title: Disorders of Sex Development (DSD): Networking and Standardization Considerations.
abstract: Syndromes resulting in Disorders of Sex Development (DSD) are individually rare. Historically, this fact has hindered both clinical research and the delivery of evidence-based care. Recognizing the need for advancement, members of European and North American medical societies produced policy statements, notably the Consensus Statement on Management of Intersex Disorders, which recognize that optimal healthcare in DSD requires multidisciplinary teams in conjunction with networking of treatment centers and continued development of patient registries. This paper summarizes efforts in Europe and the U.S. toward creating networks focused on expanding discovery and improving healthcare and quality of life outcomes in DSD. The objectives and function of registry-based networks (EuroDSD/I-DSD), learning collaboratives (DSD-net), clinical outcomes research (DSD-Life), and networking hybrids (DSD-TRN) are reviewed. Opportunities for, and barriers to standardization in research and care are highlighted in light of practical considerations, for example, limitations in reliably classifying anatomic phenotypes and gaps in behavioral health staffing resources. The role of patient-reported outcomes is considered, with emphasis on integrating patient perspectives, given findings of limited agreement in outcome ratings by healthcare providers and patients. Finally, the characteristics of clinical centers likely to deliver the highest quality outcomes are discussed.
authors.affiliation: Department of Pediatrics & Communicable Diseases and the Child Health Evaluation and Research (CHEAR) Unit, University of Michigan Medical School, Ann Arbor, USA.
authors.forename: D E
authors.initials: DE
authors.lastname: Sandberg
authors.affiliation: Department of Pediatrics & Communicable Diseases and the Child Health Evaluation and Research (CHEAR) Unit, University of Michigan Medical School, Ann Arbor, USA.
authors.forename: N
authors.initials: N
authors.lastname: Callens
authors.affiliation: Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, USA.
authors.forename: A B
authors.initials: AB
authors.lastname: Wisniewski
mesh_terms: D035843:Biomedical Research / Q000592:standards*; D003299:Cooperative Behavior; D012734:Disorders of Sex Development / Q000628:therapy*; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000592:standards*; D017410:Practice Guidelines as Topic / Q000592:standards*; D012042:Registries / Q000592:standards*