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Carriero PL, Zangari R, Sfreddo E, Ghirardi A, Schieppati A, Barbui T, Biroli F. Exploring the Clinical and Genetic Landscape of Angelman Syndrome: Patient-Reported Insights from an Italian Registry. J Clin Med 2024; 13:3520. [PMID: 38930051 PMCID: PMC11204522 DOI: 10.3390/jcm13123520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/01/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
Background: The Angelman Syndrome Registry (RISA) was developed as a retrospective study with the following objectives: to evaluate the clinical history of individuals with Angelman Syndrome (AS) in Italy and compare it with the existing literature; to investigate the feasibility of gathering data by directly involving participants in the data collection process; and to explore the relationship between different symptoms and genotypes. Methods: Established in 2018, RISA enrolled a total of 82 participants, with 62 (75.6%) providing complete data. Demographic, clinical, and genetic information was collected using electronic case report forms. Descriptive statistics characterized the sample, while associations between genotype and clinical characteristics were examined. Results: Descriptive analysis revealed a median participant age of 8.0 years, with males comprising 48.8% of the sample. Deletion (58.1%) was the most common genotype. The majority (82.2%) experienced epilepsy, with seizures typically onset before 3 years of age. Most patients (86.2%) required multiple anti-epileptic drugs for control, with generalized tonic-clonic seizures and atypical absence seizures being most prevalent. The deletion group exhibited more severe developmental delays and a trend towards higher seizure severity. Sleep problems affected 69.4% of participants, characterized by difficulties in sleep onset and maintenance. Conclusions: This study offers valuable insights into the clinical history and genetic characteristics of AS in Italy, consistent with the prior literature. Additionally, it underscores the efficacy of patient registries in capturing comprehensive data on rare diseases such as AS, highlighting their potential to advance research and enhance patient care.
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Affiliation(s)
- Pier Luigi Carriero
- FROM Research Foundation ETS, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy; (P.L.C.); (R.Z.); (E.S.); (A.G.); (T.B.)
| | - Rosalia Zangari
- FROM Research Foundation ETS, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy; (P.L.C.); (R.Z.); (E.S.); (A.G.); (T.B.)
| | - Eleonora Sfreddo
- FROM Research Foundation ETS, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy; (P.L.C.); (R.Z.); (E.S.); (A.G.); (T.B.)
| | - Arianna Ghirardi
- FROM Research Foundation ETS, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy; (P.L.C.); (R.Z.); (E.S.); (A.G.); (T.B.)
| | - Arrigo Schieppati
- Clinical Research Centre for Rare Diseases “Aldo and Cele Daccò”, Mario Negri Institute for Pharmacological Research, 24020 Ranica, Italy;
| | - Tiziano Barbui
- FROM Research Foundation ETS, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy; (P.L.C.); (R.Z.); (E.S.); (A.G.); (T.B.)
| | - Francesco Biroli
- FROM Research Foundation ETS, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy; (P.L.C.); (R.Z.); (E.S.); (A.G.); (T.B.)
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Tarride JE, Okoh A, Aryal K, Prada C, Milinkovic D, Keepanasseril A, Iorio A. Scoping review of the recommendations and guidance for improving the quality of rare disease registries. Orphanet J Rare Dis 2024; 19:187. [PMID: 38711103 PMCID: PMC11075280 DOI: 10.1186/s13023-024-03193-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: 11/21/2023] [Accepted: 04/19/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Rare disease registries (RDRs) are valuable tools for improving clinical care and advancing research. However, they often vary qualitatively, structurally, and operationally in ways that can determine their potential utility as a source of evidence to support decision-making regarding the approval and funding of new treatments for rare diseases. OBJECTIVES The goal of this research project was to review the literature on rare disease registries and identify best practices to improve the quality of RDRs. METHODS In this scoping review, we searched MEDLINE and EMBASE as well as the websites of regulatory bodies and health technology assessment agencies from 2010 to April 2023 for literature offering guidance or recommendations to ensure, improve, or maintain quality RDRs. RESULTS The search yielded 1,175 unique references, of which 64 met the inclusion criteria. The characteristics of RDRs deemed to be relevant to their quality align with three main domains and several sub-domains considered to be best practices for quality RDRs: (1) governance (registry purpose and description; governance structure; stakeholder engagement; sustainability; ethics/legal/privacy; data governance; documentation; and training and support); (2) data (standardized disease classification; common data elements; data dictionary; data collection; data quality and assurance; and data analysis and reporting); and (3) information technology (IT) infrastructure (physical and virtual infrastructure; and software infrastructure guided by FAIR principles (Findability; Accessibility; Interoperability; and Reusability). CONCLUSIONS Although RDRs face numerous challenges due to their small and dispersed populations, RDRs can generate quality data to support healthcare decision-making through the use of standards and principles on strong governance, quality data practices, and IT infrastructure.
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Affiliation(s)
- J E Tarride
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada
- Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada
- Programs for the Assessment of Technologies in Health (PATH), The Research Institute of St. Joe's Hamilton, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - A Okoh
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - K Aryal
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - C Prada
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Deborah Milinkovic
- Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
| | - A Keepanasseril
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - A Iorio
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada
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Atalaia A, Wandrei D, Lalout N, Thompson R, Tassoni A, 't Hoen PAC, Athanasiou D, Baker SA, Sakellariou P, Paliouras G, D'Angelo C, Horvath R, Mancuso M, van der Beek N, Kornblum C, Kirschner J, Pareyson D, Bassez G, Blacas L, Jacoupy M, Eng C, Lamy F, Plançon JP, Haberlova J, Brusse E, Hoeijmakers JGJ, de Visser M, Claeys KG, Paradas C, Toscano A, Silani V, Gyenge M, Reviers E, Hamroun D, Vroom E, Wilkinson MD, Lochmuller H, Evangelista T. EURO-NMD registry: federated FAIR infrastructure, innovative technologies and concepts of a patient-centred registry for rare neuromuscular disorders. Orphanet J Rare Dis 2024; 19:66. [PMID: 38355534 PMCID: PMC10865673 DOI: 10.1186/s13023-024-03059-3] [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: 06/12/2023] [Accepted: 02/03/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND The EURO-NMD Registry collects data from all neuromuscular patients seen at EURO-NMD's expert centres. In-kind contributions from three patient organisations have ensured that the registry is patient-centred, meaningful, and impactful. The consenting process covers other uses, such as research, cohort finding and trial readiness. RESULTS The registry has three-layered datasets, with European Commission-mandated data elements (EU-CDEs), a set of cross-neuromuscular data elements (NMD-CDEs) and a dataset of disease-specific data elements that function modularly (DS-DEs). The registry captures clinical, neuromuscular imaging, neuromuscular histopathology, biological and genetic data and patient-reported outcomes in a computer-interpretable format using selected ontologies and classifications. The EURO-NMD registry is connected to the EURO-NMD Registry Hub through an interoperability layer. The Hub provides an entry point to other neuromuscular registries that follow the FAIR data stewardship principles and enable GDPR-compliant information exchange. Four national or disease-specific patient registries are interoperable with the EURO-NMD Registry, allowing for federated analysis across these different resources. CONCLUSIONS Collectively, the Registry Hub brings together data that are currently siloed and fragmented to improve healthcare and advance research for neuromuscular diseases.
