiative (MLDi). Orphanet J Rare Dis 2022; 17:48. [PMID: 35164810 PMCID: PMC8842918 DOI: 10.1186/s13023-022-02189-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 01/30/2022] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Metachromatic Leukodystrophy (MLD) is a rare lysosomal disorder. Patients suffer from relentless neurological deterioration leading to premature death. Recently, new treatment modalities, including gene therapy and enzyme replacement therapy, have been developed. Those advances increase the need for high-quality research infrastructure to adequately compare treatments, execute post-marketing surveillance, and perform health technology assessments (HTA). To facilitate this, a group of MLD experts started the MLD initiative (MLDi) and initiated an academia-led European MLD registry: the MLDi. An expert-based consensus procedure, namely a modified Delphi procedure, was used to determine the data elements required to answer academic, regulatory, and HTA research questions. RESULTS Three distinct sets of data elements were defined by the 13-member expert panel. The minimal set (n = 13) contained demographics and basic disease characteristics. The core set (n = 55) included functional status scores in terms of motor, manual, speech and eating abilities, and causal and supportive treatment characteristics. Health-related quality of life scores were included that were also deemed necessary for HTA. The optional set (n = 31) contained additional clinical aspects, such as findings at neurological examination, detailed motor function, presence of peripheral neuropathy, gall bladder involvement and micturition. CONCLUSION Using a modified Delphi procedure with physicians from the main expert centers, consensus was reached on a core set of data that can be collected retrospectively and prospectively. With this consensus-based approach, an important step towards harmonization was made. This unique dataset will support knowledge about the disease and facilitate regulatory requirements related to the launch of new treatments.
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Affiliation(s)
- Daphne H Schoenmakers
- Amsterdam Leukodystrophy Center, Department of Child Neurology, Emma Children's Hospital, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Department of Endocrinology and Metabolism, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Medicine for Society, Platform at Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Shanice Beerepoot
- Amsterdam Leukodystrophy Center, Department of Child Neurology, Emma Children's Hospital, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
- Nierkens and Lindemans group, Princess Máxima Center for pediatric oncology, Utrecht, The Netherlands
| | - Sibren van den Berg
- Department of Endocrinology and Metabolism, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Medicine for Society, Platform at Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Laura Adang
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Annette Bley
- University Children's Hospital, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Jaap-Jan Boelens
- Stem Cell Transplantation and Cellular Therapies Program, Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
| | - Francesca Fumagalli
- San Raffaele Telethon Institute for Gene Therapy (SR-Tiget); IRCCS, San Raffaele Scientific Institute, Milan, Italy
| | - Wim G Goettsch
- Zorginstituut Nederland (Dutch Health Care Institute), Diemen, The Netherlands
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands
| | - Sabine Grønborg
- Centre for Inherited Metabolic Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Samuel Groeschel
- Department of Paediatric Neurology and Developmental Medicine, University Children's Hospital, Tübingen, Germany
| | - Peter M van Hasselt
- Department of Pediatric Metabolic Diseases, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Carla E M Hollak
- Department of Endocrinology and Metabolism, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Medicine for Society, Platform at Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Caroline Lindemans
- Nierkens and Lindemans group, Princess Máxima Center for pediatric oncology, Utrecht, The Netherlands
- Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Fanny Mochel
- INSERM U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau Et de La Moelle Épinière, ICM, 75013, Paris, France
- Department of Genetics, Center for Neurometabolic Diseases, AP-HP, La Pitié-Salpêtrière University Hospital, 47 Boulevard de l'Hôpital, 75013, Paris, France
| | - Peter G M Mol
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Dutch Medicines Evaluation Board, Utrecht, The Netherlands
| | - Caroline Sevin
- NeuroGenCell, Institut du Cerveau et de la Moelle Épinière, ICM, Inserm U 1127, CNRS UMR 7225, Sorbonne Université, Paris, France
- Bicêtre Hospital, Neuropediatrics Unit, Le Kremlin Bicêtre, Paris, France
| | - Ayelet Zerem
- Pediatric Neurology Institute, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Ludger Schöls
- Department of Neurology and Hertie-Institute for Clinical Brain Research, University of Tübingen, 72076, Tübingen, Germany
- German Center of Neurodegenerative Diseases, 72076, Tübingen, Germany
| | - Nicole I Wolf
- Amsterdam Leukodystrophy Center, Department of Child Neurology, Emma Children's Hospital, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands.
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Gresky J, Dorn J, Teßmann B, Petiti E. How rare is rare? A literature survey of the last 45 years of paleopathological research on ancient rare diseases. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2021; 33:94-102. [PMID: 33813348 DOI: 10.1016/j.ijpp.2021.03.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 03/17/2021] [Accepted: 03/20/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE This paper aims to provide a quantitative estimation of the representation of diseases defined as rare today in the bioarchaeological literature and to outline the reasons for this. MATERIALS A 45-year bibliometric study of publications in seven bioarchaeological journals, along with two journals and editorial groups of broader scientific focus. METHODS Analyses of distribution patterns of the search hits and diachronic trends for achondroplasia, autosomal-dominant osteopetrosis, osteogenesis imperfecta, and osteopoikilosis, compared to those for tuberculosis as control measure of coverage. RESULTS Studies of ancient rare diseases (ARD) are mostly published as case reports in specialized journals and their number did not benefit from the introduction of biomolecular studies. The higher frequency of cases of achondroplasia suggests that not all rare diseases are equally under-represented. CONCLUSIONS Rare diseases are still largely under-represented in bioarchaeological literature. Their marginality likely results from a combination of taphonomic, methodological and public visibility factors. SIGNIFICANCE This article is the first attempt to provide a quantitative assessment of the under-representation of ARD and to outline the factors behind it. LIMITATIONS Rare diseases are an etiologically heterogeneous group. The number of surveyed journals and articles, as well as targeted diseases might be limiting factors. SUGGESTIONS FOR FURTHER RESEARCH Increasing collection and dissemination of data on ARD; opening a wide-ranging debate on their definition; implementation of biomolecular studies.
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Affiliation(s)
- Julia Gresky
- German Archaeological Institute, Department of Natural Sciences, Berlin, Germany.
| | - Juliane Dorn
- German Archaeological Institute, Department of Natural Sciences, Berlin, Germany
| | - Barbara Teßmann
- Berlin Society of Anthropology, Ethnology and Prehistory, Berlin, Germany
| | - Emmanuele Petiti
- German Archaeological Institute, Department of Natural Sciences, Berlin, Germany
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6
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Valerieva A, Staevska MT, Grivcheva-Panovska V, Jesenak M, Kőhalmi KV, Hrubiskova K, Zanichelli A, Bellizzi L, Relan A, Hakl R, Farkas H. Recombinant human C1 esterase inhibitor for hereditary angioedema attacks: A European registry. World Allergy Organ J 2021; 14:100535. [PMID: 33995818 PMCID: PMC8093463 DOI: 10.1016/j.waojou.2021.100535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/05/2021] [Accepted: 03/18/2021] [Indexed: 12/20/2022] Open
Abstract
Background Hereditary angioedema (HAE) due to C1 esterase inhibitor deficiency (C1-INH-HAE) is characterized by recurrent swelling attacks. A European treatment registry was established to review the adverse event profile and efficacy of recombinant human C1 esterase inhibitor (rhC1-INH) for HAE attacks. Methods Individuals with C1-INH-HAE were enrolled following a decision to treat with rhC1-INH and provision of written informed consent. Medical history and baseline HAE information were collected at screening. Healthcare providers entered data on HAE attacks, response to treatment, and adverse events using a web-based questionnaire. Results From July 1, 2011, through December 1, 2019, 71 patients with C1-INH-HAE (30 male/41 female; mean age, 47.3 years; age range, 19–78 years) in 9 countries reported 2356 attacks and were treated with rhC1-INH. Before registry entry, patients, including 20 (28.2%) who were on maintenance therapy/prophylaxis at registry enrollment, experienced a mean of 25 HAE attacks per year (median, 16 [range, 0–185]). Most treated HAE attacks were abdominal (46.1%), followed by peripheral (38.3%), oro-facial-pharyngeal (14.8%), urogenital (3.2%), and laryngeal (2.6%). The mean rhC1-INH dose was 3307 U (43.3 U/kg). Patients reported symptom improvement within 4 h for 97.8% of attacks (2305/2356) with rhC1-INH; most attacks (99.8%; 2351/2356) required only 1 dose. Five attacks were treated with a second dose (total rhC1-INH dose administered for attack, 4200 U). No hypersensitivity, thrombotic/thromboembolic events, or drug-related serious adverse events were reported. Conclusion The rhC1-INH treatment registry provided real-world data on the treatment of 2356 HAE attacks that were consistent with clinical trial data of rhC1-INH in patients with C1-INH-HAE.
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Affiliation(s)
- Anna Valerieva
- Department of Allergology, Medical University of Sofia, Sofia, Bulgaria
- Corresponding author.
| | - Maria T. Staevska
- Department of Allergology, Medical University of Sofia, Sofia, Bulgaria
| | - Vesna Grivcheva-Panovska
- PHI University Clinic of Dermatology, School of Medicine, University Saints Cyril and Methodius, Skopje, Macedonia
| | - Milos Jesenak
- University Hospital in Martin, Comenius University in Bratislava, Jessenius Faculty of Medicine, Martin, Slovakia
| | - Kinga Viktória Kőhalmi
- Hungarian Angioedema Center of Excellence and Reference, Department of Internal Medicine and Haematology, Semmelweis University, Budapest, Hungary
- Hospital of Hospitaller Brothers of St. John of God, Budapest, Hungary
- Department of Rheumatology and Clinical Immunology, Semmelweis University, Budapest, Hungary
| | - Katarina Hrubiskova
- Comenius University in Bratislava and University Hospital, Bratislava, Slovakia
| | - Andrea Zanichelli
- ASST Fatebenefratelli Sacco, Ospedale Luigi Sacco-University of Milan, Milan, Italy
| | | | | | - Roman Hakl
- St. Anne's University Hospital, Masaryk University, Brno, Czechia
| | - Henriette Farkas
- Hungarian Angioedema Center of Excellence and Reference, Department of Internal Medicine and Haematology, Semmelweis University, Budapest, Hungary
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Yadav A, Gupta A, Kaushik S, Kapoor S, Verma M, Bhaskar V. Has national medical commission short-changed the subject of community medicine in its latest minimum requirements for Indian medical graduates? A systems review. Indian J Community Med 2021; 46:587-591. [PMID: 35068715 PMCID: PMC8729267 DOI: 10.4103/ijcm.ijcm_112_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 09/21/2021] [Indexed: 11/04/2022] Open
Abstract
System analysis is examination of various elements of a system with a view to ascertain whether the proposed solution to a problem will fit the system and in turn effect an overall improvement in the system. The National Medical Commission (NMC) which was constituted by the act of the Parliament, has brought out minimum requirements for annual MBBS admissions regulations, 2020, which replace minimum requirements published by erstwhile Medical Council of India. The NMC also published new competency-based medical education syllabus for MBBS students with an aim to focus on practical skills. This study brings out the scope of the community medicine (CM) in the present context and as envisaged by the NMC. It also analyzes the infrastructure and workforce required in the department of CM and gives recommendations to improve the system.
