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Spivack O, Gaillard L. ERN CRANIO patient coverage of craniosynostosis in Europe. Orphanet J Rare Dis 2022; 17:333. [PMID: 36056364 PMCID: PMC9438281 DOI: 10.1186/s13023-022-02475-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 08/13/2022] [Indexed: 11/10/2022] Open
Abstract
Background Against the backdrop of the European Directive on patients’ rights in cross-border healthcare, 24 European Reference Networks (ERNs) were launched in 2017. ERNs are networks of specialised hospitals working together to support patients with rare and/or complex diseases. ERN CRANIO is the ERN for craniofacial anomalies and ear, nose and throat disorders. The aim of this study was to explore ERN CRANIO’s patient coverage of craniosynostosis. Methods ERN CRANIO members and applicants were asked to retrospectively report the number of ‘new craniosynostosis patients’ (isolated and syndromic) seen in 2017. The number of live births per country in 2017 was retrieved from EUROSTAT, the EU’s statistical office. The number of new patients reported per country and the number of live births were used to generate country-specific prevalence figures per 10,000 live births. These figures were compared to expected prevalence ranges for craniosynostosis, and syndromic craniosynostosis specifically, defined by recent European studies. The percentage of syndromic craniosynostosis cases per country was also compared to the expected percentage range. Results Based on previous studies, the expected prevalence ranges for craniosynostosis and syndromic craniosynostosis specifically were respectively defined as 4.4–7.2 and 0.9–1.6 patients/10,000 live births. For craniosynostosis (‘total’; isolated + syndromic), 'new patient' data from the UK and Finland generated prevalence figures within the expected range, and those in France, Spain, Italy, Portugal and Germany are lower than expected. However, when including applicant data, the prevalence figures for France, Spain and Italy become in range. Data from the Netherlands and Sweden generated higher prevalence figures than expected. For France, Finland, Italy and Sweden, there is inconsistency between patient coverage of ‘total’ and syndromic patients. For France, Germany, Finland and Italy, the percentage of syndromic craniosynostosis was lower than the expected range. Conclusion ERN CRANIO’s coverage of craniosynostosis varies across Europe. Results may be explained by data collection methods, genetic testing policies and/or national healthcare systems. With centre caseload a driving force for quality, additional ERN membership calls may not necessarily ensure sufficient patient coverage for countries with decentralised healthcare systems. Liaison with national health ministries should be encouraged to optimise patient coverage.
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Affiliation(s)
- O Spivack
- Department of Plastic, Reconstructive and Hand Surgery, Room Ee 1591b, Dutch Craniofacial Centre, Erasmus MC - Sophia Children's Hospital, University Medical Centre, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
| | - L Gaillard
- Department of Plastic, Reconstructive and Hand Surgery, Room Ee 1591b, Dutch Craniofacial Centre, Erasmus MC - Sophia Children's Hospital, University Medical Centre, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
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Cañete A, Peris-Bonet R, Capocaccia R, Pardo-Romaguera E, Segura V, Muñoz-López A, Fernández-Teijeiro A, Galceran-Padros J, Gatta G. Neuroblastoma in Spain: Linking the national clinical database and epidemiological registries - A study by the Joint Action on Rare Cancers. Cancer Epidemiol 2022; 78:102145. [PMID: 35344745 DOI: 10.1016/j.canep.2022.102145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 02/08/2022] [Accepted: 03/11/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE Linkage between clinical databases and population-based cancer registries may serve to evaluate European Reference Networks' (ERNs) activity, by monitoring the proportion of patients benefiting from these and their impact on survival at a population level. To test this, a study targeting neuroblastoma (Nb) was conducted in Spain by the European Joint Action on Rare Cancers. MATERIAL AND METHODS Subjects: Nb cases, incident 1999-2017, aged < 15 years. Linkage included: Spanish Neuroblastoma Clinical Database (NbCDB) (1217 cases); Spanish Registry of Childhood Tumours (RETI) (1514 cases); and 10 regional population-based registries (RPBCRs) which cover 33% of the childhood population (332 cases). Linkage was semiautomatic. We estimated completeness, incidence, contribution, deficit, and 5-year survival in the databases and specific subsets. RESULTS National completeness estimates for RETI and NbCDB were 91% and 72% respectively, using the Spanish RPBCRs on International Incidence of Childhood Cancer (https://iicc.iarc.fr/) as reference. RPBCRs' specific contribution was 1.6%. Linkage required manual crossover in 54% of the semiautomatic matches. Five-year survival was 74% (0-14 years) and 90% (0-18 months). CONCLUSIONS All three databases were incomplete as regards Spain as a whole and should therefore be combined to achieve full childhood cancer registration. A unique personal patient identifier could facilitate such linkage. Most children have access to Nb clinical trials. Consolidated interconnections between the national registry and clinical registries (including ERNs and paediatric oncology clinical groups) should be established to evaluate outcomes.