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Affiliation(s)
- Antonio Atalaia
- Inserm Center of Research in Myology, Neuro-Myology Service G.H. Pitié-Salpêtrière, Sorbonne Université, Paris, France.
| | - Dagmar Wandrei
- Clinical Trials Unit, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Nawel Lalout
- Medical BioSciences Department, Radboud University Medical Center, Nijmegen, Netherlands
- Duchenne Parent Project, Veenendaal, The Netherlands
| | - Rachel Thompson
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Adrian Tassoni
- Clinical Trials Unit, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Peter A C 't Hoen
- Medical BioSciences Department, Radboud University Medical Center, Nijmegen, Netherlands
| | | | | | | | | | - Carla D'Angelo
- European Reference Network for Rare Neuromuscular Diseases EURO-NMD, Institute of Myology, University Hospital Pitie-Salpetriere-APHP, Paris, France
| | - Rita Horvath
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Michelangelo Mancuso
- Department of Clinical and Experimental Medicine, Neurological Institute, University of Pisa, Pisa, Italy
| | - Nadine van der Beek
- Department of Neurology/Center for Lysosomal and Metabolic Diseases, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Cornelia Kornblum
- Department of Neurology, Neuromuscular Diseases Section, University Hospital Bonn, Bonn, Germany
| | - Janbernd Kirschner
- Department of Neuropediatrics and Muscle Disorders, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Davide Pareyson
- Unit of Rare Neurological Diseases. Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Guillaume Bassez
- Neuromuscular Diseases Reference Center, Pitié-Salpêtrière University Hospital, APHP Paris, Paris, France
| | - Laura Blacas
- Association Institute of Myology, Hôpital Pitié-Salpêtrière, Paris, France
| | - Maxime Jacoupy
- Association Institute of Myology, Hôpital Pitié-Salpêtrière, Paris, France
| | - Catherine Eng
- Association Française Contre Les Myopathies, AFM-Téléthon, Evry, France
| | - François Lamy
- Association Française Contre Les Myopathies, AFM-Téléthon, Evry, France
| | - Jean-Philippe Plançon
- European Patient Organisation for Dysimmune and Inflammatory Neuropathies, Paris, France
| | - Jana Haberlova
- Neuromuscular Center, University Hospital Motol, Prague, Czech Republic
| | - Esther Brusse
- Department of Neurology/Center for Lysosomal and Metabolic Diseases, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Janneke G J Hoeijmakers
- Department of Neurology, Maastricht University Medical Center+, and MHeNS, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Marianne de Visser
- Department of Neurology, Amsterdam University Medical Center, Location Academic Medical Center, Amsterdam, The Netherlands
| | - Kristl G Claeys
- Department of Neurology, University Hospitals Leuven, and Laboratory for Muscle Diseases and Neuropathies, Department of Neurosciences, KU Leuven, and Leuven Brain Institute (LBI), Louvain, Belgium
| | - Carmen Paradas
- Hospital Universitario Virgen del Rocío/IBiS, Avda Manuel Siurot S/N, 41013, Seville, Andalucía, Spain
| | - Antonio Toscano
- Department of Clinical and Experimental Medicine, AOU G. Martino Di Messina, University of Messina, Messina, Italy
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Melinda Gyenge
- Neuromuscular Diseases Reference Center, Pitié-Salpêtrière University Hospital, APHP Paris, Paris, France
| | | | - Dalil Hamroun
- CHRU de Montpellier, Direction de la Recherche et de L'Innovation, Hôpital La Colombière, Montpellier, France
| | | | - Mark D Wilkinson
- Departamento de Biotecnología-Biología Vegetal, Escuela Técnica Superior de Ingeniería Agronómica, Alimentaria y de Biosistemas, Centro de Biotecnología y Genómica de Plantas UPM-INIA, Universidad Politécnica de Madrid (UPM), Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA/CSIC), 28223, Madrid, ES, Spain
| | - Hanns Lochmuller
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
- Department of Neuropediatrics and Muscle Disorders, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Teresinha Evangelista
- Neuromuscular Pathology Functional Unit; Neuropathology Service, Institute of Myology, University Hospital Pitié-Salpêtrière-APHP, Paris, France
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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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5
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Wilson AM, Lundgren KB, Schierman B, Mante A, Lien A, Benish SM, Esper GJ, Nair KV, Ney JP. Examining the National Representativeness of the Axon Registry: A Neurology-Specific Patient Registry. Neurology 2023; 101:e1167-e1177. [PMID: 37487753 PMCID: PMC10513878 DOI: 10.1212/wnl.0000000000207601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 05/15/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The objective of this study was to determine the external validity of the Axon Registry by comparing the 2019 calendar year data with 2 nationally representative, publicly available data sources, specifically the National Ambulatory Medical Care Survey (NAMCS) and the Medical Expenditure Panel Survey (MEPS). The Axon Registry is the American Academy of Neurology's neurology-focused qualified clinical data registry that reports and analyzes electronic health record data from participating US neurology providers. Its key function is to support quality improvement within ambulatory neurology practices while also promoting high-quality evidence-based care in clinical neurology. We compared demographics of patients who had an outpatient or office visit with a neurologist along with prevalence of selected neurologic conditions and neurologic procedures across the 3 data sets. METHODS We performed a cross-sectional, retrospective comparison of 3 data sets: NAMCS (2012-2016), MEPS (2013-2017, 2019), and Axon Registry (2019). We obtained patient demographics (age, birth sex, race, ethnicity), patient neurologic conditions (headache, epilepsy, cerebrovascular disease, multiple sclerosis, parkinsonism, dementia, spinal pain, and polyneuropathy), provider location, and neurologic procedures (neurology visits, MR/CT neuroimaging studies and EEG/EMG neurophysiologic studies). Parameter estimates from the pooled 5-year samples of the 2 public data sets, calculated at the visit level, were compared descriptively with those of the Axon Registry. We calculated Cohen h and performed Wald tests (α = 0.05) to conduct person-level statistical comparisons between MEPS 2019 and Axon Registry 2019 data. RESULTS The Axon Registry recorded 1.3 M annual neurology visits (NAMCS, 11 M; MEPS, 22 M) and 645 K people with neurologic conditions (MEPS, 10 M). Compared with the pooled national surveys, the Axon Registry has similar patient demographics, neurologic condition prevalence, neuroimaging and neurophysiologic utilization, and provider location. In direct comparison with MEPS 2019, the Axon Registry 2019 had fewer children (2% vs 7%), more elderly persons (21% vs 16%), fewer non-Black and non-White race persons (5% vs 8%), less number of patients with epilepsy (10% vs 13%), more patients with dementia (8% vs 6%), more patients with cerebrovascular disease (11% vs 8%), and a greater predominance of neurology providers in the Midwest (25% vs 20%). The only difference with a non-negligible effect size was the proportion of people younger than 15 years (Cohen h = 0.25). DISCUSSION The Axon Registry demonstrates high concordance with 2 nationally representative surveys. Recruiting more and diverse neurology providers will further improve the volume, representativeness, and value of the Axon Registry.