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Rubinstein YR, Robinson PN, Gahl WA, Avillach P, Baynam G, Cederroth H, Goodwin RM, Groft SC, Hansson MG, Harris NL, Huser V, Mascalzoni D, McMurry JA, Might M, Nellaker C, Mons B, Paltoo DN, Pevsner J, Posada M, Rockett-Frase AP, Roos M, Rubinstein TB, Taruscio D, van Enckevort E, Haendel MA. The case for open science: rare diseases. JAMIA Open 2020; 3:472-486. [PMID: 33426479 PMCID: PMC7660964 DOI: 10.1093/jamiaopen/ooaa030] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 05/30/2020] [Accepted: 06/23/2020] [Indexed: 01/04/2023] Open
Abstract
The premise of Open Science is that research and medical management will progress faster if data and knowledge are openly shared. The value of Open Science is nowhere more important and appreciated than in the rare disease (RD) community. Research into RDs has been limited by insufficient patient data and resources, a paucity of trained disease experts, and lack of therapeutics, leading to long delays in diagnosis and treatment. These issues can be ameliorated by following the principles and practices of sharing that are intrinsic to Open Science. Here, we describe how the RD community has adopted the core pillars of Open Science, adding new initiatives to promote care and research for RD patients and, ultimately, for all of medicine. We also present recommendations that can advance Open Science more globally.
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Affiliation(s)
- Yaffa R Rubinstein
- Special Volunteer in the Office of Strategic Initiatives, National Library of Medicine, Bethesda, Maryland, USA
| | - Peter N Robinson
- The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut, USA
| | - William A Gahl
- Undiagnosed Diseases Program and Office of the Clinical Director, National Human Genome Research Institute (NHGRI), National Institutes of Health, Bethesda, Maryland, USA
| | - Paul Avillach
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA
| | - Gareth Baynam
- Western Australian Register of Developmental Anomalies and Telethon Kids Institute, Perth, Australia
| | | | - Rebecca M Goodwin
- Department of Health and Human Services, National Library of Medicine, National Institutes of Health, Bethesda, Maryland, USA
| | - Stephen C Groft
- NCATS, National Institutes of Health, Bethesda, Maryland, USA
| | - Mats G Hansson
- Center for Research Ethics and Bioethics, Uppsala Universitet, Uppsala, Sweden
| | - Nomi L Harris
- Department of Environmental Genomics & System Biology, Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - Vojtech Huser
- Department of Health and Human Services, NCBI, National Institutes of Health, Bethesda, Maryland, USA
| | - Deborah Mascalzoni
- Center for Research Ethics and Bioethics, Uppsala University, Sweden and EURAC Research, Bolzano, Italy
| | - Julie A McMurry
- Linus Pauling Institute, Oregon State University, Corvallis, Oregon, USA
| | - Matthew Might
- Hugh Kaul Precision Medicine Institute, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Christoffer Nellaker
- Nuffield Department of Women's and Reproductive Health, Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK
| | - Barend Mons
- Department of Human Genetics, Leiden University Medical Center, Leiden, Netherlands
| | - Dina N Paltoo
- Department of Health and Human Services, National Library of Medicine, National Institutes of Health, Bethesda, Maryland, USA
| | - Jonathan Pevsner
- Department of Neurology, Kennedy Krieger Institute and Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Manuel Posada
- Rare Diseases Research Institute & CIBERER, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Marco Roos
- Human Genetics, Leiden University Medical Center, Leiden, Netherlands
| | - Tamar B Rubinstein
- Children Hospital at Montefiore/Albert Einstein College of Medicine—Pediatrics, Bronx, New York, USA
| | - Domenica Taruscio
- National Centre for Rare Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Esther van Enckevort
- Department of Genetics, University Medical Center Groningen, University of Groningen, Leiden, Netherlands
| | - Melissa A Haendel
- Linus Pauling Institute, Oregon State University, Corvallis, Oregon, USA
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Guerrini CJ, Contreras JL. Credit for and Control of Research Outputs in Genomic Citizen Science. Annu Rev Genomics Hum Genet 2020; 21:465-489. [PMID: 32873078 DOI: 10.1146/annurev-genom-083117-021812] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Citizen science encompasses activities with scientific objectives in which members of the public participate as more than passive research subjects from whom personal data or biospecimens are collected and analyzed by others. Citizen science is increasingly common in the biomedical sciences, including the fields of genetics and human genomics. Genomic citizen science initiatives are diverse and involve citizen scientists in collecting genetic data, solving genetic puzzles, and conducting experiments in community laboratories. At the same time that genomic citizen science is presenting new opportunities for individuals to participate in scientific discovery, it is also challenging norms regarding the manner in which scientific research outputs are managed. In this review, we present a typology of genomic citizen science initiatives, describe ethical and legal foundations for recognizing genomic citizen scientists' claims of credit for and control of research outputs, and detail how such claims are or might be addressed in practice across a variety of initiatives.
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Affiliation(s)
- Christi J Guerrini
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas 77030, USA;
| | - Jorge L Contreras
- S.J. Quinney College of Law and School of Medicine, University of Utah, Salt Lake City, Utah 84112, USA;
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McGettigan P, Alonso Olmo C, Plueschke K, Castillon M, Nogueras Zondag D, Bahri P, Kurz X, Mol PGM. Patient Registries: An Underused Resource for Medicines Evaluation : Operational proposals for increasing the use of patient registries in regulatory assessments. Drug Saf 2020; 42:1343-1351. [PMID: 31302896 PMCID: PMC6834729 DOI: 10.1007/s40264-019-00848-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Patient registries, 'organised systems that use observational methods to collect uniform data on a population defined by a particular disease, condition, or exposure, and that is followed over time', are potentially valuable sources of data for supporting regulatory decision-making, especially for products to treat rare diseases. Nevertheless, patient registries are greatly underused in regulatory assessments. Reasons include heterogeneity in registry design and in the data collected, even across registries for the same disease, as well as unreliable data quality and data sharing impediments. The Patient Registries Initiative was established by the European Medicines Agency in 2015 to support registries in collecting data suitable to contribute to regulatory assessments, especially post-authorisation safety and effectiveness studies. METHODS We conducted a qualitative synthesis of the published observations and recommendations from an initiative-led multi-stakeholder consultation and four disease-specific patient registry workshops. We identified the primary factors facilitating the use of registry data in regulatory assessments. We generated proposals on operational measures needed from stakeholders including registry holders, patients, healthcare professionals, regulators, marketing authorisation applicants and holders, and health technology assessment bodies for implementing these. RESULTS Ten factors were identified as facilitating registry use for supporting regulatory assessments of medicinal products. Proposals on operational measures needed for implementation were categorised according to three themes: (1) nature of the data collected and registry quality assurance processes; (2) registry governance, informed consent, data protection and sharing; and (3) stakeholder communication and planning of benefit-risk assessments. CONCLUSIONS These are the first explicit proposals, from a regulatory perspective, on operational methods for increasing the use of patient registries in medicines regulation. They apply to registry holders, patients, regulators, marketing authorisation holders/applicants and healthcare stakeholders broadly, and their implementation would greatly facilitate the use of these valuable data sources in regulatory decision-making.
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Affiliation(s)
- Patricia McGettigan
- William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, United Kingdom.
| | - Carla Alonso Olmo
- Pharmacovigilance and Epidemiology Department, European Medicines Agency, Amsterdam, Netherlands
| | - Kelly Plueschke
- Pharmacovigilance and Epidemiology Department, European Medicines Agency, Amsterdam, Netherlands
| | - Mireia Castillon
- Pharmacovigilance and Epidemiology Department, European Medicines Agency, Amsterdam, Netherlands
| | - Daniel Nogueras Zondag
- Pharmacovigilance and Epidemiology Department, European Medicines Agency, Amsterdam, Netherlands
| | - Priya Bahri
- Pharmacovigilance and Epidemiology Department, European Medicines Agency, Amsterdam, Netherlands
| | - Xavier Kurz
- Pharmacovigilance and Epidemiology Department, European Medicines Agency, Amsterdam, Netherlands
| | - Peter G M Mol
- Department of Clinical Pharmacy and Pharmacology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.,Dutch Medicines Evaluation Board, Utrecht, The Netherlands
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11
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Angural A, Spolia A, Mahajan A, Verma V, Sharma A, Kumar P, Dhar MK, Pandita KK, Rai E, Sharma S. Review: Understanding Rare Genetic Diseases in Low Resource Regions Like Jammu and Kashmir - India. Front Genet 2020; 11:415. [PMID: 32425985 PMCID: PMC7203485 DOI: 10.3389/fgene.2020.00415] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Accepted: 04/01/2020] [Indexed: 12/11/2022] Open
Abstract
Rare diseases (RDs) are the clinical conditions affecting a few percentage of individuals in a general population compared to other diseases. Limited clinical information and a lack of reliable epidemiological data make their timely diagnosis and therapeutic management difficult. Emerging Next-Generation DNA Sequencing technologies have enhanced our horizons on patho-physiological understanding of many of the RDs and ushered us into an era of diagnostic and therapeutic research related to this ignored health challenge. Unfortunately, relevant research is meager in developing countries which lack a reliable estimate of the exact burden of most of the RDs. India is to be considered as the "Pandora's Box of genetic disorders." Owing to its huge population heterogeneity and high inbreeding or endogamy rates, a higher burden of rare recessive genetic diseases is expected and supported by the literature findings that endogamy is highly detrimental to health as it enhances the degree of homozygosity of recessive alleles in the general population. The population of a low resource region Jammu and Kashmir (J&K) - India, is highly inbred. Some of its population groups variably practice consanguinity. In context with the region's typical geographical topography, highly inbred population structure and unique but heterogeneous gene pool, a huge burden of known and uncharacterized genetic disorders is expected. Unfortunately, many suspected cases of genetic disorders remain undiagnosed or misdiagnosed due to lack of appropriate clinical as well as diagnostic resources in the region, causing patients to face a huge psycho-socio-economic crisis and many a time suffer life-long with their ailment. In this review, the major challenges associated with RDs are highlighted in general and an account on the methods that can be adopted for conducting fruitful molecular genetic studies in genetically vulnerable and low resource regions is also provided, with an example of a region like J&K - India.