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Affiliation(s)
- Adela Cañete
- Spanish Registry of Childhood Tumours (RETI-SEHOP), University of Valencia, Valencia, Spain; Paediatric Oncohematology Unit, Hospital La Fe; and Department of Paediatrics, University of Valencia, Valencia, Spain.
| | - Rafael Peris-Bonet
- Spanish Registry of Childhood Tumours (RETI-SEHOP), University of Valencia, Valencia, Spain
| | | | - Elena Pardo-Romaguera
- Spanish Registry of Childhood Tumours (RETI-SEHOP), University of Valencia, Valencia, Spain
| | - Vanessa Segura
- Clinical Translational Cancer Research Group - Paediatric Oncology, IIS La Fe, Valencia, Spain
| | - Ana Muñoz-López
- Spanish Registry of Childhood Tumours (RETI-SEHOP), University of Valencia, Valencia, Spain
| | - Ana Fernández-Teijeiro
- Spanish Society of Paediatric Haematology and Oncology (SEHOP), Spain; Paediatric Oncohematology Unit, Hospital Universitario Virgen Macarena, University of Sevilla, Sevilla, Spain
| | | | - Gemma Gatta
- Department of Epidemiological Research and Molecular Medicine, Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy
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Oomen L, Leijte E, Shilhan DE, Battye M, Members Of Ern eUROGEN, Feitz WFJ. Rare and Complex Urology: Clinical Overview of ERN eUROGEN. Eur Urol 2021; 81:204-212. [PMID: 33743996 DOI: 10.1016/j.eururo.2021.02.043] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 02/26/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND In 2017, the European Commission launched 24 European Reference Networks (ERNs). ERN eUROGEN is the network for urorectogenital diseases and complex conditions, and started with 29 full member healthcare providers (HCPs) in 11 countries. It then covered 19 different disease areas distributed over three workstreams (WSs). OBJECTIVE To provide an overview and identify challenges in data collection at European level of the ERN eUROGEN patient population treated by HCPs in the network. DESIGN, SETTING, AND PARTICIPANTS A retrospective cohort study was conducted of the 29 HCPs who were full members between 2013 and 2019. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Data were extracted from the original HCP applications and the ERN continuous monitoring system. Patient volumes, new patient numbers, and procedures were compared between different WSs, countries, and HCPs. Discrepancies between monitoring and application data were identified. RESULTS AND LIMITATIONS Between 2013 and 2019, 122 040 patients required long-term care within the 29 HCPs. The volume of patients treated and procedures undertaken per year increased over time. Large discrepancies were found between patient numbers contained in the application forms and those reported in the continuous monitoring system (0-1357% deviation). CONCLUSIONS Patient numbers and procedures increased across ERN eUROGEN HCPs. Reliable data extraction appeared challenging, illustrated by the patient volume discrepancies between application forms and the continuous monitoring data. Improved disease definitions, re-evaluation of affiliated HCPs, and valid data extraction are needed for future improvements. PATIENT SUMMARY We analysed the patient population with rare urorectogenital diseases or complex conditions within the ERN eUROGEN network between 2013 and 2019. Clinical activity was found to increase, but differences in patient numbers were evident between healthcare providers. In order to acquire valid patient numbers, both improved definitions of diagnostic codes and greater insight into the data-gathering process are required.
