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Title: | The eGVHD App has the potential to improve the accuracy of graft-versus-host disease assessment: a multicenter randomized controlled trial | Authors: | Schoemans, Helene M. Goris, Kathy Van Durm, Raf FIEUWS, Steffen De Geest, Sabina Pavletic, Steven Z. Im, Annie Wolff, Daniel Lee, Stephanie J. Greinix, Hildegard Duarte, Rafael F. Poire, Xavier Selleslag, Dominik Lewalle, Philippe Kerre, Tessa Graux, Carlos Baron, Frederic Maertens, Johan A. Dobbels, Fabienne |
Issue Date: | 2018 | Publisher: | FERRATA STORTI FOUNDATION | Source: | HAEMATOLOGICA, 103(10), p. 1698-1707 | Abstract: | 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). Appassisted 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. | Notes: | [Schoemans, Helene M.; Goris, Kathy; Maertens, Johan A.] Univ Hosp Leuven, Dept Hematol, Leuven, Belgium. [Schoemans, Helene M.; Goris, Kathy; Maertens, Johan A.] Katholieke Univ Leuven, Leuven, Belgium. [Schoemans, Helene M.; De Geest, Sabina; Dobbels, Fabienne] Katholieke Univ Leuven, Acad Ctr Nursing & Midwifery, Leuven, Belgium. [Van Durm, Raf] Katholieke Univ Leuven, IT Dept, Univ Hosp Leuven, Leuven, Belgium. [Fieuws, Steffen] KU Leuven Univ Leuven, L BioStat, Leuven, Belgium. [Fieuws, Steffen] Univ Hasselt, Leuven, Belgium. [De Geest, Sabina] Univ Basel, Inst Nursing Sci, Dept Publ Hlth, Basel, Switzerland. [Pavletic, Steven Z.] NCI, Expt Transplantat & Immunol Branch, CCR, NIH, Bethesda, MD 20892 USA. [Im, Annie] Univ Pittsburgh, Med Ctr, Pittsburgh, PA USA. [Wolff, Daniel] Univ Regensburg, Dept Hematol & Clin Oncol, Regensburg, Germany. [Lee, Stephanie J.] Fred Hutchinson Canc Res Ctr, Div Clin Res, 1124 Columbia St, Seattle, WA 98104 USA. [Greinix, Hildegard] Med Univ Graz, Div Hematol, Graz, Austria. [Duarte, Rafael F.] ICO Hosp Duran I Reynals, Lhospitalet De Llobregat, Spain. [Poire, Xavier] Clin Univ St Luc, Brussels, Belgium. [Selleslag, Dominik] AZ Sint Jan Brugge, Dept Hematol, Brugge, Belgium. [Lewalle, Philippe] Univ Libre Bruxelles, Inst Jules Bordet, Brussels, Belgium. [Kerre, Tessa] Ghent Univ Hosp, Hematol & Stem Cell Transplantat, Ghent, Belgium. [Graux, Carlos] Catholic Univ Louvain, CHU UCL Namur Godinne Site, Yvoir, Belgium. [Baron, Frederic] Univ Liege, Hematol, GIGA I3, Liege, Belgium. | Document URI: | http://hdl.handle.net/1942/28834 | ISSN: | 0390-6078 | e-ISSN: | 1592-8721 | DOI: | 10.3324/haematol.2018.190777 | ISI #: | 000445883500033 | Rights: | 2018 Ferrata Storti Foundation Material published in Haematologica is covered by copyright. All rights are reserved to the Ferrata Storti Foundation. Use of published material is allowed under the following terms and conditions: https://creativecommons.org/licenses/by-nc/4.0/legalcode. Copies of published material are allowed for personal or internal use. Sharing published material for non-commercial purposes is subject to the following conditions: https://creativecommons.org/licenses/by-nc/4.0/legalcode, sect. 3. Reproducing and sharing published material for commercial purposes is not allowed without permission in writing from the publisher. | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2019 |
Appears in Collections: | Research publications |
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