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Affiliation(s)
- Andrew M Wilson
- From the Department of Neurology (A.M.W.), University of California, Los Angeles; Department of Neurology (A.M.W.), Greater Los Angeles Healthcare System, Los Angeles, CA; American Academy of Neurology (K.B.L., B.S., A.M.), Minneapolis, MN; Verana Health (A.L.), San Francisco, CA; Department of Neurology (S.M.B.), University of Minnesota, Minneapolis; Department of Neurology (G.J.E.), Emory University, Atlanta, GA; Department of Neurology (K.V.N.), University of Colorado, Denver; and Department of Neurology (J.P.N.), Edith Nourse Rogers VA Medical Center, Bedford, MA.
| | - Karen B Lundgren
- From the Department of Neurology (A.M.W.), University of California, Los Angeles; Department of Neurology (A.M.W.), Greater Los Angeles Healthcare System, Los Angeles, CA; American Academy of Neurology (K.B.L., B.S., A.M.), Minneapolis, MN; Verana Health (A.L.), San Francisco, CA; Department of Neurology (S.M.B.), University of Minnesota, Minneapolis; Department of Neurology (G.J.E.), Emory University, Atlanta, GA; Department of Neurology (K.V.N.), University of Colorado, Denver; and Department of Neurology (J.P.N.), Edith Nourse Rogers VA Medical Center, Bedford, MA
| | - Becky Schierman
- From the Department of Neurology (A.M.W.), University of California, Los Angeles; Department of Neurology (A.M.W.), Greater Los Angeles Healthcare System, Los Angeles, CA; American Academy of Neurology (K.B.L., B.S., A.M.), Minneapolis, MN; Verana Health (A.L.), San Francisco, CA; Department of Neurology (S.M.B.), University of Minnesota, Minneapolis; Department of Neurology (G.J.E.), Emory University, Atlanta, GA; Department of Neurology (K.V.N.), University of Colorado, Denver; and Department of Neurology (J.P.N.), Edith Nourse Rogers VA Medical Center, Bedford, MA
| | - Aristotle Mante
- From the Department of Neurology (A.M.W.), University of California, Los Angeles; Department of Neurology (A.M.W.), Greater Los Angeles Healthcare System, Los Angeles, CA; American Academy of Neurology (K.B.L., B.S., A.M.), Minneapolis, MN; Verana Health (A.L.), San Francisco, CA; Department of Neurology (S.M.B.), University of Minnesota, Minneapolis; Department of Neurology (G.J.E.), Emory University, Atlanta, GA; Department of Neurology (K.V.N.), University of Colorado, Denver; and Department of Neurology (J.P.N.), Edith Nourse Rogers VA Medical Center, Bedford, MA
| | - Amanda Lien
- From the Department of Neurology (A.M.W.), University of California, Los Angeles; Department of Neurology (A.M.W.), Greater Los Angeles Healthcare System, Los Angeles, CA; American Academy of Neurology (K.B.L., B.S., A.M.), Minneapolis, MN; Verana Health (A.L.), San Francisco, CA; Department of Neurology (S.M.B.), University of Minnesota, Minneapolis; Department of Neurology (G.J.E.), Emory University, Atlanta, GA; Department of Neurology (K.V.N.), University of Colorado, Denver; and Department of Neurology (J.P.N.), Edith Nourse Rogers VA Medical Center, Bedford, MA
| | - Sarah M Benish
- From the Department of Neurology (A.M.W.), University of California, Los Angeles; Department of Neurology (A.M.W.), Greater Los Angeles Healthcare System, Los Angeles, CA; American Academy of Neurology (K.B.L., B.S., A.M.), Minneapolis, MN; Verana Health (A.L.), San Francisco, CA; Department of Neurology (S.M.B.), University of Minnesota, Minneapolis; Department of Neurology (G.J.E.), Emory University, Atlanta, GA; Department of Neurology (K.V.N.), University of Colorado, Denver; and Department of Neurology (J.P.N.), Edith Nourse Rogers VA Medical Center, Bedford, MA
| | - Gregory J Esper
- From the Department of Neurology (A.M.W.), University of California, Los Angeles; Department of Neurology (A.M.W.), Greater Los Angeles Healthcare System, Los Angeles, CA; American Academy of Neurology (K.B.L., B.S., A.M.), Minneapolis, MN; Verana Health (A.L.), San Francisco, CA; Department of Neurology (S.M.B.), University of Minnesota, Minneapolis; Department of Neurology (G.J.E.), Emory University, Atlanta, GA; Department of Neurology (K.V.N.), University of Colorado, Denver; and Department of Neurology (J.P.N.), Edith Nourse Rogers VA Medical Center, Bedford, MA
| | - Kavita V Nair
- From the Department of Neurology (A.M.W.), University of California, Los Angeles; Department of Neurology (A.M.W.), Greater Los Angeles Healthcare System, Los Angeles, CA; American Academy of Neurology (K.B.L., B.S., A.M.), Minneapolis, MN; Verana Health (A.L.), San Francisco, CA; Department of Neurology (S.M.B.), University of Minnesota, Minneapolis; Department of Neurology (G.J.E.), Emory University, Atlanta, GA; Department of Neurology (K.V.N.), University of Colorado, Denver; and Department of Neurology (J.P.N.), Edith Nourse Rogers VA Medical Center, Bedford, MA
| | - John P Ney
- From the Department of Neurology (A.M.W.), University of California, Los Angeles; Department of Neurology (A.M.W.), Greater Los Angeles Healthcare System, Los Angeles, CA; American Academy of Neurology (K.B.L., B.S., A.M.), Minneapolis, MN; Verana Health (A.L.), San Francisco, CA; Department of Neurology (S.M.B.), University of Minnesota, Minneapolis; Department of Neurology (G.J.E.), Emory University, Atlanta, GA; Department of Neurology (K.V.N.), University of Colorado, Denver; and Department of Neurology (J.P.N.), Edith Nourse Rogers VA Medical Center, Bedford, MA
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Solebo AL, Hysi P, Horvat-Gitsels LA, Rahi JS. Data saves lives: optimising routinely collected clinical data for rare disease research. Orphanet J Rare Dis 2023; 18:285. [PMID: 37697298 PMCID: PMC10496203 DOI: 10.1186/s13023-023-02912-1] [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: 12/14/2022] [Accepted: 09/06/2023] [Indexed: 09/13/2023] Open