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Affiliation(s)
- Arshia Angural
- Human Genetics Research Group, School of Biotechnology, Shri Mata Vaishno Devi University, Katra, India
| | - Akshi Spolia
- Human Genetics Research Group, School of Biotechnology, Shri Mata Vaishno Devi University, Katra, India
| | - Ankit Mahajan
- Human Genetics Research Group, School of Biotechnology, Shri Mata Vaishno Devi University, Katra, India
| | - Vijeshwar Verma
- Bioinformatics Infrastructure Facility, School of Biotechnology, Shri Mata Vaishno Devi University, Katra, India
| | - Ankush Sharma
- Shri Mata Vaishno Devi Narayana Superspeciality Hospital, Katra, India
| | - Parvinder Kumar
- Institute of Human Genetics, University of Jammu, Jammu, India
| | | | - Kamal Kishore Pandita
- Shri Mata Vaishno Devi Narayana Superspeciality Hospital, Katra, India
- Independent Researcher, Health Clinic, Jammu, India
| | - Ekta Rai
- Human Genetics Research Group, School of Biotechnology, Shri Mata Vaishno Devi University, Katra, India
| | - Swarkar Sharma
- Human Genetics Research Group, School of Biotechnology, Shri Mata Vaishno Devi University, Katra, India
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12
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Steele L, O'Toole EA. Pachyonychia congenita, a paradigm for rare skin disorders. Br J Dermatol 2020; 182:521-522. [PMID: 32107781 DOI: 10.1111/bjd.18817] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- L Steele
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Queen Mary University of London and Department of Dermatology, Barts Health NHS Trust, London, ERN-Skin, U.K
| | - E A O'Toole
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Queen Mary University of London and Department of Dermatology, Barts Health NHS Trust, London, ERN-Skin, U.K
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13
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Shapiro AD, Menegatti M, Palla R, Boscarino M, Roberson C, Lanzi P, Bowen J, Nakar C, Janson IA, Peyvandi F. An international registry of patients with plasminogen deficiency (HISTORY). Haematologica 2020; 105:554-561. [PMID: 32001536 PMCID: PMC7049368 DOI: 10.3324/haematol.2019.241158] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 01/20/2020] [Indexed: 12/20/2022] Open
Abstract
Plasminogen deficiency is an ultra-rare multisystem disorder characterized by the development of fibrin-rich pseudomembranes on mucous membranes. Ligneous conjunctivitis, which can result in vision impairment or loss, is the most frequent symptom reported. Affected systems may also include the respiratory tract, oropharynx, female reproductive tract, gingiva, middle ear, renal collecting system, skin and central nervous system. Untreated, plasminogen deficiency may result in significant reduction in quality of life and morbidity with potential life-threatening complications. Non-specific therapies are inadequate and plasminogen concentrates are not commercially available. The current understanding of plasminogen deficiency and management of disease symptoms and its progression are based on case reports/series and two small clinical trials. To date there has never been a comprehensive, international study to examine the natural history or optimal therapeutic intervention; knowledge gaps include identification of contributing factors and triggers of disease manifestations, inability to predict disease course, and insufficient real-world data for use of therapeutics. We have created an international, observational study (HISTORY) in a large cohort of persons with plasminogen deficiency and first-degree family members to address these gaps and to advance knowledge and care. HISTORY will build upon the established relationship between the Indiana Hemophilia and Thrombosis Center and the Fondazione Angelo Bianchi Bonomi, IRCCS Ca' Granda Ospedale Maggiore Policlinico - University of Milan and will utilize a modified version of the Prospective Rare Bleeding Disorders Database (PRO-RBDD). A biorepository containing samples from subjects with plasminogen deficiency will be established. This article describes the rationale behind the study and efforts towards its goals.
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Affiliation(s)
- Amy D Shapiro
- Indiana Hemophilia & Thrombosis Center, Indianapolis, IN, USA
| | - Marzia Menegatti
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and Fondazione Luigi Villa, Milan, Italy
| | - Roberta Palla
- Università degli Studi di Milano, Department of Pathophysiology and Transplantation, Milan, Italy
| | - Marco Boscarino
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and Fondazione Luigi Villa, Milan, Italy
| | | | | | | | - Charles Nakar
- Indiana Hemophilia & Thrombosis Center, Indianapolis, IN, USA
| | - Isaac A Janson
- Indiana Hemophilia & Thrombosis Center, Indianapolis, IN, USA
| | - Flora Peyvandi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center and Fondazione Luigi Villa, Milan, Italy.,Università degli Studi di Milano, Department of Pathophysiology and Transplantation, Milan, Italy
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14
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Feng S, Liu S, Zhu C, Gong M, Zhu Y, Zhang S. National Rare Diseases Registry System of China and Related Cohort Studies: Vision and Roadmap. Hum Gene Ther 2019; 29:128-135. [PMID: 29284292 DOI: 10.1089/hum.2017.215] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Rare diseases are major challenges in healthcare and medical research and are the basis of national development strategies in many countries. However, inadequate definition of rare diseases and lags in orphan drug development in China hinder rare disease research. In response, the first National Rare Diseases Registry System of China (NRDRS) was established, and various cohort studies have been launched since 2016. More than 20 top academic institutions in China are currently participating in this joint effort to carry out nationwide registration of rare diseases. The primary objectives are to establish standardization for the registration platform, build biobanks of genomic data, and create partnerships for data sharing and research collaboration. Innovative informatics technologies have been implemented to develop the NRDRS, including employment of ontological and knowledge bases to render standardization and support standard of care. Development of informatics analysis tools will facilitate accurate and more efficient diagnoses for rare diseases. Long-term research collaboration is encouraged to create additional national rare disease networks for research translation and to benefit patients with rare diseases. The NRDRS of China and related cohort studies are anticipated to enlighten rare disease research significantly in China.
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Affiliation(s)
- Shi Feng
- 1 Peking Union Medical College , Beijing, China
| | - Shuang Liu
- 1 Peking Union Medical College , Beijing, China
| | - Chong Zhu
- 2 National Rare Diseases Registry System of China , Beijing, China .,3 Digital China Health Technologies Co., Ltd. , Beijing, China
| | - Mengchun Gong
- 2 National Rare Diseases Registry System of China , Beijing, China .,4 Rare Diseases Research Center , Chinese Academy of Medical Sciences, Beijing, China
| | - Yicheng Zhu
- 2 National Rare Diseases Registry System of China , Beijing, China .,5 Peking Union Medical College Hospital , Beijing, China
| | - Shuyang Zhang
- 2 National Rare Diseases Registry System of China , Beijing, China .,5 Peking Union Medical College Hospital , Beijing, China
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15
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Jansen-van der Weide MC, Gaasterland CMW, Roes KCB, Pontes C, Vives R, Sancho A, Nikolakopoulos S, Vermeulen E, van der Lee JH. Rare disease registries: potential applications towards impact on development of new drug treatments. Orphanet J Rare Dis 2018; 13:154. [PMID: 30185208 PMCID: PMC6126025 DOI: 10.1186/s13023-018-0836-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 06/05/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Low prevalence, lack of knowledge about the disease course, and phenotype heterogeneity hamper the development of drugs for rare diseases. Rare disease registries (RDRs) can be helpful by playing a role in understanding the course of the disease, and providing information necessary for clinical trial design, if designed and maintained properly. We describe the potential applications of a RDR and what type of information should be incorporated to support the design of clinical trials in the process of drug development, based on a broad inventory of registry experience. We evaluated two existing RDRs in more detail to check the completeness of these RDRs for trial design. RESULTS Before and during the application for regulatory approval a RDR can improve the efficiency and quality in clinical trial design by informing the sample size calculation and expected disease course. In exceptional circumstances information from RDRs has been used as historical controls for a one-armed clinical trial, and high quality RDRs may be used for registry-based randomized controlled trials. In the post marketing phase of (conditional) drug approval a disease-specific RDR is likely to provide more relevant information than a product-specific registry. CONCLUSIONS A RDR can be very helpful to improve the efficiency and quality of clinical trial design in several ways. To enable the applicability and optimal use of a RDR longitudinal data collection is indispensable, and specific data collection, prepared for repeated measurement, is needed. The developed checklist can help to define the appropriate variables to include. Attention should be paid to the inclusion of patient-relevant outcome measures in the RDR from the start. More research and experience is needed on the possibilities and limitations of combining RDR information with clinical trial data to maximize the availability of relevant evidence for regulatory decisions in rare diseases.
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Affiliation(s)
- Marijke C Jansen-van der Weide
- Pediatric Clinical Research Office, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. .,Academic Medical Center, H8-236, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Charlotte M W Gaasterland
- Pediatric Clinical Research Office, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Kit C B Roes
- Department of Biostatistics and Research Support, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - Caridad Pontes
- Clinical Pharmacology Unit, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT, Sabadell, Spain
| | - Roser Vives
- Clinical Pharmacology Unit, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT, Sabadell, Spain
| | - Arantxa Sancho
- Clinical Pharmacology Unit, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT, Sabadell, Spain.,Servicio de Farmacología Clínica - Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Stavros Nikolakopoulos
- Department of Biostatistics and Research Support, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - Eric Vermeulen
- Pediatric Clinical Research Office, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Johanna H van der Lee
- Pediatric Clinical Research Office, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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16
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Wood L, Bassez G, Bleyenheuft C, Campbell C, Cossette L, Jimenez-Moreno AC, Dai Y, Dawkins H, Manera JAD, Dogan C, el Sherif R, Fossati B, Graham C, Hilbert J, Kastreva K, Kimura E, Korngut L, Kostera-Pruszczyk A, Lindberg C, Lindvall B, Luebbe E, Lusakowska A, Mazanec R, Meola G, Orlando L, Takahashi MP, Peric S, Puymirat J, Rakocevic-Stojanovic V, Rodrigues M, Roxburgh R, Schoser B, Segovia S, Shatillo A, Thiele S, Tournev I, van Engelen B, Vohanka S, Lochmüller H. Eight years after an international workshop on myotonic dystrophy patient registries: case study of a global collaboration for a rare disease. Orphanet J Rare Dis 2018; 13:155. [PMID: 30185236 PMCID: PMC6126043 DOI: 10.1186/s13023-018-0889-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 08/12/2018] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Myotonic Dystrophy is the most common form of muscular dystrophy in adults, affecting an estimated 10 per 100,000 people. It is a multisystemic disorder affecting multiple generations with increasing severity. There are currently no licenced therapies to reverse, slow down or cure its symptoms. In 2009 TREAT-NMD (a global alliance with the mission of improving trial readiness for neuromuscular diseases) and the Marigold Foundation held a workshop of key opinion leaders to agree a minimal dataset for patient registries in myotonic dystrophy. Eight years after this workshop, we surveyed 22 registries collecting information on myotonic dystrophy patients to assess the proliferation and utility the dataset agreed in 2009. These registries represent over 10,000 myotonic dystrophy patients worldwide (Europe, North America, Asia and Oceania). RESULTS The registries use a variety of data collection methods (e.g. online patient surveys or clinician led) and have a variety of budgets (from being run by volunteers to annual budgets over €200,000). All registries collect at least some of the originally agreed data items, and a number of additional items have been suggested in particular items on cognitive impact. CONCLUSIONS The community should consider how to maximise this collective resource in future therapeutic programmes.
