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Improved accuracy of acute graft-versus-host disease staging among multiple centers.

Authors
  • Levine, John E
  • Hogan, William J
  • Harris, Andrew C
  • Litzow, Mark R
  • Efebera, Yvonne A
  • Devine, Steven M
  • Reshef, Ran
  • Ferrara, James L M
Type
Published Article
Journal
Best Practice & Research Clinical Haematology
Publisher
Elsevier
Publication Date
Jan 01, 2014
Volume
27
Issue
3-4
Pages
283–287
Identifiers
DOI: 10.1016/j.beha.2014.10.011
PMID: 25455279
Source
Medline
Keywords
License
Unknown

Abstract

The clinical staging of acute graft-versus-host disease (GVHD) varies significantly among bone marrow transplant (BMT) centers, but adherence to long-standing practices poses formidable barriers to standardization among centers. We have analyzed the sources of variability and developed a web-based remote data entry system that can be used by multiple centers simultaneously and that standardizes data collection in key areas. This user-friendly, intuitive interface resembles an online shopping site and eliminates error-prone entry of free text with drop-down menus and pop-up detailed guidance available at the point of data entry. Standardized documentation of symptoms and therapeutic response reduces errors in grade assignment and allows creation of confidence levels regarding the diagnosis. Early review and adjudication of borderline cases improves consistency of grading and further enhances consistency among centers. If this system achieves widespread use it may enhance the quality of data in multicenter trials to prevent and treat acute GVHD.

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