Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
Rare Voices Australia, VIC, 3194, Melbourne, Australia.
Orphanet J Rare Dis. 2023 Jul 27;18(1):216. doi: 10.1186/s13023-023-02823-1.
Rare diseases (RDs) affect approximately 8% of all people or > 400 million people globally. The Australian Government's National Strategic Action Plan for Rare Diseases has identified the need for a national, coordinated, and systematic approach to the collection and use of RD data, including registries. Rare disease registries (RDRs) are established for epidemiological, quality improvement and research purposes, and they are critical infrastructure for clinical trials. The aim of this scoping review was to review literature on the current state of RDRs in Australia; to describe how they are funded; what data they collect; and their impact on patient outcomes.
We conducted a literature search on MEDLINE, EMBASE, CINAHL and PsychINFO databases, in addition to Google Scholar and grey literature. Dissertations, government reports, randomised control trials, conference proceedings, conference posters and meeting abstracts were also included. Articles were excluded if they did not discuss RDs or if they were written in a language other than English. Studies were assessed on demographic and clinical patient characteristics, procedure or treatment type and health-related quality of life captured by RDRs or databases that have been established to date.
Seventy-four RDRs were identified; 19 were global registries in which Australians participated, 24 were Australian-only registries, 10 were Australia and New Zealand based, and five were Australian jurisdiction-based registries. Sixteen "umbrella" registries collected data on several different conditions, which included some RDs, and thirteen RDRs stored rare cancer-specific information. Most RDRs and databases captured similar types of information related to patient characteristics, comorbidities and other clinical features, procedure or treatment type and health-related quality of life measures. We found considerable heterogeneity among existing RDRs in Australia, especially with regards to data collection, scope and quality of registries, suggesting a national coordinated approach to RDRs is required.
This scoping review highlights the current state of Australian RDRs, identifying several important gaps and opportunities for improvement through national coordination and increased investment.
罕见病(RDs)影响全球约 8%的人口或超过 4 亿人。澳大利亚政府的国家罕见病战略行动计划已经确定需要采取一种全国性的、协调的和系统的方法来收集和使用 RD 数据,包括登记处。罕见病登记处(RDR)是为流行病学、质量改进和研究目的而设立的,它们是临床试验的关键基础设施。本范围审查的目的是审查澳大利亚 RDR 的现状文献;描述它们是如何资助的;他们收集的数据;以及它们对患者结果的影响。
我们在 MEDLINE、EMBASE、CINAHL 和 PsychINFO 数据库上进行了文献检索,此外还在 Google Scholar 和灰色文献上进行了检索。还包括学位论文、政府报告、随机对照试验、会议记录、会议海报和会议摘要。如果文章不讨论 RD 或不是用英语撰写,则将其排除在外。根据登记处或迄今为止建立的数据库中记录的人口统计学和临床患者特征、程序或治疗类型以及与健康相关的生活质量,对研究进行评估。
确定了 74 个 RDR;其中 19 个是澳大利亚人参与的全球登记处,24 个是澳大利亚独有的登记处,10 个是澳大利亚和新西兰的,5 个是澳大利亚司法管辖区的登记处。16 个“伞式”登记处收集了几种不同疾病的数据,其中包括一些 RD,还有 13 个 RDR 存储了罕见癌症的具体信息。大多数 RDR 和数据库都记录了与患者特征、合并症和其他临床特征、程序或治疗类型以及与健康相关的生活质量测量相关的类似类型的信息。我们发现澳大利亚现有的 RDR 之间存在相当大的异质性,特别是在数据收集、范围和登记处的质量方面,这表明需要采取全国协调的方法来管理 RDR。
本范围审查突出了澳大利亚 RDR 的现状,通过国家协调和增加投资,确定了几个重要的差距和改进机会。