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Affiliation(s)
- Libby Wood
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Guillaume Bassez
- Centre de référence des maladies neuromusculaires, Hôpital Henri Mondor, Paris, France
| | | | | | - Louise Cossette
- Centre de recherche du CHU de Québec, Université Laval, Quebec, Canada
| | | | - Yi Dai
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Hugh Dawkins
- Office of Population Health Genomics, Perth, Western Australia
| | | | - Celine Dogan
- Centre de référence des maladies neuromusculaires, Hôpital Henri Mondor, Paris, France
| | - Rasha el Sherif
- Neuromuscular & Neuro-genetics Unit, Air Hospital, Cairo, Egypt
| | - Barbara Fossati
- U.O. Neurology and Stroke Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Caroline Graham
- Office of Population Health Genomics, Perth, Western Australia
| | - James Hilbert
- Department of Neurology, University of Rochester Medical Center, Rochester, NY USA
| | - Kristinia Kastreva
- Department of Neurology, Alexandrovska University Hospital, Medical University, Sofia, Bulgaria
| | - En Kimura
- Department of Promoting Clinical Trial and Translational Medicine, National Center for Neurology and Psychiatry, Translational Medical Center, Kodaira, Japan
| | | | | | | | | | - Elizabeth Luebbe
- Department of Neurology, University of Rochester Medical Center, Rochester, NY USA
| | - Anna Lusakowska
- Department of Neurology, Medical University of Warsaw, Warszawa, Poland
| | - Radim Mazanec
- University Hospital Prague- Motol and Charles University Prague, Prague, Czech Republic
| | - Giovani Meola
- U.O. Neurology and Stroke Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | | | - Masanori P. Takahashi
- Department of Functional Diagnostic Science, Osaka University Graduate School of Medicine, Suita, Japan
| | - Stojan Peric
- Neurology Clinic, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Jack Puymirat
- Centre de recherche du CHU de Québec, Université Laval, Quebec, Canada
| | | | - Miriam Rodrigues
- Neurology, Auckland City Hospital, Private Bag 92024, Auckland, 1142 New Zealand
| | - Richard Roxburgh
- Neurology, Auckland City Hospital, Private Bag 92024, Auckland, 1142 New Zealand
| | - Benedikt Schoser
- Friedrich-Baur-Institute, Department of Neurology, Klinikum München, Munich, Germany
| | - Sonia Segovia
- Centro de Investigación Biomédica en Red en Enfermedades Raras (CIBERER), Valencia, Spain
| | - Andriy Shatillo
- Institute of Neurology, Psychiatry and Narcology, Academy of medical science of Ukraine, Kharkiv, Ukraine
| | - Simone Thiele
- Friedrich-Baur-Institute, Department of Neurology, Klinikum München, Munich, Germany
| | - Ivailo Tournev
- Department of Neurology, Alexandrovska University Hospital, Medical University, Sofia, Bulgaria
| | | | - Stanislav Vohanka
- University Hospital and Masaryk University Brno, Brno, Czech Republic
| | - Hanns Lochmüller
- Department of Neuropediatrics and Muscle Disorders, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Centro Nacional de Análisis Genómico (CNAG-CRG), Center for Genomic Regulation, Barcelona Institute of Science and Technology (BIST), Barcelona, Spain
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17
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Abstract
There are several benefits to clinical registries as an information repository tool, ultimately lending itself to the acquisition of new knowledge. Registries have the unique advantage of garnering much data quickly and are, therefore, especially helpful for niche populations or low-prevalence diseases. They can be used to inform on the ideal structure, process, or outcome involving an identified population. The data can be used in many ways, for example, as an observational tool to reveal associations or as a basis for framing future research studies or quality improvement projects.
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Arias Merino G, Sánchez Díaz G, Villaverde-Hueso A, Posada de la Paz M, Alonso Ferreira V. Mortality Statistics and their Contribution to Improving the Knowledge of Rare Diseases Epidemiology: The Example of Hereditary Ataxia in Europe. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1031:521-533. [PMID: 29214590 DOI: 10.1007/978-3-319-67144-4_28] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Official mortality statistics provide population-based data and serve to improve epidemiological knowledge of rare diseases (RDs), by helping with the description of the natural history of the disease. They are an important complement of registries and estimates of disease burden and costs. At the same time, they heighten both the visibility of these diseases and the interest in their study and the search for treatments that may increase survival. This chapter contains a European analysis of hereditary ataxia mortality, which considers the time trend in different countries and the geographical variability in risk of death. Despite the limitations of applying this data source to RDs, mortality statistics share criteria which facilitate international comparisons and are of great utility for obtaining sufficiently uniform and robust time series for analysis of low-prevalence diseases.
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Affiliation(s)
- Greta Arias Merino
- Instituto de Investigación de Enfermedades Raras (IIER), Instituto de Salud Carlos III, Madrid, Spain
| | - Germán Sánchez Díaz
- Instituto de Investigación de Enfermedades Raras (IIER), Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Villaverde-Hueso
- Instituto de Investigación de Enfermedades Raras (IIER), Instituto de Salud Carlos III, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
| | | | - Verónica Alonso Ferreira
- Instituto de Investigación de Enfermedades Raras (IIER), Instituto de Salud Carlos III, Madrid, Spain. .,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain.
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19
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Evans SM, Millar JL, Moore CM, Lewis JD, Huland H, Sampurno F, Connor SE, Villanti P, Litwin MS. Cohort profile: the TrueNTH Global Registry - an international registry to monitor and improve localised prostate cancer health outcomes. BMJ Open 2017; 7:e017006. [PMID: 29183925 PMCID: PMC5719323 DOI: 10.1136/bmjopen-2017-017006] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Globally, prostate cancer treatment and outcomes for men vary according to where they live, their race and the care they receive. The TrueNTH Global Registry project was established as an international registry monitoring care provided to men with localised prostate cancer (CaP). PARTICIPANTS Sites with existing CaP databases in Movember fundraising countries were invited to participate in the international registry. In total, 25 Local Data Centres (LDCs) representing 113 participating sites across 13 countries have nominated to contribute to the project. It will collect a dataset based on the International Consortium for Health Outcome Measures (ICHOM) standardised dataset for localised CaP. FINDINGS TO DATE A governance strategy has been developed to oversee registry operation, including transmission of reversibly anonymised data. LDCs are represented on the Project Steering Committee, reporting to an Executive Committee. A Project Coordination Centre and Data Coordination Centre (DCC) have been established. A project was undertaken to compare existing datasets, understand capacity at project commencement (baseline) to collect the ICHOM dataset and assist in determining the final data dictionary. 21/25 LDCs provided data dictionaries for review. Some ICHOM data fields were well collected (diagnosis, treatment start dates) and others poorly collected (complications, comorbidities). 17/94 (18%) ICHOM data fields were relegated to non-mandatory fields due to poor capture by most existing registries. Participating sites will transmit data through a web interface biannually to the DCC. FUTURE PLANS Recruitment to the TrueNTH Global Registry-PCOR project will commence in late 2017 with sites progressively contributing reversibly anonymised data following ethical review in local regions. Researchers will have capacity to source deidentified data after the establishment phase. Quality indicators are to be established through a modified Delphi approach in later 2017, and it is anticipated that reports on performance against quality indicators will be provided to LDCs.
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Affiliation(s)
- Sue M Evans
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jeremy L Millar
- William Buckland Radiotherapy Centre, Alfred Hospital, Melbourne, Victoria, Australia
| | - Caroline M Moore
- Department of Urology, Division of Surgical and Interventional Science, University College London, London, UK
| | - John D Lewis
- Department of Oncology, University of Alberta, Edmonton, Alberta, Canada
| | - Hartwig Huland
- Universitatsklinikum Hamburg-Eppendorf, Hamburg, Hamburg, Germany
| | - Fanny Sampurno
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sarah E Connor
- Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, USA
| | - Paul Villanti
- Movember Foundation, East Melbourne, Victoria, Australia
| | - Mark S Litwin
- Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, USA
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20
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Babac A, Litzkendorf S, Schmidt K, Pauer F, Damm K, Frank M, Graf von der Schulenburg JM. Shaping an Effective Health Information Website on Rare Diseases Using a Group Decision-Making Tool: Inclusion of the Perspectives of Patients, Their Family Members, and Physicians. Interact J Med Res 2017; 6:e23. [PMID: 29158209 PMCID: PMC5715203 DOI: 10.2196/ijmr.7352] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 06/22/2017] [Accepted: 09/14/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Despite diverging definitions on rare conditions, people suffering from rare diseases share similar difficulties. A lack of experience by health professionals, a long wait from first symptoms to diagnosis, scarce medical and scientific knowledge, and unsatisfactory treatment options all trigger the search for health information by patients, family members, and physicians. Examining and systematically integrating stakeholder needs can help design information platforms that effectively support this search. OBJECTIVE The aim of this study was to innovate on the group decision-making process involving patients, family members, and physicians for the establishment of a national rare disease Internet platform. We determined differences in the relevance of health information-especially examining quantifiable preference weights-between these subgroups and elucidated the structure and distribution of these differences in people suffering from rare diseases, their family members, and physicians, thus providing information crucial to their collaboration. METHODS The included items were identified using a systematic Internet research and verified through a qualitative interview study. The identified major information needs included medical issues, research, social help offers, and current events. These categories further comprised sublevels of diagnosis, therapy, general disease pattern, current studies, study results, registers, psychosocial counseling, self-help, and sociolegal advice. The analytic hierarchy process was selected as the group decision-making tool. A sensitivity analysis was used to determine the stability and distribution of results. t tests were utilized to examine the results' significance. RESULTS A total of 176 questionnaires were collected; we excluded some questionnaires in line with our chosen consistency level of 0.2. Ultimately, 120 patients, 24 family members, and 32 physicians participated in the study (48 men and 128 women, mean age=48 years, age range=17-87 years). Rankings and preference weights were highly heterogeneous. Global ranking positions of patients, family members, and physicians are shown in parentheses, as follows: medical issues (3/4, 4, 4), research (3/4, 2/3, 3), social help offers (1, 2/3, 2), and current events (2, 1, 1); diagnosis (6, 8, 9), therapy (5, 9, 7), general disease pattern (9, 4/5/6, 6), current studies (7, 4/5/6, 3), study results (8, 7, 8), registers (4, 1, 5), psychosocial counseling (1, 2, 4), self-help (3, 3, 2), and sociolegal advice (2, 4/5/6, 1). Differences were verified for patients for 5 information categories (P=.03), physicians for 6 information categories (P=.03), and family members for 4 information categories (P=.04). CONCLUSIONS Our results offer a clear-cut information structure that can transparently translate group decisions into practice. Furthermore, we found different preference structures for rare disease information among patients, family members, and physicians. Some websites already address differences in comprehension between those subgroups. Similar to pharmaceutical companies, health information providers on rare diseases should also acknowledge different information needs to improve the accessibility of information.
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Affiliation(s)
- Ana Babac
- Center for Health Economic Research Hannover, University Hannover, Hannover, Germany
| | - Svenja Litzkendorf
- Center for Health Economic Research Hannover, University Hannover, Hannover, Germany
| | - Katharina Schmidt
- Center for Health Economic Research Hannover, University Hannover, Hannover, Germany
| | - Frédéric Pauer
- Center for Quality and Management in Health Care, Medical Association of Lower Saxony, Hannover, Germany
| | - Kathrin Damm
- Center for Health Economic Research Hannover, University Hannover, Hannover, Germany
| | - Martin Frank
- Center for Quality and Management in Health Care, Medical Association of Lower Saxony, Hannover, Germany
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Mizuno A, Iguchi H, Sawada Y, Nomura H, Komiyama N, Watanabe S, Yoshikawa A. Real clinical management of patients with isolated superior mesenteric artery dissection in Japan. J Cardiol 2017; 71:155-158. [PMID: 28969970 DOI: 10.1016/j.jjcc.2017.08.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 07/28/2017] [Accepted: 08/22/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Due to the rarity of this condition, clinical treatment and outcomes in isolated superior mesenteric artery dissection (ISMAD) patients remain unknown. The primary aim of this retrospective multicenter study was to elucidate the treatment strategies and in-hospital outcomes for ISMAD patients by using administrative data. METHODS We retrospectively analyzed patients that were primarily diagnosed with ISMAD using the Diagnosis Procedure Combination data collected at 141 hospitals in Japan in 2015. Patients with comorbidities that included "aneurysm" were excluded. RESULTS A total of 221 ISMAD without aneurysm patients (male: 90.5%; mean age: 52.5±10.1 years) were enrolled, and 95 (67.4%) of these encountered just one ISMAD case per year. We found only one (0.5%) in-hospital death and length of stay for ISMAD patients was 13.2±9.1 days. One-third of patients received antiplatelet therapy (32.1%) and anticoagulation therapies, such as heparin (38.9%) and warfarin (10.0%). A total of 146 (66.1%) patients received antihypertensive treatment (either orally or via an intravenous route) during hospitalization. Twelve (5.4%) patients underwent surgical procedures during hospitalization as follows: 4 (33.3%) patients underwent bypass surgery, 3 (25.0%) patients underwent exploratory laparotomies, 2 (16.7%) patients underwent bowel resection, 1 (8.3%) patient underwent a thrombectomy, and 2 (16.7%) patients underwent surgical angioplasties. CONCLUSIONS We found that conservative therapy for ISMAD patients without aneurysm is safe and is also associated with a low rate of surgical intervention in clinical practice.