Abstract
Necessity driven organisational change in the post-pandemic landscape has seen health care providers adopting innovations to manage and process health data. These include the use of 'real-world' datasets of routinely collected clinical information, enabling data-driven delivery. Rare disease risks being 'left-behind' unless our clinical and research communities engage with the challenges and opportunities afforded by the burgeoning field of health data informatics. We address the challenges to the meaningful use and reuse of rare disease data, and, through a series of recommendations around workforce education, harmonisation of taxonomy, and ensuring an inclusive health data environment, we highlight the role that those who manage rare disease must play in addressing them.
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Affiliation(s)
- Ameenat Lola Solebo
- Population, Policy and Practice Research and Teaching Department, Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK.
- Ulverscroft Vision Research Group, Great Ormond Street Institute of Child Health, University College London, London, UK.
- Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK.
| | - Pirro Hysi
- Population, Policy and Practice Research and Teaching Department, Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK
- Section of Ophthalmology, School of Life Course Sciences, King's College London, London, UK
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, UK
| | - Lisanne Andra Horvat-Gitsels
- Population, Policy and Practice Research and Teaching Department, Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK
- Ulverscroft Vision Research Group, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Jugnoo Sangeeta Rahi
- Population, Policy and Practice Research and Teaching Department, Great Ormond Street Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK
- Ulverscroft Vision Research Group, Great Ormond Street Institute of Child Health, University College London, London, UK
- Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
- Institute of Ophthalmology, University College London and NIHR Moorfields Biomedical Research Centre London, London, UK
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Bernardi FA, Mello de Oliveira B, Bettiol Yamada D, Artifon M, Schmidt AM, Machado Scheibe V, Alves D, Félix TM. The Minimum Data Set for Rare Diseases: Systematic Review. J Med Internet Res 2023; 25:e44641. [PMID: 37498666 PMCID: PMC10415943 DOI: 10.2196/44641] [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: 12/15/2022] [Revised: 04/24/2023] [Accepted: 06/27/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND The minimum data set (MDS) is a collection of data elements to be grouped using a standard approach to allow the use of data for clinical and research purposes. Health data are typically voluminous, complex, and sometimes too ambiguous to generate indicators that can provide knowledge and information on health. This complexity extends further to the rare disease (RD) domain. MDSs are essential for health surveillance as they help provide services and generate recommended population indicators. There is a bottleneck in international literature that reveals a global problem with data collection, recording, and structuring in RD. OBJECTIVE This study aimed to identify and analyze the MDSs used for RD in health care networks worldwide and compare them with World Health Organization (WHO) guidelines. METHODS The population, concept, and context methodology proposed by the Joanna Briggs Institute was used to define the research question of this systematic review. A total of 4 databases were reviewed, and all the processes were reported using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology. The data elements were analyzed, extracted, and organized into 10 categories according to WHO digital health guidelines. The quality assessment used the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist. RESULTS We included 20 studies in our review, 70% (n=14) of which focused on a specific health domain and 30% (n=6) of which referred to RD in general. WHO recommends that health systems and networks use standard terminology to exchange data, information, knowledge, and intelligence in health. However, there was a lack of terminological standardization of the concepts in MDSs. Moreover, the selected studies did not follow the same standard structure for classifying the data from their MDSs. All studies presented MDSs with limitations or restrictions because they covered only a specific RD, or their scope of application was restricted to a specific context or geographic region. Data science methods and clinical experience were used to design, structure, and recommend a fundamental global MDS for RD patient records in health care networks. CONCLUSIONS Our study highlights the difficulties in standardizing and categorizing findings from MDSs for RD because of the varying structures used in different studies. The fundamental RD MDS designed in this study comprehensively covers the data needs in the clinical and management sectors. These results can help public policy makers support other aspects of their policies. We highlight the potential of our results to help strategic decisions related to RD. TRIAL REGISTRATION PROSPERO CRD42021221593; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=221593. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1016/j.procs.2021.12.034.
