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Coppola E, Sgrulletti M, Cortesi M, Romano R, Cirillo E, Giardino G, Dotta L, Cancrini C, Bruzzese D, Badolato R, Moschese V, Pignata C. The Inborn Errors of Immunity-Virtual Consultation System Platform in Service for the Italian Primary Immunodeficiency Network: Results from the Validation Phase. J Clin Immunol 2024; 44:47. [PMID: 38231401 PMCID: PMC10794402 DOI: 10.1007/s10875-023-01644-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 12/17/2023] [Indexed: 01/18/2024]
Abstract
PURPOSE Inborn errors of immunity (IEI) represent a heterogeneous group of rare genetically determined diseases. In some cases, patients present with complex or atypical phenotypes, not fulfilling the accepted diagnostic criteria for IEI and, thus, at high risk of misdiagnosis or diagnostic delay. This study aimed to validate a platform that, through the opinion of immunologist experts, improves the diagnostic process and the level of care of patients with atypical/complex IEI. METHODS Here, we describe the functioning of the IEI-Virtual Consultation System (VCS), an innovative platform created by the Italian Immunodeficiency Network (IPINet). RESULTS In the validation phase, from January 2020 to June 2021, 68 cases were entered on the IEI-VCS platform. A final diagnosis was achieved in 35/68 cases (51%, 95% CI 38.7 to 64.2). In 22 out of 35 solved cases, the diagnosis was confirmed by genetic analysis. In 3/35 cases, a diagnosis of secondary immunodeficiency was made. In the remaining 10 cases, an unequivocal clinical and immunological diagnosis was obtained, even though not substantiated by genetic analysis. CONCLUSION From our preliminary study, the VCS represents an innovative and useful system to improve the diagnostic process of patients with complex unsolved IEI disorders, with benefits both in terms of reduction of time of diagnosis and access to the required therapies. These results may help the functioning of other international platforms for the management of complex cases.
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Affiliation(s)
- Emma Coppola
- Section of Pediatrics, Department of Translational Medical Sciences, Federico II University, Via S. Pansini, 5-80131, Naples, Italy
| | - Mayla Sgrulletti
- Pediatric Immunopathology and Allergology Unit, Policlinico Tor Vergata, University of Tor Vergata, Rome, Italy
- PhD Program in Immunology, Molecular Medicine and Applied Biotechnology, University of Rome Tor Vergata, Rome, Italy
| | - Manuela Cortesi
- Pediatrics Clinic and Institute for Molecular Medicine A. Nocivelli, Department of Clinical and Experimental Sciences, ASST- Spedali Civili of Brescia, University of Brescia, Brescia, Italy
| | - Roberta Romano
- Section of Pediatrics, Department of Translational Medical Sciences, Federico II University, Via S. Pansini, 5-80131, Naples, Italy
| | - Emilia Cirillo
- Section of Pediatrics, Department of Translational Medical Sciences, Federico II University, Via S. Pansini, 5-80131, Naples, Italy
| | - Giuliana Giardino
- Section of Pediatrics, Department of Translational Medical Sciences, Federico II University, Via S. Pansini, 5-80131, Naples, Italy
| | - Laura Dotta
- Pediatrics Clinic and Institute for Molecular Medicine A. Nocivelli, Department of Clinical and Experimental Sciences, ASST- Spedali Civili of Brescia, University of Brescia, Brescia, Italy
| | - Caterina Cancrini
- Research Unit of Primary Immunodeficiency, IRCCS Bambin Gesù Children Hospital, Rome, Italy
| | - Dario Bruzzese
- Department of Public Health, Federico II University, Naples, Italy
| | - Raffaele Badolato
- Pediatrics Clinic and Institute for Molecular Medicine A. Nocivelli, Department of Clinical and Experimental Sciences, ASST- Spedali Civili of Brescia, University of Brescia, Brescia, Italy
| | - Viviana Moschese
- Pediatric Immunopathology and Allergology Unit, Policlinico Tor Vergata, University of Tor Vergata, Rome, Italy
| | - Claudio Pignata
- Section of Pediatrics, Department of Translational Medical Sciences, Federico II University, Via S. Pansini, 5-80131, Naples, Italy.