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Affiliation(s)
| | - Hayato Iguchi
- Global Health Consulting Japan Co. Ltd, Tokyo, Japan
| | - Yuuka Sawada
- Global Health Consulting Japan Co. Ltd, Tokyo, Japan
| | | | | | | | - Aki Yoshikawa
- Global Health Consulting Japan Co. Ltd, Tokyo, Japan
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Haver K. The time is right for an international primary ciliary dyskinesia disease registry. Eur Respir J 2017; 49:49/1/1602143. [PMID: 28052961 DOI: 10.1183/13993003.02143-2016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 11/08/2016] [Indexed: 01/15/2023]
Affiliation(s)
- Kenan Haver
- Harvard Medical School, Boston, MA, USA .,Division of Respiratory Diseases, Children's Hospital Boston, Boston, MA, USA
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Rubinstein YR, Posada de la Paz M, Mora M. Rare Disease Biospecimens and Patient Registries: Interoperability for Research Promotion, a European Example: EuroBioBank and SpainRDR-BioNER. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1031:141-147. [PMID: 29214569 DOI: 10.1007/978-3-319-67144-4_7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Well-annotated and properly preserved specimens are crucial both for diagnostic purposes and for use in basic and pre-clinical research, and are especially important for rare disease (RD) studies. Several consortia have been established in the recent years in order to facilitate research and to maximise access to rare biological samples and data stored in rare disease biobanks and registries, among them the EuroBioBank network and the Spain National Rare Disease Registry (RDR) and Biobank (BioNER).EuroBioBank, established in 2001, was the first network of RD biobanks to operate in Europe as a service distributing human DNA, cells, and tissue to the scientific community conducting research on rare diseases.The Spanish RDR and BioNER were created for facilitating rare disease research and health-related matters. The coordination of these two bodies represents an example of great scientific value as biological samples donated by patients at BioNER are linked to clinical information collected in the RDR.Rare disease biobanks and registries will need for the future to increase their effort to improve interconnection so to enable investigators to better locate samples and associated data, while protecting security of the data and privacy of the participants and adhering to international ethical and legal requirements.
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Affiliation(s)
- Yaffa R Rubinstein
- National Information Center of Health Services Research & Health Care Technology, National Library of Medicine/National Institute of Health, Bethesda, MD, 20892-1851, USA.
| | | | - Marina Mora
- Neuromuscular and Neuroimmunology Unit, C. Besta Neurological Institute, Milan, Italy
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Lim S, Tucker CS, Kumara S. An unsupervised machine learning model for discovering latent infectious diseases using social media data. J Biomed Inform 2016; 66:82-94. [PMID: 28034788 DOI: 10.1016/j.jbi.2016.12.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 12/03/2016] [Accepted: 12/14/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The authors of this work propose an unsupervised machine learning model that has the ability to identify real-world latent infectious diseases by mining social media data. In this study, a latent infectious disease is defined as a communicable disease that has not yet been formalized by national public health institutes and explicitly communicated to the general public. Most existing approaches to modeling infectious-disease-related knowledge discovery through social media networks are top-down approaches that are based on already known information, such as the names of diseases and their symptoms. In existing top-down approaches, necessary but unknown information, such as disease names and symptoms, is mostly unidentified in social media data until national public health institutes have formalized that disease. Most of the formalizing processes for latent infectious diseases are time consuming. Therefore, this study presents a bottom-up approach for latent infectious disease discovery in a given location without prior information, such as disease names and related symptoms. METHODS Social media messages with user and temporal information are extracted during the data preprocessing stage. An unsupervised sentiment analysis model is then presented. Users' expressions about symptoms, body parts, and pain locations are also identified from social media data. Then, symptom weighting vectors for each individual and time period are created, based on their sentiment and social media expressions. Finally, latent-infectious-disease-related information is retrieved from individuals' symptom weighting vectors. DATASETS AND RESULTS Twitter data from August 2012 to May 2013 are used to validate this study. Real electronic medical records for 104 individuals, who were diagnosed with influenza in the same period, are used to serve as ground truth validation. The results are promising, with the highest precision, recall, and F1 score values of 0.773, 0.680, and 0.724, respectively. CONCLUSION This work uses individuals' social media messages to identify latent infectious diseases, without prior information, quicker than when the disease(s) is formalized by national public health institutes. In particular, the unsupervised machine learning model using user, textual, and temporal information in social media data, along with sentiment analysis, identifies latent infectious diseases in a given location.
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Affiliation(s)
- Sunghoon Lim
- Department of Industrial and Manufacturing Engineering, The Pennsylvania State University, University Park, PA 16802, USA
| | - Conrad S Tucker
- School of Engineering Design, Technology, and Professional Programs, The Pennsylvania State University, University Park, PA 16802, USA; Department of Industrial and Manufacturing Engineering, The Pennsylvania State University, University Park, PA 16802, USA.
| | - Soundar Kumara
- Department of Industrial and Manufacturing Engineering, The Pennsylvania State University, University Park, PA 16802, USA
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Casamento K, Laverty A, Wilsher M, Twiss J, Gabbay E, Glaspole I, Jaffe A. Assessing the feasibility of a web-based registry for multiple orphan lung diseases: the Australasian Registry Network for Orphan Lung Disease (ARNOLD) experience. Orphanet J Rare Dis 2016; 11:42. [PMID: 27090393 PMCID: PMC4835874 DOI: 10.1186/s13023-016-0389-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 01/17/2016] [Indexed: 12/03/2022] Open
Abstract
Background We investigated the feasibility of using an online registry to provide prevalence data for multiple orphan lung diseases in Australia and New Zealand. Methods A web-based registry, The Australasian Registry Network of Orphan Lung Diseases (ARNOLD) was developed based on the existing British Paediatric Orphan Lung Disease Registry. All adult and paediatric respiratory physicians who were members of the Thoracic Society of Australia and New Zealand in Australia and New Zealand were sent regular emails between July 2009 and June 2014 requesting information on patients they had seen with any of 30 rare lung diseases. Prevalence rates were calculated using population statistics. Results Emails were sent to 649 Australian respiratory physicians and 65 in New Zealand. 231 (32.4 %) physicians responded to emails a total of 1554 times (average 7.6 responses per physician). Prevalence rates of 30 rare lung diseases are reported. Conclusions A multi-disease rare lung disease registry was implemented in the Australian and New Zealand health care settings that provided prevalence data on orphan lung diseases in this region but was limited by under reporting.
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Affiliation(s)
- K Casamento
- Sydney Children's Hospitals Network, Sydney, Australia.
| | - A Laverty
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, England
| | - M Wilsher
- Auckland District Health Board, Auckland, New Zealand
| | - J Twiss
- Starship Children's Health, Grafton, Auckland, New Zealand
| | - E Gabbay
- Institute for Health Research, University of Notre Dame, Fremantle, WA, Australia
| | - I Glaspole
- Alfred Hospital, Melbourne, Australia.,Monash University, Melbourne, Australia
| | - A Jaffe
- School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia.,Department of Respiratory Medicine, Sydney Children's Hospital Randwick, Sydney, NSW, Australia
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McCormack P, Kole A, Gainotti S, Mascalzoni D, Molster C, Lochmüller H, Woods S. 'You should at least ask'. The expectations, hopes and fears of rare disease patients on large-scale data and biomaterial sharing for genomics research. Eur J Hum Genet 2016; 24:1403-8. [PMID: 27049302 DOI: 10.1038/ejhg.2016.30] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 01/27/2016] [Accepted: 03/01/2016] [Indexed: 01/30/2023] Open
Abstract
Within the myriad articles about participants' opinions of genomics research, the views of a distinct group - people with a rare disease (RD) - are unknown. It is important to understand if their opinions differ from the general public by dint of having a rare disease and vulnerabilities inherent in this. Here we document RD patients' attitudes to participation in genomics research, particularly around large-scale, international data and biosample sharing. This work is unique in exploring the views of people with a range of rare disorders from many different countries. The authors work within an international, multidisciplinary consortium, RD-Connect, which has developed an integrated platform connecting databases, registries, biobanks and clinical bioinformatics for RD research. Focus groups were conducted with 52 RD patients from 16 countries. Using a scenario-based approach, participants were encouraged to raise topics relevant to their own experiences, rather than these being determined by the researcher. Issues include wide data sharing, and consent for new uses of historic samples and for children. Focus group members are positively disposed towards research and towards allowing data and biosamples to be shared internationally. Expressions of trust and attitudes to risk are often affected by the nature of the RD which they have experience of, as well as regulatory and cultural practices in their home country. Participants are concerned about data security and misuse. There is an acute recognition of the vulnerability inherent in having a RD and the possibility that open knowledge of this could lead to discrimination.
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Affiliation(s)
- Pauline McCormack
- PEALS Research Centre, Newcastle University, Newcastle upon Tyne, UK
| | | | | | - Deborah Mascalzoni
- Centre for Research Ethics & Bioethics, Uppsala University, Uppsala, Sweden
| | - Caron Molster
- Office of Population Health Genomics, Perth, Western Australia, Australia
| | - Hanns Lochmüller
- John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Simon Woods
- PEALS Research Centre, Newcastle University, Newcastle upon Tyne, UK
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Pai M, Iorio A, Meerpohl J, Taruscio D, Laricchiuta P, Mincarone P, Morciano C, Leo CG, Sabina S, Akl E, Treweek S, Djulbegovic B, Schunemann H. Developing methodology for the creation of clinical practice guidelines for rare diseases: A report from RARE-Bestpractices. Rare Dis 2015. [PMCID: PMC4590012 DOI: 10.1080/21675511.2015.1058463] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Rare diseases are a global public health priority; they can cause significant morbidity and mortality, can gravely affect quality of life, and can confer a social and economic burden on families and communities. These conditions are, by their nature, encountered very infrequently by clinicians. Thus, clinical practice guidelines are potentially very helpful in supporting clinical decisions, health policy and resource allocation. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system is a structured and transparent approach to developing and presenting summaries of evidence, grading its quality, and then transparently interpreting the available evidence to make recommendations in health care. GRADE has been adopted widely. However, its use in creating guidelines for rare diseases – which are often plagued by a paucity of high quality evidence – has not yet been explored. RARE-Bestpractices is a project to create and populate a platform for sharing best practices for management of rare diseases. A major aim of this project is to ensure that European Union countries have the capacity to produce high quality clinical practice guidelines for rare diseases. On February 12, 2013 at the Istituto Superiore di Sanità, in Rome, Italy, the RARE-Bestpractices group held the first of a series of 2 workshops to discuss methodology for creating clinical practice guidelines, and explore issues specific to rare diseases. This paper summarizes key results of the first workshop, and explores how the current GRADE approach might (or might not) work for rare diseases. Avenues for future research are also identified.