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Affiliation(s)
- Filipe Andrade Bernardi
- Health Intelligence Laboratory, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirão Preto, Brazil
- Brazilian Rare Disease Network, Porto Alegre, Brazil
| | - Bibiana Mello de Oliveira
- Brazilian Rare Disease Network, Porto Alegre, Brazil
- Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
- Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Diego Bettiol Yamada
- Health Intelligence Laboratory, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirão Preto, Brazil
- Brazilian Rare Disease Network, Porto Alegre, Brazil
| | - Milena Artifon
- Brazilian Rare Disease Network, Porto Alegre, Brazil
- Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Amanda Maria Schmidt
- Brazilian Rare Disease Network, Porto Alegre, Brazil
- Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
| | - Victória Machado Scheibe
- Brazilian Rare Disease Network, Porto Alegre, Brazil
- Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
- Faculty of Medicine, Lutheran University of Brazil, Canoas, Brazil
| | - Domingos Alves
- Health Intelligence Laboratory, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirão Preto, Brazil
- Brazilian Rare Disease Network, Porto Alegre, Brazil
| | - Têmis Maria Félix
- Brazilian Rare Disease Network, Porto Alegre, Brazil
- Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
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8
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Abdul-Fatah A, Esmaeilisaraji L, Juan CM, Holcik M. Mitochondrial disease registries worldwide: A scoping review. PLoS One 2022; 17:e0276883. [PMID: 36301904 PMCID: PMC9612561 DOI: 10.1371/journal.pone.0276883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 10/13/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Mitochondrial diseases are a large group of genetically heterogeneous and clinically diverse disorders. Diagnosis often takes many years for which treatment may not exist. Registries are often used to conduct research, establish natural disease progression, engage the patient community, and develop best disease management practices. In Canada, there are limited centralized registries for mitochondrial disease patients, presenting a challenge for patients and professionals. OBJECTIVE To support the creation of such a registry, a systematic scoping review was conducted to map the landscape of mitochondrial disease patient registries worldwide, with a focus on registry design and challenges. Furthermore, it addresses a knowledge gap by providing a narrative synthesis of published literature that describes these registries. METHODS Arksey and O'Malley's methodological framework was followed to systematically search English-language literature in PubMed and CINAHL describing the designs of mitochondrial disease patient registries, supplemented by a grey literature search. Data were extracted in Microsoft Excel. Stakeholder consultations were also performed with patient caregivers, advocates, and researchers to provide perspectives beyond those found in the literature. These data were thematically analyzed and were reported in accordance with the PRISMA-ScR reporting guidelines. RESULTS A total of 17 articles were identified describing 13 unique registries located in North America, Europe, Australia, and West Asia. These papers described the registries' designs, their strengths, and weaknesses, as well as their tangible outcomes such as facilitating recruitment for research and supporting epidemiological studies. CONCLUSION Based on our findings in this review, recommendations were formulated. These include establishing registry objectives, respecting patients and their roles in the registry, adopting international data standards, data evaluations, and considerations to privacy legislation, among others. These recommendations could be used to support designing a future Canadian mitochondrial disease patient registry, and to further research directly engaging these registries worldwide.
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Affiliation(s)
| | | | - Crisel Mae Juan
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
| | - Martin Holcik
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
- * E-mail:
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9
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Mistry PK, Kishnani P, Wanner C, Dong D, Bender J, Batista JL, Foster J. Rare lysosomal disease registries: lessons learned over three decades of real-world evidence. Orphanet J Rare Dis 2022; 17:362. [PMID: 36244992 PMCID: PMC9573793 DOI: 10.1186/s13023-022-02517-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 09/04/2022] [Indexed: 12/24/2022] Open
Abstract
Lysosomal storage disorders (LSD) are rare diseases, caused by inherited deficiencies of lysosomal enzymes/transporters, that affect 1 in 7000 to 1 in 8000 newborns. Individuals with LSDs face long diagnostic journeys during which debilitating and life-threatening events can occur. Clinical trials and classical descriptions of LSDs typically focus on common manifestations, which are not representative of the vast phenotypic heterogeneity encountered in real-world experience. Additionally, recognizing that there was a limited understanding of the natural history, disease progression, and real-world clinical outcomes of rare LSDs, a collaborative partnership was pioneered 30 years ago to address these gaps. The Rare Disease Registries (RDR) (for Gaucher, Fabry, Mucopolysaccharidosis type I, and Pompe), represent the largest observational database for these LSDs. Over the past thirty years, data from the RDRs have helped to inform scientific understanding and the development of comprehensive monitoring and treatment guidelines by creating a framework for data collection and establishing a standard of care, with an overarching goal to improve the quality of life of affected patients. Here, we highlight the history, process, and impact of the RDRs, and discuss the lessons learned and future directions.
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Affiliation(s)
- P K Mistry
- Department of Medicine, Yale Liver Center, Yale University School of Medicine, 333 Cedar Street, PO Box 208019, New Haven, CT, 06520, USA.
| | - P Kishnani
- Division of Medical Genetics, Department of Pediatrics, Duke University, Durham, USA
| | - C Wanner
- University Hospital of Würzburg, Würzburg, Germany
| | - D Dong
- Global Operations and Advocacy Lead, Rare Disease Registries, Sanofi, Cambridge, MA, USA
| | - J Bender
- Head of Global Rare Disease Registries, Sanofi, Cambridge, MA, USA
| | - J L Batista
- Epidemiology/Biostatistics, Sanofi, Cambridge, MA, USA
| | - J Foster
- Data Management, Sanofi, Cambridge, MA, USA
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10
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Pasquini TLS, Mesfin M, Schmitt J, Raskin J. Global Registries in Congenital Hyperinsulinism. Front Endocrinol (Lausanne) 2022; 13:876903. [PMID: 35721728 PMCID: PMC9201947 DOI: 10.3389/fendo.2022.876903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/02/2022] [Indexed: 11/13/2022] Open
Abstract
Congenital hyperinsulinism (HI) is the most frequent cause of severe, persistent hypoglycemia in newborn babies and children. There are many areas of need for HI research. Some of the most critical needs include describing the natural history of the disease, research leading to new and better treatments, and identifying and managing hypoglycemia before it is prolonged and causes brain damage or death. Patient-reported data provides a basis for understanding the day-to-day experience of living with HI. Commonly identified goals of registries include performing natural history studies, establishing a network for future product and treatment studies, and supporting patients and families to offer more successful and coordinated care. Congenital Hyperinsulinism International (CHI) created the HI Global Registry (HIGR) in October 2018 as the first global patient-powered hyperinsulinism registry. The registry consists of thirteen surveys made up of questions about the patient's experience with HI over their lifetime. An international team of HI experts, including family members of children with HI, advocates, clinicians, and researchers, developed the survey questions. HIGR is managed by CHI and advised by internationally recognized HI patient advocates and experts. This paper aims to characterize HI through the experience of individuals who live with it. This paper includes descriptive statistics on the birthing experience, hospitalizations, medication management, feeding challenges, experiences with glucose monitoring devices, and the overall disease burden to provide insights into the current data in HIGR and demonstrate the potential areas of future research. As of January 2022, 344 respondents from 37 countries consented to participate in HIGR. Parents or guardians of individuals living with HI represented 83.9% of the respondents, 15.3% were individuals living with HI. Data from HIGR has already provided insight into access challenges, patients' and caregivers' quality of life, and to inform clinical trial research programs. Data is also available to researchers seeking to study the pathophysiology of HI retrospectively or to design prospective trials related to improving HI patient outcomes. Understanding the natural history of the disease can also guide standards of care. The data generated through HIGR provides an opportunity to improve the lives of all those affected by HI.
