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Shin J, Epperson K, Yanjanin NM, Albus J, Borgenheimer L, Bott N, Brennan E, Castellanos D, Cheng M, Clark M, Devany M, Ensslin C, Farivari N, Fernando S, Gabriel L, Gallardo R, Castleman M, Gutierrez O, Herschel A, Hodge S, Horst A, Howard M, James E, Jones L, Kearns M, Kelly M, Kim C, Kiser K, Klazura G, Knoedler C, Kolbus E, Lange L, Lee J, Li E, Lu W, Luttrell A, Ly E, McKeough K, McSorley B, Miller C, Mitchell S, Moon A, Moser K, O'Brien S, Olivieri P, Patzwahl A, Pereira M, Pymento C, Ramelb E, Ramos B, Raya T, Riney S, Roberts G, Robertshaw M, Rudolf F, Rund S, Sansone S, Schwartz L, Shay R, Siu E, Spear T, Tan C, Truong M, Uddin M, VanTrieste J, Veloz O, White E, Porter FD, Haldar K. Defining natural history: assessment of the ability of college students to aid in characterizing clinical progression of Niemann-Pick disease, type C. PLoS One 2011; 6:e23666. [PMID: 21984891 PMCID: PMC3184943 DOI: 10.1371/journal.pone.0023666] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Accepted: 07/25/2011] [Indexed: 11/19/2022] Open
Abstract
Niemann-Pick Disease, type C (NPC) is a fatal, neurodegenerative, lysosomal storage disorder. It is a rare disease with broad phenotypic spectrum and variable age of onset. These issues make it difficult to develop a universally accepted clinical outcome measure to assess urgently needed therapies. To this end, clinical investigators have defined emerging, disease severity scales. The average time from initial symptom to diagnosis is approximately 4 years. Further, some patients may not travel to specialized clinical centers even after diagnosis. We were therefore interested in investigating whether appropriately trained, community-based assessment of patient records could assist in defining disease progression using clinical severity scores. In this study we evolved a secure, step wise process to show that pre-existing medical records may be correctly assessed by non-clinical practitioners trained to quantify disease progression. Sixty-four undergraduate students at the University of Notre Dame were expertly trained in clinical disease assessment and recognition of major and minor symptoms of NPC. Seven clinical records, randomly selected from a total of thirty seven used to establish a leading clinical severity scale, were correctly assessed to show expected characteristics of linear disease progression. Student assessment of two new records donated by NPC families to our study also revealed linear progression of disease, but both showed accelerated disease progression, relative to the current severity scale, especially at the later stages. Together, these data suggest that college students may be trained in assessment of patient records, and thus provide insight into the natural history of a disease.
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Affiliation(s)
- Jenny Shin
- Center for Rare and Neglected Diseases, University of Notre Dame, Notre Dame, Indiana, United States of America
| | - Katrina Epperson
- Center for Rare and Neglected Diseases, University of Notre Dame, Notre Dame, Indiana, United States of America
| | - Nicole M. Yanjanin
- Program in Developmental Endocrinology and Genetics, NICHD, National Institutes of Health, DHHS, Bethesda, Maryland, United States of America
| | - Jennifer Albus
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Laura Borgenheimer
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Natalie Bott
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Erin Brennan
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Daniel Castellanos
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Melissa Cheng
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Michael Clark
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Margaret Devany
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Courtney Ensslin
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Nina Farivari
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Shanik Fernando
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Lauren Gabriel
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Rani Gallardo
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Moriah Castleman
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Olimpia Gutierrez
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Allison Herschel
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Sarah Hodge
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Anne Horst
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Mary Howard
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Evan James
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Lindsey Jones
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Mary Kearns
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Mary Kelly
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Christine Kim
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Kinzie Kiser
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Gregory Klazura
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Chris Knoedler
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Emily Kolbus
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Lauren Lange
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Joan Lee
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Eileena Li
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Wei Lu
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Andrew Luttrell
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Emily Ly
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Katherine McKeough
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Brianna McSorley
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Catherine Miller
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Sean Mitchell
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Abbey Moon
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Kevin Moser
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Shane O'Brien
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Paula Olivieri
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Aaron Patzwahl
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Marie Pereira
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Craig Pymento
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Erin Ramelb
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Bryce Ramos
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Teresa Raya
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Stephen Riney
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Geoff Roberts
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Mark Robertshaw
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Frannie Rudolf
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Samuel Rund
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Stephanie Sansone
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Lindsay Schwartz
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Ryan Shay
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Edwin Siu
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Timothy Spear
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Catherine Tan
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Marisa Truong
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Mairaj Uddin
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Jennifer VanTrieste
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Omar Veloz
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Elizabeth White
- NPC Consortium for Community-Based Assessment of Patient Records, Cape Town, South Africa
| | - Forbes D. Porter
- Program in Developmental Endocrinology and Genetics, NICHD, National Institutes of Health, DHHS, Bethesda, Maryland, United States of America
| | - Kasturi Haldar
- Center for Rare and Neglected Diseases, University of Notre Dame, Notre Dame, Indiana, United States of America
- * E-mail:
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