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Affiliation(s)
- Menaka Pai
- McMaster University; Hamilton, Canada
- Hamilton Regional Laboratory Medicine Program; Hamilton, Canada
| | | | | | - Domenica Taruscio
- National Center for Rare Diseases; Istituto Superiore di Sanità; Rome, Italy
| | - Paola Laricchiuta
- National Center for Rare Diseases; Istituto Superiore di Sanità; Rome, Italy
| | - Pierpaolo Mincarone
- National Research Council; Institute for Research on Population and Social Policies; Rome, Italy
| | - Cristina Morciano
- National Center for Rare Diseases; Istituto Superiore di Sanità; Rome, Italy
| | - Carlo Giacomo Leo
- National Research Council; Institute of Clinical Physiology; Lecce, Italy
- Tufts Medical Center; Boston, MA USA
| | | | - Elie Akl
- American University of Beirut; Beirut, Lebanon
| | | | | | - Holger Schunemann
- McMaster University; Hamilton, Canada
- Universitaetsklinikum; Freiburg, Germany
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Bertini E, Gospe SM. SSADH deficiency in an adult: Venturing outside of the diagnostic box and inside of the registry. Neurology 2015; 85:842-3. [PMID: 26268899 DOI: 10.1212/wnl.0000000000001916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Enrico Bertini
- From the Unit of Neuromuscular and Neurodegenerative Disorders (E.B.), Laboratory of Molecular Medicine, Bambino Gesu' Children's Research Hospital, Rome, Italy; and Departments of Neurology and Pediatrics (S.M.G.), University of Washington, and Division of Neurology, Seattle Children's Hospital, Seattle, WA
| | - Sidney M Gospe
- From the Unit of Neuromuscular and Neurodegenerative Disorders (E.B.), Laboratory of Molecular Medicine, Bambino Gesu' Children's Research Hospital, Rome, Italy; and Departments of Neurology and Pediatrics (S.M.G.), University of Washington, and Division of Neurology, Seattle Children's Hospital, Seattle, WA.
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Cavero-Carbonell C, Gras-Colomer E, Guaita-Calatrava R, López-Briones C, Amorós R, Abaitua I, Posada M, Zurriaga O. Consensus on the criteria needed for creating a rare-disease patient registry. A Delphi study. J Public Health (Oxf) 2015; 38:e178-86. [DOI: 10.1093/pubmed/fdv099] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cismondi IA, Kohan R, Adams H, Bond M, Brown R, Cooper JD, de Hidalgo PK, Holthaus SMK, Mole SE, Mugnaini J, de Ramirez AMO, Pesaola F, Rautenberg G, Platt FM, Noher de Halac I. Guidelines for incorporating scientific knowledge and practice on rare diseases into higher education: neuronal ceroid lipofuscinoses as a model disorder. Biochim Biophys Acta Mol Basis Dis 2015; 1852:2316-23. [PMID: 26117801 DOI: 10.1016/j.bbadis.2015.06.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 06/18/2015] [Accepted: 06/22/2015] [Indexed: 01/07/2023]
Abstract
This article addresses the educational issues associated with rare diseases (RD) and in particular the Neuronal Ceroid Lipofuscinoses (NCLs, or CLN diseases) in the curricula of Health Sciences and Professional's Training Programs. Our aim is to develop guidelines for improving scientific knowledge and practice in higher education and continuous learning programs. Rare diseases (RD) are collectively common in the general population with 1 in 17 people affected by a RD in their lifetime. Inherited defects in genes involved in metabolism are the commonest group of RD with over 8000 known inborn errors of metabolism. The majority of these diseases are neurodegenerative including the NCLs. Any professional training program on NCL must take into account the medical, social and economic burdens related to RDs. To address these challenges and find solutions to them it is necessary that individuals in the government and administrative authorities, academia, teaching hospitals and medical schools, the pharmaceutical industry, investment community and patient advocacy groups all work together to achieve these goals. The logistical issues of including RD lectures in university curricula and in continuing medical education should reflect its complex nature. To evaluate the state of education in the RD field, a summary should be periodically up dated in order to assess the progress achieved in each country that signed up to the international conventions addressing RD issues in society. It is anticipated that auditing current practice will lead to higher standards and provide a framework for those educators involved in establishing RD teaching programs world-wide.
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Affiliation(s)
- Inés Adriana Cismondi
- Centro de Estudio de las Metabolopatías Congénitas (CEMECO), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Ferroviarios 1250, 5014 Córdoba, Argentina; Facultad de Odontología, Universidad Nacional de Córdoba, Haya de la Torre s/n, 5000 Córdoba, Argentina.
| | - Romina Kohan
- Centro de Estudio de las Metabolopatías Congénitas (CEMECO), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Ferroviarios 1250, 5014 Córdoba, Argentina; Facultad de Odontología, Universidad Nacional de Córdoba, Haya de la Torre s/n, 5000 Córdoba, Argentina.
| | - Heather Adams
- Department of Neurology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
| | - Mike Bond
- MRC Laboratory for Molecular Cell Biology, University College London, Gower Street, London WC1E 6BT, UK.
| | - Rachel Brown
- MRC Laboratory for Molecular Cell Biology, University College London, Gower Street, London WC1E 6BT, UK.
| | - Jonathan D Cooper
- Department of Basic and Clinical Neuroscience, King's College London, Institute of Psychiatry, Psychology & Neuroscience, James Black Centre, 125 Coldharbour Lane, London SE5 9NU, UK.
| | - Perla K de Hidalgo
- Facultad de Odontología, Universidad Nacional de Córdoba, Haya de la Torre s/n, 5000 Córdoba, Argentina.
| | - Sophia-Martha Kleine Holthaus
- MRC Laboratory for Molecular Cell Biology, University College London, Gower Street, London WC1E 6BT, UK; Department of Genetics, UCL Institute of Ophthalmology, London EC1V 9EL, UK.
| | - Sara E Mole
- MRC Laboratory for Molecular Cell Biology, University College London, Gower Street, London WC1E 6BT, UK.
| | - Julia Mugnaini
- Centro de Estudio de las Metabolopatías Congénitas (CEMECO), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Ferroviarios 1250, 5014 Córdoba, Argentina.
| | - Ana María Oller de Ramirez
- Centro de Estudio de las Metabolopatías Congénitas (CEMECO), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Ferroviarios 1250, 5014 Córdoba, Argentina.
| | - Favio Pesaola
- Centro de Estudio de las Metabolopatías Congénitas (CEMECO), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Ferroviarios 1250, 5014 Córdoba, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Av. Rivadavia 1917, C1033AAJ CABA, Argentina.
| | - Gisela Rautenberg
- Centro de Estudio de las Metabolopatías Congénitas (CEMECO), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Ferroviarios 1250, 5014 Córdoba, Argentina.
| | - Frances M Platt
- Department of Pharmacology, University of Oxford, Mansfield Road, Oxford OX1 3QT, UK.
| | - Inés Noher de Halac
- Centro de Estudio de las Metabolopatías Congénitas (CEMECO), Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Ferroviarios 1250, 5014 Córdoba, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Av. Rivadavia 1917, C1033AAJ CABA, Argentina.
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Struik MHL, van Moorsel CHM, van Beek FT, Veltkamp M, McCormack FX, Grutters JC. The importance of biobank and nationwide registry for lymphangioleiomyomatosis in a small sized country. Expert Opin Orphan Drugs 2015. [DOI: 10.1517/21678707.2015.1022529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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NIH/NCATS/GRDR® Common Data Elements: A leading force for standardized data collection. Contemp Clin Trials 2015; 42:78-80. [PMID: 25797358 DOI: 10.1016/j.cct.2015.03.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 03/11/2015] [Accepted: 03/12/2015] [Indexed: 11/21/2022]
Abstract
The main goal of the NIH/NCATS GRDR® program is to serve as a central web-based global data repository to integrate de-identified patient clinical data from rare disease registries, and other data sources, in a standardized manner, to be available to researchers for conducting various biomedical studies, including clinical trials and to support analyses within and across diseases. The aim of the program is to advance research for many rare diseases. One of the first tasks toward achieving this goal was the development of a set of Common Data Elements (CDEs), which are controlled terminologies that represent collected data. A list of 75 CDEs was developed by a national committee and was validated and implemented during a period of 2 year proof of concept. Access to GRDR CDEs is freely available at: https://grdr.ncats.nih.gov/index.php?option=com_content&view=article&id=3&Itemid=5. The GRDR CDEs have been the cornerstone of the GRDR repository, as well as of several other national and international patient registries. The establishment of the GRDR program has elevated the issue of data standardization and interoperability for rare disease patient registries, to international attention, resulting in a global dialog and significant change in the mindset of registry developers, patient advocacy groups, and other national and international organizations.
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Zoni A, Domínguez Berjón M, Barceló E, Esteban Vasallo M, Abaitua I, Jiménez Villa J, Margolles Martins M, Navarro C, Posada M, Ramos Aceitero J, Vázquez Santos C, Zurriaga Llorens O, Astray Mochales J. Identifying data sources for a national population-based registry: the experience of the Spanish Rare Diseases Registry. Public Health 2015; 129:271-5. [DOI: 10.1016/j.puhe.2014.12.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Revised: 12/09/2014] [Accepted: 12/12/2014] [Indexed: 10/24/2022]
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Joly D, Béroud C, Grünfeld JP. Rare inherited disorders with renal involvement-approach to the patient. Kidney Int 2015; 87:901-8. [PMID: 25651365 DOI: 10.1038/ki.2014.432] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 08/14/2014] [Accepted: 08/21/2014] [Indexed: 12/18/2022]
Abstract
The list of rare inherited disorders with renal involvement is rapidly growing. Many are single gene diseases affecting children, but cases are not restricted to pediatrics and diagnosis is often difficult and delayed. The expanding use of next-generation sequencing techniques is expected to discover new diseases, to challenge the definition of rarity, to accelerate and shake up our diagnostic paradigms, to promote 'deep phenotyping', and ultimately improve disease ontology. Rare renal diseases are exemplary of a transition from pediatric to adult-type care and pluridisciplinary approach, necessitating cooperation between geneticists, nephropediatricians, adult nephrologists, other physicians, nurses, social workers, and dietitians. They have raised new ethical issues, not only in genetic counseling, but also in public health, regarding equity, and distribution of care. Patient's organizations have grown and have been very active to promote information and research. Efforts are underway to create interoperable patient's registries and ultimately worldwide networks gathering patients, researchers, clinicians, pharmaceutical industry, and health authorities. Progress in genetics and pathophysiological mechanisms will hopefully increase the number of efficient orphan medicinal products. Finally, new frontiers set by rare nephropathies may improve the understanding, treatments, and outcomes of more frequent renal diseases.
