title: Improved accuracy of acute graft-versus-host disease staging among multiple centers.
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.
authors.affiliation: Blood and Marrow Transplantation Program, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, USA.
authors.forename: John E
authors.initials: JE
authors.lastname: Levine
authors.affiliation: Blood and Marrow Transplant Program, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA.
authors.forename: William J
authors.initials: WJ
authors.lastname: Hogan
authors.affiliation: Blood and Marrow Transplantation Program, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, USA.
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Harris
authors.affiliation: Blood and Marrow Transplant Program, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Litzow
authors.affiliation: Blood and Marrow Transplant Program, Ohio State University, 300 W. 10th Ave., Columbus, OH 43210, USA.
authors.forename: Yvonne A
authors.initials: YA
authors.lastname: Efebera
authors.affiliation: Blood and Marrow Transplant Program, Ohio State University, 300 W. 10th Ave., Columbus, OH 43210, USA.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Devine
authors.affiliation: Blood and Marrow Transplant Program, University of Pennsylvania, 3400 Civic Center Blvd., Philadelphia, PA 19104, USA.
authors.forename: Ran
authors.initials: R
authors.lastname: Reshef
authors.affiliation: Translational Research Center, The Tisch Cancer Institute, The Icahn School of Medicine at Mount Sinai Hospital, 1470 Madison Avenue, New York, NY 10029, USA. Electronic address: james.ferrara@mssm.edu.
authors.forename: James L M
authors.initials: JL
authors.lastname: Ferrara
mesh_terms: D000208:Acute Disease; D016208:Databases, Factual; D006086:Graft vs Host Disease / Q000175:diagnosis* / Q000517:prevention & control*; D006801:Humans; D015337:Multicenter Studies as Topic; D017410:Practice Guidelines as Topic
keywords: BMT; GVHD; bone marrow transplant; data entry system; graft-versus-host disease; guidance; multiple centers; online; staging; standardization; web