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Joneborg U, Bergamini A, Wallin E, Mangili G, Solheim O, Marquina G, Casado A, Rokkones E, Coulter J, Lok CAR, van Trommel N, Amant F, Bolze PA, Sehouli J, Han S, Kridelka F, Goffin F, Pautier P, Ray-Coquard I, Seckl M. European multidisciplinary tumor boards support cross-border networking and increase treatment options for patients with rare gynecological tumors. Int J Gynecol Cancer 2023; 33:1621-1626. [PMID: 37783481 PMCID: PMC10579460 DOI: 10.1136/ijgc-2023-004599] [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: 04/26/2023] [Accepted: 08/24/2023] [Indexed: 10/04/2023] Open
Abstract
OBJECTIVE To evaluate outcomes of European cross-border multidisciplinary tumor boards in terms of participation, adherence to treatment recommendations, and access to novel treatment strategies. METHODS The European reference network for rare gynecological tumors (EURACAN G2 domain) aims to improve the diagnosis, management, and treatment of patients with these cancers. Cross-border multidisciplinary tumor boards were initiated to facilitate intercollegiate clinical discussions across Europe and increase patients' access to specialist treatment recommendations and clinical trials. All G2 healthcare providers were invited to participate in monthly multidisciplinary meetings. Patient data were collected using a standardized form and case summaries were distributed before each meeting. After each tumor board, a meeting summary with treatment recommendations was sent to all participants and the project manager at the coordinating center. The multidisciplinary tumor board format and outcomes were regularly discussed at G2 domain meetings. Anonymized clinical data and treatment recommendations were registered in a prospective database. For this report, clinical data were collected between November 2017 and December 2020 and follow-up data retrieved until May 2021. RESULTS During the 3-year period, 31 multidisciplinary tumor boards were held with participants from 10 countries and 20 centers. 91 individual patients were discussed between one and six times for a total of 109 case discussions. Follow-up data were retrieved from 64 patients and 80 case discussions. Adherence to treatment recommendations was 99%. Multidisciplinary tumor board recommendations resulted in 11 patients getting access to off-label treatment and one patient being enrolled in a clinical trial in another European country. 14/91 patients were recommended for surveillance only when additional treatment had been considered locally. CONCLUSION Cross-border multidisciplinary tumor boards enable networking and clinical collaboration between healthcare professionals in different countries. Surveillance strategies, off-label drug use, and increased participation in clinical trials are possible benefits to patients with rare gynecological tumors.