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Affiliation(s)
- Loes Oomen
- Department of Urology, Division of Paediatric Urology, Radboudumc Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Erik Leijte
- Department of Urology, Division of Paediatric Urology, Radboudumc Amalia Children's Hospital, Nijmegen, The Netherlands
| | | | | | | | - Wout F J Feitz
- Department of Urology, Division of Paediatric Urology, Radboudumc Amalia Children's Hospital, Nijmegen, The Netherlands.
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Khonsari RH, Paternoster G. International Society of Craniofacial Surgery, XVIIIth biennal meeting in Paris: A report. J Stomatol Oral Maxillofac Surg 2019; 121:102-104. [PMID: 31672682 DOI: 10.1016/j.jormas.2019.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 10/17/2019] [Indexed: 10/25/2022]
Affiliation(s)
- R H Khonsari
- Unité fonctionnelle de chirurgie craniofaciale, Service de neurochirurgie pédiatrique, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Centre de Référence Maladies Rares CRANIOST, Filière Maladies Rares TETECOU, Université Paris - Descartes, Université de Paris, Paris, France
| | - G Paternoster
- Unité fonctionnelle de chirurgie craniofaciale, Service de neurochirurgie pédiatrique, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Centre de Référence Maladies Rares CRANIOST, Filière Maladies Rares TETECOU, Université Paris - Descartes, Université de Paris, Paris, France
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Piperno-Neumann S, Piulats JM, Goebeler M, Galloway I, Lugowska I, Becker JC, Vihinen P, Van Calster J, Hadjistilianou T, Proença R, Caminal JM, Rogasik M, Blay JY, Kapiteijn E. Uveal Melanoma: A European Network to Face the Many Challenges of a Rare Cancer. Cancers (Basel) 2019; 11:E817. [PMID: 31200439 DOI: 10.3390/cancers11060817] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 06/07/2019] [Accepted: 06/10/2019] [Indexed: 12/11/2022] Open
Abstract
Uveal melanoma (UM) is the most frequent primary ocular cancer in adults, accounting for 5% of all melanomas. Despite effective treatments for the primary tumour, up to 50% of UM patients will develop metastasis, leading to a very poor prognosis and a median overall survival of 6 to 12 months, with no major improvements in the last 30 years. There is no standard oncological treatment available for metastatic UM patients, and BRAF/MEK and immune checkpoint inhibitors show disappointing results when compared to cutaneous melanoma (CM). Recent advances in biology, however, identified specific gene and chromosome alterations, potentially permitting an actively tailored surveillance strategy, and dedicated clinical studies. Being a rare cancer, UM patients have to overcome issues such as identifying referral centres, having access to information, and partnering with oncologists for specific management strategies and research priorities. Here, we describe how the European Rare Adult solid Cancer Network (EURACAN) will help in addressing these challenges and accelerating international collaborations to enhance the development of innovative treatments in UM.