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11
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Javaid MK, Mordenti M, Boarini M, Sangiorgi L, Westerheim I, Alves I, Skarberg RT, Appelman-Dijkstra NM, Grasemann C. Patients' priorities and expectations on an EU registry for rare bone and mineral conditions. Orphanet J Rare Dis 2021; 16:463. [PMID: 34732217 PMCID: PMC8564998 DOI: 10.1186/s13023-021-02069-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 09/30/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Understanding the natural history of rare bone and mineral conditions is essential for improving clinical practice and the development of new diagnostics and therapeutics. Recruitment and long-term participation in registries are key challenges for researchers. METHODS To understand the user needs, the European Reference Network on Rare Bone Diseases (ERN BOND) and European Patient Advocacy Groups developed and implemented a multinational survey about the patient's preferred database content and functionality through an iterative consensus process. The survey was disseminated by national and international patient groups and healthcare professionals. The findings were analysed using descriptive statistics and multivariate regression. RESULTS There were 493 eligible responses from 378 adults, 15 children and 100 parents, guardians or carers (PGC) across 22 rare bone and mineral conditions. Osteogenesis imperfecta constituted 53.4% of responses. Contents related to improving treatment and medical services scored the highest and contents about anxiety and socializing scored less highly. Additional content was recommended by 205 respondents. Respondents preferred data entry by their Healthcare Provider (HCP). However, less than 50% of adults received followup from their specialist HCP at least annually and 29% were followed up as needed. CONCLUSIONS This survey of individuals, their family, guardians and carers has prioritised the key components for an EU-based rare bone and mineral condition research database. The survey highlights issues around collecting psychosocial impacts as well as measures of HCP trust. The survey demonstrated that using only specialist centre visits for data collection, while preferred by patients, will miss a substantial number of individuals, limiting generalisability. Combined HCP and patient platforms will be required to collect representative and complete natural history data for this patient group.
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Affiliation(s)
- Muhammad Kassim Javaid
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD, UK.
| | - Marina Mordenti
- Department of Rare Skeletal Disorders, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Manila Boarini
- Department of Rare Skeletal Disorders, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Luca Sangiorgi
- Department of Rare Skeletal Disorders, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | | | - Ingunn Westerheim
- Osteogenesis Imperfecta Federation Europe (OIFE), Eindhoven, The Netherlands
| | - Inês Alves
- Associação Nacional de Displasias Ósseas (ANDO), Evora, Portugal
| | | | - Natasha M Appelman-Dijkstra
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Centre, Leiden, Netherlands
| | - Corinna Grasemann
- Department of Pediatrics, Division of Rare Diseases, Ruhr-University Bochum, Bochum, Germany
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12
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Vucic S, Wray N, Henders A, Henderson RD, Talman P, Mathers S, Bellgard M, Aoun S, Birks C, Thomas G, Hansen C, Thomas G, Hogden A, Needham M, Schultz D, Soulis T, Sheean B, Milne J, Rowe D, Zoing M, Kiernan MC. MiNDAUS partnership: a roadmap for the cure and management of motor Neurone disease. Amyotroph Lateral Scler Frontotemporal Degener 2021; 23:321-328. [PMID: 34590512 DOI: 10.1080/21678421.2021.1980889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
An innovative approach to patient management, evidence-based policy development, and clinical drug trials is required to provide personalized care and to improve the likelihood of finding an effective treatment for Motor Neurone Disease (MND). The MiNDAus Partnership builds on and extends existing national collaborations in a targeted approach to improve the standard and coordination of care for people living with MND in Australia, and to enhance the prospects of discovering a cure or treatment. Relationships have been developed between leading clinical and research groups as well as patient-centered organizations, care providers, and philanthropy with a shared vision. MiNDAus has established a corporate structure and meets at least biannually to decide on how best to progress research, drug development, and patient management. The key themes are; (i) empowering patients and their family carers to engage in self-management and ensure personalized service provision, treatment, and policy development, (ii) integration of data collection so as to better inform policy development, (iii) unifying patients and carers with advocacy groups, funding bodies, clinicians and academic institutions so as to inform policy development and research, (iv) coordination of research efforts and development of standardized national infrastructure for conducting innovative clinical MND trials that can be harmonized within Australia and with international trials consortia. Such a collaborative approach is required across stakeholders in order to develop innovative management guidelines, underpinned by necessary and evidence-based policy change recommendations, which, will ensure the best patient care until a cure is discovered.