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Affiliation(s)
- Dominique Joly
- 1] Service de Néphrologie, Université Paris-Descartes, Hôpital Necker-Enfants Malades, AP-HP, Paris, France [2] INSERM U845, Hôpital Necker-Enfants Malades, Paris, France
| | - Christophe Béroud
- 1] Aix-Marseille Université, Marseille, France [2] Département de Génétique Médicale, Hôpital d'enfants Timone, AP-HM, Marseille, France
| | - Jean-Pierre Grünfeld
- Service de Néphrologie, Université Paris-Descartes, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
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Tan MH, Thomas M, MacEachern MP. Using registries to recruit subjects for clinical trials. Contemp Clin Trials 2014; 41:31-8. [PMID: 25545027 DOI: 10.1016/j.cct.2014.12.012] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 12/17/2014] [Accepted: 12/18/2014] [Indexed: 11/29/2022]
Abstract
AIM We studied the use of patient/disease registries to recruit potential subjects for prospective clinical trials - describing the number, types and major benefits of using this approach. METHODS In December 2013, we conducted a focused database search in PubMed, EMBASE, and Web of Science for studies (English language only) that used registries to recruit subjects for clinical trials published in 2004-2013. Of the 233 unique citations identified, 21 used registries to recruit subjects - 10 papers and 11 abstracts. Pearling and search for subsequent full papers of the abstracts identified 4 more papers. RESULTS Our analysis, based on these 25 citations, showed that 14 are related to cancer, 3 to diabetes mellitus, 1 each to stroke, asthma, and celiac disease and 5 are disease neutral. Many types of registries (population-based cancer, quality improvement, disease-specific, web-based disease-neutral registries, local general practice registers, and national health database) are used to recruit subjects for clinical trials and uncover new knowledge. Overall, 16 registries are in the US, 4 in UK, 1 each in Canada, Spain, and Australia and 1 involved in many countries. Registries can identify very large number of subjects for screening for eligibility for clinical trials, especially in very large trials, rare disease trials, and trials involving minority patients. CONCLUSIONS Registries can retrospectively identify very large numbers of potential subjects for screening for eligibility and enrollment in prospective clinical trials. This matching can lead to more timely recruitment and help solve a major problem in conducting clinical trials.
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Affiliation(s)
- Meng H Tan
- Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, MI, USA.
| | - Matthew Thomas
- College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Mark P MacEachern
- Taubman Health Sciences Library, University of Michigan, Ann Arbor, MI, USA
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Bellgard MI, Sleeman MW, Guerrero FD, Fletcher S, Baynam G, Goldblatt J, Rubinstein Y, Bell C, Groft S, Barrero R, Bittles AH, Wilton SD, Mason CE, Weeramanthri T. Rare Disease Research Roadmap: Navigating the bioinformatics and translational challenges for improved patient health outcomes. HEALTH POLICY AND TECHNOLOGY 2014. [DOI: 10.1016/j.hlpt.2014.08.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Soon SS, Lopes G, Lim HY, Wong-Rieger D, Bahri S, Hickinbotham L, Jha A, Ko BS, MacDonell D, Pwu JRF, Shih R, Sirachainan E, Suh DC, Wale J, Zhang X, Wee HL. A call for action to improve access to care and treatment for patients with rare diseases in the Asia-Pacific region. Orphanet J Rare Dis 2014; 9:137. [PMID: 25223275 PMCID: PMC4172816 DOI: 10.1186/s13023-014-0137-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Accepted: 08/21/2014] [Indexed: 12/02/2022] Open
Abstract
This article is a call for action to the relevant stakeholders to improve access to care and treatment for patients with rare diseases in the Asia-Pacific region by looking into three main areas: (a) developing legislative definitions to confer enforceable protection, (b) creating or strengthening policies by objectively measuring the impact brought about by rare diseases and establishing platforms to reach out to the rare disease community, and (c) fostering collaboration across sectors and countries. It is hoped that these suggested actions can catalyze discussions and progress in the region.
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Choquet R, Maaroufi M, de Carrara A, Messiaen C, Luigi E, Landais P. A methodology for a minimum data set for rare diseases to support national centers of excellence for healthcare and research. J Am Med Inform Assoc 2014; 22:76-85. [PMID: 25038198 DOI: 10.1136/amiajnl-2014-002794] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Although rare disease patients make up approximately 6-8% of all patients in Europe, it is often difficult to find the necessary expertise for diagnosis and care and the patient numbers needed for rare disease research. The second French National Plan for Rare Diseases highlighted the necessity for better care coordination and epidemiology for rare diseases. A clinical data standard for normalization and exchange of rare disease patient data was proposed. The original methodology used to build the French national minimum data set (F-MDS-RD) common to the 131 expert rare disease centers is presented. METHODS To encourage consensus at a national level for homogeneous data collection at the point of care for rare disease patients, we first identified four national expert groups. We reviewed the scientific literature for rare disease common data elements (CDEs) in order to build the first version of the F-MDS-RD. The French rare disease expert centers validated the data elements (DEs). The resulting F-MDS-RD was reviewed and approved by the National Plan Strategic Committee. It was then represented in an HL7 electronic format to maximize interoperability with electronic health records. RESULTS The F-MDS-RD is composed of 58 DEs in six categories: patient, family history, encounter, condition, medication, and questionnaire. It is HL7 compatible and can use various ontologies for diagnosis or sign encoding. The F-MDS-RD was aligned with other CDE initiatives for rare diseases, thus facilitating potential interconnections between rare disease registries. CONCLUSIONS The French F-MDS-RD was defined through national consensus. It can foster better care coordination and facilitate determining rare disease patients' eligibility for research studies, trials, or cohorts. Since other countries will need to develop their own standards for rare disease data collection, they might benefit from the methods presented here.
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Affiliation(s)
- Rémy Choquet
- BNDMR, Assistance Publique Hôpitaux de Paris, Hôpital Necker Enfants Malades, Paris, France INSERM, U1142, LIMICS, Paris, France
| | - Meriem Maaroufi
- BNDMR, Assistance Publique Hôpitaux de Paris, Hôpital Necker Enfants Malades, Paris, France INSERM, U1142, LIMICS, Paris, France
| | - Albane de Carrara
- BNDMR, Assistance Publique Hôpitaux de Paris, Hôpital Necker Enfants Malades, Paris, France
| | - Claude Messiaen
- BNDMR, Assistance Publique Hôpitaux de Paris, Hôpital Necker Enfants Malades, Paris, France
| | - Emmanuel Luigi
- Direction Générale de l'Offre de Soins, Ministère de la Santé et de la Solidarité, Paris, France
| | - Paul Landais
- BNDMR, Assistance Publique Hôpitaux de Paris, Hôpital Necker Enfants Malades, Paris, France Faculty of Medicine, EA2415, Clinical Research University Institute, Montpellier 1 University and BESPIM, Nîmes University Hospital, France
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Mazzucato M, Visonà Dalla Pozza L, Manea S, Minichiello C, Facchin P. A population-based registry as a source of health indicators for rare diseases: the ten-year experience of the Veneto Region's rare diseases registry. Orphanet J Rare Dis 2014; 9:37. [PMID: 24646171 PMCID: PMC4000007 DOI: 10.1186/1750-1172-9-37] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 03/06/2014] [Indexed: 12/01/2022] Open
Abstract
Background Although rare diseases have become a major public health issue, there is a paucity of population-based data on rare diseases. The aim of this epidemiological study was to provide descriptive figures referring to a sizable group of unrelated rare diseases. Methods Data from the rare diseases registry established in the Veneto Region of north-east Italy (population 4,900,000), referring to the years from 2002 to 2012, were analyzed. The registry is based on a web-based system accessed by different users. Cases are enrolled by two different sources: clinicians working at Centers of expertise officially designated to diagnose and care patients with rare diseases and health professionals working in the local health districts. Deaths of patients are monitored by Death Registry. Results So far, 19,547 patients with rare diseases have been registered, and 23% of them are pediatric cases. The overall raw prevalence of the rare diseases monitored in the population under study is 33.09 per 10,000 inhabitants (95% CI 32.56-33.62), whilst the overall incidence is 3.85 per 10,000 inhabitants (95% CI 3.67-4.03). The most commonly-recorded diagnoses belong to the following nosological groups: congenital malformations (Prevalence: 5.45/10,000), hematological diseases (4.83/10,000), ocular disorders (4.47/10,000), diseases of the nervous system (3.51/10,000), and metabolic disorders (2,95/10,000). Most of the deaths in the study population occur among pediatric patients with congenital malformations, and among adult cases with neurological diseases. Rare diseases of the central nervous system carry the highest fatality rate (71.36/1,000). Rare diseases explain 4.2% of general population Years of Life Lost (YLLs), comparing to 1.2% attributable to infectious diseases and 2.6% to diabetes mellitus. Conclusions Our estimates of the burden of rare diseases at population level confirm that these conditions are a relevant public health issue. Our snapshot of their epidemiology is important for public health planning purposes, going to show that population-based registries are useful tools for generating health indicators relating to a considerable number of rare diseases, rather than to specific conditions.
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Affiliation(s)
| | | | | | | | - Paola Facchin
- Rare Diseases Coordinating Center, Rare Diseases Registry, Veneto Region, Padua, Italy.
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Statland JM, Tawil R. Risk of functional impairment in Facioscapulohumeral muscular dystrophy. Muscle Nerve 2014; 49:520-7. [DOI: 10.1002/mus.23949] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 05/30/2013] [Accepted: 07/03/2013] [Indexed: 01/02/2023]
Affiliation(s)
- Jeffrey M. Statland
- Department of Neurology; University of Rochester Medical Center; 265 Crittenden Boulevard, CU 420669 Rochester New York 14642-0669 USA
| | - Rabi Tawil
- Department of Neurology; University of Rochester Medical Center; 265 Crittenden Boulevard, CU 420669 Rochester New York 14642-0669 USA
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Groft SC, Rubinstein YR. New and evolving rare diseases research programs at the National Institutes of Health. Public Health Genomics 2014; 16:259-67. [PMID: 24503586 DOI: 10.1159/000355929] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Research emphasis on rare diseases and orphan products remains a major focus of the research Institutes and Centers of National Institutes of Health (NIH). NIH provides more than USD 31 billion annually in biomedical research and research support. This research is the basis of many of the health advances in rare and common diseases. Numerous efforts and a major emphasis by the public and private sector initiatives have resulted in an increase of interventions and diagnostics for rare diseases. Newer translational research programs provide a more systematic and coordinated approach to rare diseases research and orphan products development. The approach that is offered requires extensive public-private partnerships with the pharmaceutical industry, contract research organizations, philanthropic foundations, medical and scientific advisory boards, patient advocacy groups, the academic research community, research and regulatory scientists, government funding agencies, and the public. Each program is unique and requires lengthy planning and collaborative efforts to reach programmatic goals.
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Affiliation(s)
- S C Groft
- Office of Rare Diseases Research, National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, Md., USA
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Baxter K, Horn E, Gal-Edd N, Zonno K, O'Leary J, Terry PF, Terry SF. An end to the myth: there is no drug development pipeline. Sci Transl Med 2014; 5:171cm1. [PMID: 23390245 DOI: 10.1126/scitranslmed.3003505] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
A new map is presented for creating an open, collaborative, and coordinated system for drug development.