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Vos JR, Giepmans L, Röhl C, Geverink N, Hoogerbrugge N. Boosting care and knowledge about hereditary cancer: European Reference Network on Genetic Tumour Risk Syndromes. Fam Cancer 2019; 18:281-284. [PMID: 30302652 PMCID: PMC6449296 DOI: 10.1007/s10689-018-0110-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Approximately 27-36 million patients in Europe have one of the ~ 5.000-8.000 known rare diseases. These patients often do not receive the care they need or they have a substantial delay from diagnosis to treatment. In March 2017, twenty-four European Reference Networks (ERNs) were launched with the aim to improve the care for these patients through cross border healthcare, in a way that the medical knowledge and expertise travels across the borders, rather than the patients. It is expected that through the ERNs, European patients with a rare disease get access to expert care more often and more quickly, and that research and guideline development will be accelerated resulting in improved diagnostics and therapies. The ERN on Genetic Tumour Risk Syndromes (ERN GENTURIS) aims to improve the identification, genetic diagnostics, prevention of cancer, and treatment of European patients with a genetic predisposition for cancer. The ERN GENTURIS focuses on syndromes such as hereditary breast cancer, hereditary colorectal cancer and polyposis, neurofibromatosis and more rare syndromes e.g. PTEN Hamartoma Tumour Syndrome, Li Fraumeni Syndrome and hereditary diffuse gastric cancer.
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Affiliation(s)
- Janet R Vos
- Department of Human Genetics, Radboud University Medical Center, P.O. box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Lisette Giepmans
- Research B.V, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Claas Röhl
- Patient representative, European Patient Advocacy Group, European Reference Network on Genetic Tumour Risk Syndromes (ERN GENTURIS), Vienna, Austria
| | - Nicoline Geverink
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nicoline Hoogerbrugge
- Department of Human Genetics, Radboud University Medical Center, P.O. box 9101, 6500 HB, Nijmegen, The Netherlands.
- Coordinator European Reference Network on Genetic Tumour Risk Syndromes (ERN GENTURIS), Nijmegen, The Netherlands.
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Abstract
The aim of the European Reference Network for Rare Endocrine Disorders (Endo-ERN) is to ensure equal access to high-quality care for all those affected by a rare endocrine condition across Europe, such as a disorder/difference of sex development (DSD), both for children and adults. Although differences in resources, health care systems, and health insurances between the European countries are challenging and require political action, a European laboratory network within Endo-ERN could improve the diagnostic process in individuals with DSD, building on the work done by previous European collaborations such as the COST action DSDnet. In close collaboration, clinicians and laboratory specialists must make every effort to standardize diagnostic protocols, achieve necessary harmonization of various laboratory tests, e.g., the hCG stimulation test, and implement an external quality control system. This should ideally result in comparable quality across the network centers allowing the sharing of reference values. This would not only improve patient care but also greatly facilitate research.
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Affiliation(s)
- Sabine E Hannema
- Department of Pediatric Endocrinology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
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Pogány G. [The actual questions of the care of rare diseases]. Orv Hetil 2017; 158:1851-1856. [PMID: 29153019 DOI: 10.1556/650.2017.30908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The aim was to present the actual situation of rare diseases, especially to characterize the circumstances in Hungary. The most important developments were summarized which could help the care of rare disease patients in the everyday practice. There are around 800 000 patients with rare diseases in Hungary. The lack of information leads to "invisibility" for the health and social care system (most of them without ICD code). Therefore, these patients still have a huge disadvantage even when compared to the patients of common diseases. Important national and international measures took place in the last years to decrease these disadvantages. The Hungarian Centres of Expertise were officially approved, thus several health care providers were able to get membership in the forming European Reference Networks. The rare disease specific "Lifebelt" Information Centre and Help Line was established by HUFERDIS. These steps assist the implementation of the National Rare Disease Plan, although its formal approval process has temporarily stopped because of the reorganization of the health care system. The summarized developments can contribute to define better patient directions, and thus decrease the family knocks about the maze of health, social and educational systems. The realization of Rare Disease National Strategy is needed to improve the current fragmentation of services and enable patients and health, social and educational professionals to provide and use best practice care. This will ensure that all patients with rare disease cannot only be diagnosed quickly, but also have timely access to the care and support that they need, resulting in a decreasing burden of families and society. Orv Hetil. 2017; 158(47): 1851-1856.
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Affiliation(s)
- Gábor Pogány
- Ritka és Veleszületett Rendellenességgel Élők Országos Szövetsége Budapest, Orczy út 2., 1089
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