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Affiliation(s)
- Ulrika Joneborg
- Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Alice Bergamini
- San Raffaele Hospital Department of Obstetrics and Gynaecology, Milano, Italy
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milano, Italy
| | - Emelie Wallin
- Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden
- Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Giorgia Mangili
- San Raffaele Hospital Department of Obstetrics and Gynaecology, Milano, Italy
| | - Olesya Solheim
- Department of Gynecological Oncology, Oslo University Hospital, Oslo, Norway
| | - Gloria Marquina
- Department of Medical Oncology, Hospital Clinico San Carlos, Madrid, Spain
- Department of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Antonio Casado
- Department of Medicine, Complutense University of Madrid, Madrid, Spain
- Department of Medical Oncology, Hospital Clínico San Carlos, Madrid, Spain
| | - Erik Rokkones
- Department of Gynecological Oncology, Oslo University Hospital, Oslo, Norway
| | - John Coulter
- Department of Gynaecological Oncology, Cork University Hospital, Cork, Ireland
| | - Christianne A R Lok
- Department of Gynecologic Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Nienke van Trommel
- Department of Gynecologic Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Frédéric Amant
- Division of Gynecologic Oncology, KU Leuven University Hospitals Leuven, Leuven, Belgium
- Division of Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Pierre-Adrien Bolze
- Hospices Civils de Lyon, Universite Lyon 1 Faculte de Medecine et de Maieutique Lyon-Sud Charles Merieux, Lyon, France
- Department of Gynecological and Oncological Surgery and Obstetrics, Hospital Lyon-South, Lyon, France
| | - Jalid Sehouli
- Department of Gynecology with Center of Oncological Surgery, Charite Medical Faculty Berlin, Berlin, Germany
| | - Sileny Han
- Division of Gynecologic Oncology, KU Leuven University Hospitals Leuven, Leuven, Belgium
| | - Frédéric Kridelka
- Department of Obstetrics & Gynecology, Division of Gynecologic Oncology, Central University Hospital of Liege, Liege, Belgium
| | - Frederic Goffin
- Department of Obstetrics and gynecology, Central University Hospital of Liege, Liege, Belgium
| | - Patricia Pautier
- Gustave Roussy Institute, Villejuif, France
- Paris-Saclay University, Villejuif, France
| | - Isabelle Ray-Coquard
- Centre Leon Berard, Lyon, France
- Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Michael Seckl
- Department of Medical Oncology, Imperial College London - Charing Cross Campus, London, UK
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Iotova V, Schalin-Jäntti C, Van Beuzekom C, Bruegmann P, Broesamle M, Hiort O, Pereira AM. An overview of the outreach of the 2019-2021 Endo-ERN knowledge generation webinars. Endocr Connect 2023; 12:e220512. [PMID: 37450855 PMCID: PMC10448595 DOI: 10.1530/ec-22-0512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 07/14/2023] [Indexed: 07/18/2023]
Abstract
The current study aims to assess the development of the knowledge generation program of the European Reference Network on Rare Endocrine Conditions (Endo-ERN) from its start in 2019 until December 2021, with special reference to webinars. We analyzed the number of webinars and live/postevent participants and whether participation and engagement of the attendees changed over time. A total of 30 (86%) self-prepared webinars comprising 300 h of knowledge and competence sharing were broadcasted (2019 - 3; 2020 - 13; 2021 - 14). A total of six webinars were broadcasted live prior to the coronavirus disease 2019 pandemic (https://endo-ern.eu/events/webinars/). The most active main thematic group (MTG) was MTG3 Genetic Disorders of Glucose and Insulin Homeostasis with eight (27%) webinars. Two (25%) MTGs fulfilled the goal to prepare at least two to three webinars per year. Patients were actively involved in 20% of the accounted webinars as both creators and presenters. The total number of live and postevent participants was 3023. The availability of the webinars after the live broadcast increased their outreach with a larger number of postevent viewers (n = 1629, 54%). Within the formal structured evaluation of the webinars, 40-85% of the participants replied on separate occasions and helped improve content. The free webinar access is among the perceived reasons for the rapidly increasing number of total hits to the Endo-ERN website. In conclusion, for its short existence, the Endo-ERN rapidly developed educational outreach, and further efforts to attract creators and learners are warranted.
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Affiliation(s)
- Violeta Iotova
- Department of Pediatrics, Medical University of Varna, Varna, Bulgaria
| | - Camilla Schalin-Jäntti
- Department of Endocrinology, Abdominal Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Charlotte Van Beuzekom
- Department of Endocrinology and Metabolism, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Petra Bruegmann
- Department of Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Manuela Broesamle
- Department of Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Olaf Hiort
- Department of Paediatric and Adolescent Medicine, Division of Paediatric Endocrinology and Diabetes, University of Lübeck, Lübeck, Germany
| | - Alberto M Pereira
- Department of Endocrinology and Metabolism, Amsterdam University Medical Center, Amsterdam, the Netherlands
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