Accuracy and usability of the eGVHD app in assessing the severity of graft-versus-host disease at the 2017 EBMT annual congress

Schoemans, Hélène; Goris, Kathy; Durm, Raf Van; Vanbrabant, Koen; Geest, Sabina De; Maertens, Johan; Wolff, Daniel; Greinix, Hildegard; Ruutu, Tapani; Pavletić, S.Ž.; Im, Annie; Lee, Stephanie J.; Basak, Grzegorz W.; Duarte, Rafael F.; Dobbels, Fabienne

doi:10.1038/s41409-017-0017-0

Cited by 22 publications

(26 citation statements)

References 11 publications

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“…Notably, EBMT‐NIH‐CIBMTR Task Force supports the standardization of GVHD assessments as a dynamic process that incorporates progress in new diagnostic and therapeutic interventions . Similar efforts in the standardization of GVHD data capture are underway to increase the reliability of the GVHD evaluation process including the development of new software and the eGVHD app …”

Section: Discussionmentioning

confidence: 99%

Establishing a standardized system for review and adjudication of chronic graft‐vs‐host disease data in accordance with the National Institutes Consensus criteria

et al. 2019

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Graft‐vs‐host Disease (GVHD) is a frequent complication following allogeneic stem cell transplantation (allo‐HCT). The National Institute of Health consensus group established new guidelines for the evaluation of chronic GVHD. However, GVHD assessment remains challenging due to its complexity and requirement for laborious evaluation. We, therefore, established a standardized approach for the assessment of chronic GVHD in accordance with the NIH consensus criteria (NCC) guidelines. At a single institution, all allograft recipients were evaluated for GVHD within the first‐year post allo‐HCT following a three‐step workflow (real‐time assessment, consensus review, and documentation). A GVHD adjudication committee was created and a dynamic electronic GVHD data capture form was developed guiding the clinician through a comprehensive review of systems following the NCC guidelines. We found that the assessment and reporting of GVHD reached 100% compliance. The establishment of an institutional GVHD adjudication committee enabled standardized assessment of GVHD. Our workflow can be adopted by other centers to create a similar framework for dedicated GVHD evaluation.

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Section: Discussionmentioning

confidence: 99%

Establishing a standardized system for review and adjudication of chronic graft‐vs‐host disease data in accordance with the National Institutes Consensus criteria

et al. 2019

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“…cGvHD was further classified definitions. There are continuous efforts by the NIH, Center for International Blood and Marrow Transplant Research, and European Society for Blood and Marrow Transplantation (EBMT) to review the existing guidelines, address ambiguities, and develop more reliable terminology [32][33][34][35][36][37].…”

Section: Historical Perspectivementioning

confidence: 99%

“…The NIH guidelines were originally developed for research purposes, so their application to "real-life" situations can sometimes be challenging. Due to complexities in cGvHD diagnosis and staging, several studies have shown a lack of adherence to recommendations and inconsistencies in cGvHD evaluation, even among experienced transplant physicians [36,[40][41][42]. In clinical trials, this can cause patients to be excluded from the analysis post hoc and significantly impact the interpretation of trial results [43].…”

Section: Applying the Nih Guidelines To Clinical Practicementioning

confidence: 99%

“…In clinical trials, this can cause patients to be excluded from the analysis post hoc and significantly impact the interpretation of trial results [43]. Therefore, there are increasing efforts to further standardize cGvHD terminology and to improve the quality and precision of the data collected [32][33][34][35][36]. In collaboration with the EBMT Transplantation Complications Working Party and the NIH, Schoemans and colleagues developed an electronic tool, the "eGvHD App, " to assist transplant healthcare professionals with their evaluation of GvHD [33].…”

Section: Applying the Nih Guidelines To Clinical Practicementioning

confidence: 99%

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Challenges in Conducting Studies in Chronic Graft-versus-Host Disease

Pusic¹,

Pavletić²

2019

CHI

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The lack of standardized criteria for measuring therapeutic response has been a major obstacle to the development of therapeutic trials in chronic graft-versus-host disease (cGvHD). Nevertheless, recent advances have been made in understanding of the biology and pathophysiology of cGvHD, as well as establishing more precise criteria for the diagnosis and classification of disease manifestations. The momentum has shifted, and currently there is a long list of new potential treatment targets being identified for cGvHD. Consequently, new drugs are being implemented for its prophylaxis and treatment. It is crucial to continue that trend and develop better systems to test new drugs in clinical practice that would eventually translate toward seeking regulatory review and approval. We provide a historical perspective and current challenges in conducting cGvHD clinical trials.

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“…Moreover, the recommendations underlying this evaluation are plethoric and sometimes even contradictory, potentially leading to confusion in the HCT community. 1 In fact, it has been repeatedly shown that many HCT professionals have problems implementing GvHD assessment correctly, as demonstrated by a low observed accuracy in GvHD assessment 2 – 5 and a slow uptake of the most up-to-date guidelines. 5 – 7 …”

Section: Introductionmentioning

confidence: 99%

The eGVHD App has the potential to improve the accuracy of graft-versus-host disease assessment: a multicenter randomized controlled trial

et al. 2018

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Graft-versus-host disease (GvHD) assessment has been shown to be a challenge for healthcare professionals, leading to the development of the eGVHD App (www.uzleuven.be/egvhd). In this study, we formally evaluated the accuracy of using the App compared to traditional assessment methods to assess GvHD. Our national multicenter randomized controlled trial involved seven Belgian transplantation centers and 78 healthcare professionals selected using a 2-stage convenience sampling approach between January and April 2017. Using a 1:1 randomization stratified by profession, healthcare professionals were assigned to use either the App (“APP”) or their usual GvHD assessment aids (“No APP”) to assess the diagnosis and severity score of 10 expert-validated clinical vignettes. Our main outcome measure was the difference in accuracy for GvHD severity scoring between both groups. The odds of being correct were 6.14 (95%CI: 2.83–13.34) and 6.29 (95%CI: 4.32–9.15) times higher in favor of the “APP” group for diagnosis and scoring, respectively (P<0.001). App-assisted GvHD severity scoring was significantly superior for both acute and chronic GvHD, with an Odds Ratio of 17.89 and 4.34 respectively (P<0.001) and showed a significantly increased inter-observer agreement compared to standard practice. Despite a mean increase of 24 minutes (95%CI: 20.45–26.97) in the time needed to score the whole GvHD test package in the “APP” group (P<0.001), usability feedback was positive. The eGVHD App shows superior GvHD assessment accuracy compared to standard practice and has the potential to improve the quality of outcome data registration in allogeneic stem cell transplantation.

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Accuracy and usability of the eGVHD app in assessing the severity of graft-versus-host disease at the 2017 EBMT annual congress

Cited by 22 publications

References 11 publications

Establishing a standardized system for review and adjudication of chronic graft‐vs‐host disease data in accordance with the National Institutes Consensus criteria

Establishing a standardized system for review and adjudication of chronic graft‐vs‐host disease data in accordance with the National Institutes Consensus criteria

Challenges in Conducting Studies in Chronic Graft-versus-Host Disease

The eGVHD App has the potential to improve the accuracy of graft-versus-host disease assessment: a multicenter randomized controlled trial

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