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Affiliation(s)
- Steve Vucic
- Brain and Nerve Research Center, Concord Clinical School, University of Sydney and Concord Hospital, Sydney, Australia
| | - Naomi Wray
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - Anjali Henders
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - Robert D Henderson
- Royal Brisbane and Women's Hospital, University of Queensland, Brisbane, Australia
| | - Paul Talman
- Deakin University, University Hospital Geelong, Geelong, Australia
| | - Susan Mathers
- Department of Neurology, Calvary Health Care Bethlehem Monash University, Melbourne, Australia
| | - Matthew Bellgard
- Office of eResearch, Queensland University of Technology, Brisbane, Australia
| | - Samar Aoun
- Perron Institute for Neurological and translational Science, Perth, Western Australia.,La Trobe University, Melbourne, Victoria
| | | | | | | | - Geoff Thomas
- Thomas MND Research Group, Adelaide, South Australia, Australia
| | - Anne Hogden
- Australian Institute of Health Service Management, University of Tasmania, Hobart, Tasmania, Australia
| | - Merrilee Needham
- Department of Neurology, Fiona Stanley Hospital, CMMIT Murdoch University and School of Medicine, University of Notre Dame, Western Australia, Perth, Australia
| | - David Schultz
- Department of Neurology, Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia, Australia
| | - Tina Soulis
- Neuroscience Trials Australia, Melbourne, Australia
| | | | - Jane Milne
- MND and Me Foundation, Brisbane, Queensland, Australia
| | - Dominic Rowe
- MCentre for Motor Neurone Disease Research, Faculty of Medicine, Human and Health Sciences, Macquarie University, Sydney, Australia
| | - Margie Zoing
- Brain and Mind Center, University of Sydney, University of Sydney, Sydney, Australia.,Department of Neurology, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Matthew C Kiernan
- Brain and Mind Center, University of Sydney, University of Sydney, Sydney, Australia.,Department of Neurology, Royal Prince Alfred Hospital, Camperdown, Australia
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13
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Sathe S, Ware J, Levey J, Neacy E, Blumenstein R, Noble S, Mühlbäck A, Rosser A, Landwehrmeyer GB, Sampaio C. Enroll-HD: An Integrated Clinical Research Platform and Worldwide Observational Study for Huntington's Disease. Front Neurol 2021; 12:667420. [PMID: 34484094 PMCID: PMC8416308 DOI: 10.3389/fneur.2021.667420] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 06/21/2021] [Indexed: 12/20/2022] Open
Abstract
Established in July 2012, Enroll-HD is both an integrated clinical research platform and a worldwide observational study designed to meet the clinical research requirements necessary to develop therapeutics for Huntington's disease (HD). The platform offers participants a low-burden entry into HD research, providing a large, well-characterized, research-engaged cohort with associated clinical data and biosamples that facilitates recruitment into interventional trials and other research studies. Additional studies that use Enroll-HD data and/or biosamples are built into the platform to further research on biomarkers and outcome measures. Enroll-HD is now operating worldwide in 21 countries at 159 clinical sites across four continents—Europe, North America, Latin America, and Australasia—and has recruited almost 25,000 participants, generating a large, rich clinical database with associated biosamples to expedite HD research; any researcher at a verifiable research organization can access the clinical datasets and biosamples from Enroll-HD and nested studies. Important operational features of Enroll-HD include a strong emphasis on standardization, data quality, and protecting participant identity, a single worldwide study protocol, a flexible EDC system capable of integrating multiple studies, a comprehensive monitoring infrastructure, an online portal to train and certify site personnel, and standardized study documents including informed consent forms and contractual agreements.
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Affiliation(s)
- Swati Sathe
- CHDI Management/CHDI Foundation, Princeton, NJ, United States
| | - Jen Ware
- CHDI Management/CHDI Foundation, Princeton, NJ, United States
| | - Jamie Levey
- CHDI Management/CHDI Foundation, Princeton, NJ, United States
| | - Eileen Neacy
- CHDI Management/CHDI Foundation, Princeton, NJ, United States
| | | | - Simon Noble
- CHDI Management/CHDI Foundation, Princeton, NJ, United States
| | | | - Anne Rosser
- Brain Repair Group, School of Biosciences, Cardiff University, Cardiff, United Kingdom.,Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, United Kingdom.,Brain Research and Intracranial Neurotherapeutics Unit, Cardiff University, Cardiff, United Kingdom
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14
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Nikles J, Onghena P, Vlaeyen JW, Wicksell RK, Simons LE, McGree JM, McDonald S. Establishment of an International Collaborative Network for N-of-1 Trials and Single-Case Designs. Contemp Clin Trials Commun 2021; 23:100826. [PMID: 34401597 PMCID: PMC8350373 DOI: 10.1016/j.conctc.2021.100826] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 06/15/2021] [Accepted: 07/26/2021] [Indexed: 11/24/2022] Open
Abstract
In this article we briefly examine the unique features of Single-Case Designs (SCDs) (studies in a single participant), their history and current trends, and real-world clinical applications. The International Collaborative Network for N-of-1 Trials and Single-Case Designs (ICN) is a formal collaborative network for individuals with an interest in SCDs. The ICN was established in 2017 to support the SCD scientific community and provide opportunities for collaboration, a global communication channel, resource sharing and knowledge exchange. In May 2021, there were more than 420 members in 31 countries. A member survey was undertaken in 2019 to identify priorities for the ICN for the following few years. This article outlines the key priorities identified and the ICN's progress to date in these key areas including network activities (developing a communications strategy to increase awareness, collecting/sharing a comprehensive set of resources, guidelines and tips, and incorporating the consumer perspective) and scientific activities (writing position papers and guest editing special journal issues, exploring key stakeholder perspectives about SCDs, and working to streamline ethical approval processes for SCDs). The ICN provides a practical means to engage with this methodology through membership. We encourage clinicians, researchers, industry, and healthcare consumers to learn more about and conduct SCDs, and to join us in our mission of using SCDs to improve health outcomes for individuals and populations.