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Siu J, Lim M, Fischer J, Dobbs B, Wakeman C, Ing A, Frizelle F. Ten-year review of gastrointestinal stromal tumours at a tertiary referral hospital in New Zealand. ANZ J Surg 2013; 86:162-6. [PMID: 24325620 DOI: 10.1111/ans.12429] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2013] [Indexed: 12/13/2022]
Abstract
BACKGROUND Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumours of the gastrointestinal tract and make up 1-2% of all gastrointestinal malignancies. Traditionally, the treatment of choice for primary disease is surgical resection; however, no single surgeon or institution gets extensive exposure to these patients so appropriate decision-making is difficult, particularly since the introduction of the tyrosine kinase inhibitor imatinib, which has become an important additional management tool. METHOD All patients were diagnosed and treated for GISTs in Christchurch Hospital (Christchurch, New Zealand) between 1 January 2000 and 31 December 2010. We maintain a prospective database of all patients with GISTs. Data on clinical and histopathological variables, management and survival outcomes were recorded. These were then reviewed. RESULTS There were 93 patients in this study. Fifty were women. Median age was 69 (interquartile range (IQR) 59-76) years. Fifty-one tumours were located in the stomach, 27 in the small bowel, six in the colon, three in the oesophagus, one in the rectum and five were extra-gastrointestinal. In total, 22 patients received imatinib therapy; four patients with metastatic disease had imatinib as sole therapy. The median follow-up was 58 (IQR 30-90) months. The 5-year overall survival and disease-free survival (DFS) for the entire study population was 69% and 64%, respectively. The 5-year DFS was higher for all patients who have localized disease when compared with those who have metastatic disease (76% versus 28%, P-value 0.001). CONCLUSION Surgery aiming at an R0 resection remains the mainstay of treatment. We propose the most effective way to grow the knowledge base in New Zealand is the establishment of a national register, thereby allowing better clinical decision-making by interpretation of a larger data set.
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Affiliation(s)
- Joey Siu
- Colorectal Unit, Department of Surgery, Christchurch Hospital, Christchurch, New Zealand
| | - Michael Lim
- Colorectal Unit, Department of Surgery, Christchurch Hospital, Christchurch, New Zealand
| | - Jesse Fischer
- Colorectal Unit, Department of Surgery, Christchurch Hospital, Christchurch, New Zealand
| | - Bruce Dobbs
- Colorectal Unit, Department of Surgery, Christchurch Hospital, Christchurch, New Zealand
| | - Chris Wakeman
- Colorectal Unit, Department of Surgery, Christchurch Hospital, Christchurch, New Zealand
| | - Andrew Ing
- Colorectal Unit, Department of Surgery, Christchurch Hospital, Christchurch, New Zealand
| | - Frank Frizelle
- Colorectal Unit, Department of Surgery, Christchurch Hospital, Christchurch, New Zealand
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Bellgard M, Beroud C, Parkinson K, Harris T, Ayme S, Baynam G, Weeramanthri T, Dawkins H, Hunter A. Dispelling myths about rare disease registry system development. SOURCE CODE FOR BIOLOGY AND MEDICINE 2013; 8:21. [PMID: 24131574 PMCID: PMC4015362 DOI: 10.1186/1751-0473-8-21] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 10/04/2013] [Indexed: 02/02/2023]
Abstract
Rare disease registries (RDRs) are an essential tool to improve knowledge and monitor interventions for rare diseases. If designed appropriately, patient and disease related information captured within them can become the cornerstone for effective diagnosis and new therapies. Surprisingly however, registries possess a diverse range of functionality, operate in different, often-times incompatible, software environments and serve various, and sometimes incongruous, purposes. Given the ambitious goals of the International Rare Diseases Research Consortium (IRDiRC) by 2020 and beyond, RDRs must be designed with the agility to evolve and efficiently interoperate in an ever changing rare disease landscape, as well as to cater for rapid changes in Information Communication Technologies. In this paper, we contend that RDR requirements will also evolve in response to a number of factors such as changing disease definitions and diagnostic criteria, the requirement to integrate patient/disease information from advances in either biotechnology and/or phenotypying approaches, as well as the need to adapt dynamically to security and privacy concerns. We dispel a number of myths in RDR development, outline key criteria for robust and sustainable RDR implementation and introduce the concept of a RDR Checklist to guide future RDR development.
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Affiliation(s)
- Matthew Bellgard
- Centre for Comparative Genomics, Murdoch University, Perth 6150, Western Australia.
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Groft SC. Rare diseases research: expanding collaborative translational research opportunities. Chest 2013; 144:16-23. [PMID: 23880676 DOI: 10.1378/chest.13-0606] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Extensive public-private partnerships, including the National Institutes of Health (NIH) and the rare diseases community, which is seeing a renewed industry interest in smaller niche markets, have resulted in an increase of interventions for rare diseases. Significant collaborative efforts are required among the pharmaceutical industry, foundations, patient-advocacy groups, academic and government investigators and funding programs, regulatory scientists, and reimbursement agencies to meet the unmet diagnostic and treatment needs for approximately 25 million people in the United States with 7,000 rare diseases. The expanding role and outreach activities of patient-advocacy groups have increased public awareness. In the United States, a rare disease is defined as a disorder or condition with a prevalence of <200,000 people. In 2011, the NIH provided >$3.5 billion for rare diseases research, including $750 million for orphan product development activities, nearly 11.4% of the NIH research budget. Several research institutes and centers of the NIH, including the National Center for Advancing Translational Sciences, have initiated varied translational research efforts to address the absence of preclinical and clinical data required for regulatory review purposes. Clinicians can expect to see significant increases in requests from patients and their families to participate in patient registries and natural history or observational studies to gather specific information from a larger pool of patients on the progression of the disease or response to treatments. An expanding emphasis on rare diseases provides hope for the millions of patients with rare diseases.
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Affiliation(s)
- Stephen C Groft
- Office of Rare Diseases Research, National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD.
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Scully MA, Cwik VA, Marshall BC, Ciafaloni E, Wolff JM, Getchius TS, Griggs RC. Can outcomes in Duchenne muscular dystrophy be improved by public reporting of data? Neurology 2013; 80:583-9. [PMID: 23382369 DOI: 10.1212/wnl.0b013e318282334e] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To review current approaches for obtaining patient data in Duchenne muscular dystrophy (DMD) and consider how monitoring and comparing outcome measures across DMD clinics could facilitate standardized and improved patient care. METHODS We reviewed annual standardized data from cystic fibrosis (CF) clinics and DMD care guidelines and consensus statements; compared current approaches to obtain DMD patient data and outcome measures; and considered the best method for implementing public reporting of outcomes, to drive improvements in health care delivery. RESULTS Current methods to monitor DMD patient information (MD STARnet, DuchenneConnect, and TREAT-NMD) do not yet provide patients with comparative outcome data. The CF patient registry allows for reporting of standard outcomes across clinics and is associated with improved CF outcomes. A similar patient registry is under development for the Muscular Dystrophy Association (MDA) clinic network. Suggested metrics for quality care include molecular diagnosis, ambulatory status and age at loss of ambulation, age requiring ventilator support, and survival. CONCLUSIONS CF longevity has increased by almost 33% from 1986 to 2010, in part due to a CF patient registry that has been stratified by individual care centers since 1999, and publically available since 2006. Implementation of outcome reporting for MDA clinics might promote a similar benefit to patients with DMD.
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Position statement of the World Heart Federation on the prevention and control of rheumatic heart disease. Nat Rev Cardiol 2013; 10:284-92. [DOI: 10.1038/nrcardio.2013.34] [Citation(s) in RCA: 172] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Nagel G, Unal H, Rosenbohm A, Ludolph AC, Rothenbacher D. Implementation of a population-based epidemiological rare disease registry: study protocol of the amyotrophic lateral sclerosis (ALS)--registry Swabia. BMC Neurol 2013; 13:22. [PMID: 23414001 PMCID: PMC3582473 DOI: 10.1186/1471-2377-13-22] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Accepted: 02/06/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The social and medical impact of rare diseases is increasingly recognized. Amyotrophic lateral sclerosis (ALS) is the most prevalent of the motor neuron diseases. It is characterized by rapidly progressive damage to the motor neurons with a survival of 2-5 years for the majority of patients. The objective of this work is to describe the study protocol and the implementation steps of the amyotrophic lateral sclerosis (ALS) registry Swabia, located in the South of Germany. METHODS/DESIGN The ALS registry Swabia started in October 2010 with both, the retrospective (01.10.2008-30.09.2010) and prospective (from 01.10.2010) collection of ALS cases, in a target population of 8.6 million persons in Southern Germany. In addition, a population based case-control study was implemented based on the registry that also included the collection of various biological materials.Retrospectively, 420 patients (222 men and 198 women) were identified. Prospectively data of ALS patients were collected, of which about 70% agreed to participate in the population-based case-control study. All participants in the case-control study provided also a blood sample. The prospective part of the study is ongoing. DISCUSSION The ALS registry Swabia has been implemented successfully. In rare diseases such as ALS, the collaboration of registries, the comparison with external samples and biorepositories will facilitate to identify risk factors and to further explore the potential underlying pathophysiological mechanisms.
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Affiliation(s)
- Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr, 22, Ulm 89081, Germany.
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Planté-Bordeneuve V, Suhr OB, Maurer MS, White B, Grogan DR, Coelho T. The Transthyretin Amyloidosis Outcomes Survey (THAOS) registry: design and methodology. Curr Med Res Opin 2013. [PMID: 23193943 DOI: 10.1185/03007995.2012.754349] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
UNLABELLED Abstract Background: Transthyretin (TTR) amyloidosis - the most common type of hereditary amyloidosis - also has an acquired form and is observed in geographically dispersed populations. TTR amyloidosis is marked by considerable clinical heterogeneity, and the main phenotypes are neurologic and cardiovascular. METHODS THAOS is an international, noninterventional, longitudinal, observational registry designed to evaluate overall survival in patients, better understand genotype-phenotype relationships and the natural history of TTR amyloidosis, and evaluate the effects of liver transplantation and other treatments on disease progression in TTR amyloidosis. All individuals with a confirmed TTR mutation with or without a diagnosis of TTR amyloidosis and patients with wild-type TTR amyloidosis are eligible to be enrolled in the registry. PURPOSE To describe the design and methodology of the recently established registry. Procedures for data collection are outlined and a minimum set of assessments for the standard evaluation of all subjects with TTR amyloidosis is described. Demographic information, TTR genotype, medical history, family history of the disease, and transplant history are assessed at baseline. On return visits, signs and symptoms of the disease are evaluated, general examinations are conducted, and laboratory data, measures of neurologic and cardiovascular function, and quality of life are assessed according to the standard of care for patients. Visits on at least a biannual basis are recommended. The registry will remain open for a period of at least 10 years. RESULTS The initial experience suggests that the registry is characterized by a comprehensive set of data elements which can be completed by providers from the various clinical backgrounds who administer care to individuals with TTR amyloidosis. CONCLUSION As of September 2011, 30 centers in 15 of the 19 countries participating in the THAOS registry have enrolled 975 patients. Such data provide a representative sample of the global TTR amyloidosis patient population, including asymptomatic TTR variant carriers, which can inform the natural history of the disease and offer the potential to evaluate novel therapeutic modalities in diverse patient subpopulations.
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