Sharkey Evelyn K, Zoellner Nancy L, Abadin Salmafatima, Gutmann David H, Johnson Kimberly J
Brown School, Washington University, St. Louis, MO 63130, United States.
Department of Neurology, Washington University School of Medicine, St. Louis, MO, United States.
Contemp Clin Trials. 2015 Jan;40:212-7. doi: 10.1016/j.cct.2014.12.006. Epub 2014 Dec 19.
With increased internet accessibility worldwide, it is now possible to assemble individuals with rare diseases through web-based patient registries. However, the validity of participant-reported medical diagnoses is unknown. The objective of this study was to evaluate the accuracy of participant-reported Neurofibromatosis Type 1 (NF1) diagnoses among participants in the NF1 Patient Registry Initiative (NPRI).
Subjects enrolled in the NPRI from 5/17/2011 to 7/7/2014 were included. Medical records (MRs) were obtained for participants who returned medical record release forms (MRRFs) during the study period. Participants were classified as having definite, probable, suspected, or no NF1 diagnosis based on MR information. To assess whether a returned MRRF served as a reliable marker of MR-documented NF1, we calculated the positive predictive value (PPV) as the proportion of individuals with MR-documented NF1 among those from whom MRs were obtained. We further examined whether a returned MRRF predicted the number of reported NF1 clinical signs in multivariable linear regression analyses.
A total of 1456 individuals were included in the analyses. Of 416 individuals who returned MRRFs, 205 MRs were reviewed within the study period. The PPV ranged from 72.0 to 98.5% when including definite or definite/probable/suspected cases, respectively. The mean number of reported NF1 clinical signs was similar between those who returned (mean=3.3 ± 1.2) and did not return (mean=3.2 ± 1.3) their MRRFs. MRRF return was not a significant predictor of the number of NF1 clinical signs after adjusting for covariates.
These data strongly suggest that individuals enrolling in the NPRI accurately report their NF1 diagnosis.
随着全球互联网接入的增加,现在可以通过基于网络的患者登记系统召集患有罕见疾病的个体。然而,参与者报告的医学诊断的有效性尚不清楚。本研究的目的是评估1型神经纤维瘤病(NF1)患者登记计划(NPRI)参与者报告的NF1诊断的准确性。
纳入2011年5月17日至2014年7月7日参加NPRI的受试者。在研究期间,为返还病历发布表(MRRF)的参与者获取病历(MR)。根据MR信息,将参与者分类为患有明确、可能、疑似或无NF1诊断。为了评估返还的MRRF是否作为MR记录的NF1的可靠标志物,我们计算了阳性预测值(PPV),即获得MR的个体中MR记录有NF1的个体比例。我们进一步在多变量线性回归分析中检查返还的MRRF是否能预测报告的NF1临床体征数量。
共有1456名个体纳入分析。在416名返还MRRF的个体中,205份MR在研究期间得到审查。当分别纳入明确或明确/可能/疑似病例时,PPV范围为72.0%至98.5%。返还MRRF的个体(平均=3.3±1.2)和未返还MRRF的个体(平均=3.2±1.3)报告的NF1临床体征平均数相似。在调整协变量后,返还MRRF不是NF1临床体征数量的显著预测因素。
这些数据有力地表明,参加NPRI的个体准确报告了他们的NF1诊断。