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Affiliation(s)
- Jane Nikles
- Centre for Clinical Research, The University of Queensland, Australia
| | | | | | | | | | | | - Suzanne McDonald
- Centre for Clinical Research, The University of Queensland, Australia
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15
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Alves D, Yamada DB, Bernardi FA, Carvalho I, Filho MEC, Neiva MB, Lima VC, Félix TM. Mapping, Infrastructure, and Data Analysis for the Brazilian Network of Rare Diseases: Protocol for the RARASnet Observational Cohort Study. JMIR Res Protoc 2021; 10:e24826. [PMID: 33480849 PMCID: PMC7864771 DOI: 10.2196/24826] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/10/2020] [Accepted: 12/15/2020] [Indexed: 01/12/2023] Open
Abstract
Background A rare disease is a medical condition with low prevalence in the general population, but these can collectively affect up to 10% of the population. Thus, rare diseases have a significant impact on the health care system, and health professionals must be familiar with their diagnosis, management, and treatment. Objective This paper aims to provide health indicators regarding the rare diseases in Brazil and to create a network of reference centers with health professionals from different regions of the country. RARASnet proposes to map, analyze, and communicate all the data regarding the infrastructure of the centers and the patients’ progress or needs. The focus of the proposed study is to provide all the technical infrastructure and analysis, following the World Health Organization and the Brazilian Ministry of Health guidelines. Methods To build this digitized system, we will provide a security framework to assure the privacy and protection of each patient when collecting data. Systems development life cycle methodologies will also be applied to align software development, infrastructure operation, and quality assurance. After data collection of all information designed by the specialists, the computational analysis, modeling, and results will be communicated in scientific research papers and a digital health observatory. Results The project has several activities, and it is in an initial stage. Initially, a survey was given to all health care centers to understand the technical aspects of each network member, such as the existence of computers, technical support staff, and digitized systems. In this survey, we detected that 59% (23/39) of participating health units have electronic medical records, while 41% (16/39) have paper records. Therefore, we will have different strategies to access the data from each center in the data collection phase. Later, we will standardize and analyze the clinical and epidemiological data and use these data to develop a national network for monitoring rare diseases and a digital health observatory to make the information available. The project had its financing approved in December 2019. Retrospective data collection started in October 2020, and we expect to finish in January 2021. During the third quarter of 2020, we enrolled 40 health institutions from all regions of Brazil. Conclusions The nature of rare disease diagnosis is complex and diverse, and many problems will be faced in the evolution of the project. However, decisions based on data analysis are the best option for the improvement of the rare disease network in Brazil. The creation of RARASnet, along with all the digitized infrastructure, can improve the accessibility of information and standardization of rare diseases in the country. International Registered Report Identifier (IRRID) DERR1-10.2196/24826
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Affiliation(s)
- Domingos Alves
- Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Diego Bettiol Yamada
- Public Health Postgraduate Program, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Filipe Andrade Bernardi
- Bioengineering Postgraduate Program, School of Engineering, University of São Paulo, São Carlos, Brazil.,Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Isabelle Carvalho
- Institute of Mathematics and Computer Sciences, University of São Paulo, São Carlos, Brazil
| | - Márcio Eloi Colombo Filho
- Bioengineering Postgraduate Program, School of Engineering, University of São Paulo, São Carlos, Brazil
| | - Mariane Barros Neiva
- Institute of Mathematics and Computer Sciences, University of São Paulo, São Carlos, Brazil
| | - Vinícius Costa Lima
- Bioengineering Postgraduate Program, School of Engineering, University of São Paulo, São Carlos, Brazil.,Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Têmis Maria Félix
- Medical Genetics Service, Porto Alegre Clinical Hospital, Porto Alegre, Brazil
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Senarathne SGJ, Overstall AM, McGree JM. Bayesian adaptive N‐of‐1 trials for estimating population and individual treatment effects. Stat Med 2020; 39:4499-4518. [DOI: 10.1002/sim.8737] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 07/18/2020] [Accepted: 07/28/2020] [Indexed: 12/20/2022]
Affiliation(s)
| | - Antony M. Overstall
- Southampton Statistical Sciences Research Institute University of Southampton Southampton UK
| | - James M. McGree
- School of Mathematical Sciences Queensland University of Technology Brisbane Queensland Australia
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17
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Napier KR, Hooper AJ, Ng DM, Render L, Bell DA, Pang J, Watts GF, Bellgard MI, Burnett JR. Design, development and deployment of a web-based patient registry for rare genetic lipid disorders. Pathology 2020; 52:447-452. [PMID: 32276786 DOI: 10.1016/j.pathol.2020.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 02/04/2020] [Accepted: 02/07/2020] [Indexed: 10/24/2022]
Abstract
Rare genetic lipid disorders comprise all the monogenic disorders of lipoprotein metabolism with the exception of heterozygous familial hypercholesterolaemia (FH). The creation and maintenance of patient registries is critical for disease monitoring, improving clinical best practice, facilitating research and enabling the development of novel therapeutics, but very few disease-specific rare genetic lipid disorder registries currently exist. Our aim was to design, develop and deploy a web-based patient registry for rare genetic lipid disorders. The Rare Genetic Lipid Disorders Registry is based on the FH Australasia Network (FHAN) Registry, which has been operating since 2015. The Rare Genetic Lipid Disorders Registry was deployed utilising the open-source Rare Disease Registry Framework (RDRF), which enables the efficient customisation and sustainable deployment of web-based registries. The Registry has been designed to capture longitudinal data on 13 rare genetic lipid disorders, with the ability to add more if required in the future. Recruitment of volunteers into the Registry is currently through the Royal Perth Hospital Lipid Disorders Clinic in Western Australia. Although in essence a clinic-based patient registry, the web-based design allows for expansion and distribution across Australia and beyond. Data collated by the Registry may ultimately improve the diagnosis, management and treatment of these conditions.
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Affiliation(s)
- Kathryn R Napier
- Centre for Comparative Genomics, Murdoch University, Murdoch, WA, Australia
| | - Amanda J Hooper
- Department of Clinical Biochemistry, PathWest Laboratory Medicine WA, Royal Perth Hospital and Fiona Stanley Hospital Network, Perth, WA, Australia; School of Medicine, University of Western Australia, Nedlands, WA, Australia
| | - David M Ng
- School of Medicine, University of Western Australia, Nedlands, WA, Australia
| | - Lee Render
- Centre for Comparative Genomics, Murdoch University, Murdoch, WA, Australia
| | - Damon A Bell
- Department of Clinical Biochemistry, PathWest Laboratory Medicine WA, Royal Perth Hospital and Fiona Stanley Hospital Network, Perth, WA, Australia; School of Medicine, University of Western Australia, Nedlands, WA, Australia; Lipid Disorders Clinic, Cardiometabolic Service, Royal Perth Hospital, Perth, WA, Australia
| | - Jing Pang
- School of Medicine, University of Western Australia, Nedlands, WA, Australia
| | - Gerald F Watts
- School of Medicine, University of Western Australia, Nedlands, WA, Australia; Lipid Disorders Clinic, Cardiometabolic Service, Royal Perth Hospital, Perth, WA, Australia
| | - Matthew I Bellgard
- eResearch Office, Queensland University of Technology, Brisbane, Qld, Australia
| | - John R Burnett
- Department of Clinical Biochemistry, PathWest Laboratory Medicine WA, Royal Perth Hospital and Fiona Stanley Hospital Network, Perth, WA, Australia; School of Medicine, University of Western Australia, Nedlands, WA, Australia.
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