Expert OpinionE-tools can improve the accuracy of GvHD assessment and also can enhance the validity of research findings and clinical observations. These tools offer an easy and intuitive access to the latest guidelines, as well as provide automated help in applying complex decision algorithms. The eGvHD App was recently developed for these very reasons.
On Wednesday 21 March 2018 during an oral abstract session at the 44th Annual Meeting of the European Society for Blood and Marrow Transplantation (EBMT), Lisbon, Portugal, Hélène M Schoemans from UZ Leuven, Leuven, Belgium, reported results on behalf of her colleagues of a study which aimed to evaluate the present clinical procedures in GvHD assessment, the additional significance of using the eGvHD App compared with standard methods on the accuracy, reliability and time needed to assess GvHD.
HCPs were divided into two groups: the first group were allocated to use the App (App group), the second group used their usual GvHD assessment guides (UM group) to evaluate the diagnosis and severity score of 10 clinical vignettes validated by a group of separate GvHD experts (gold standard), who implemented the MAGIC and NIH 2014 guidelines for acute (4 vignettes) and chronic (6 vignettes) GvHD. Seven Belgian allogenic HCT centers contributed to this study, covering >80% of the national HCT activity. In total, 77 HCPs completed the assessment.
Key findings:
- Number of vignettes for correct diagnosis in the App group and the UM group: 10 vs5, OR = 6.14 (95% CI, 2.83–13.34), P < 0.001
- Number of vignettes for GvHD scoring in the App and the UM groups: 9 vs5, OR = 6.29 (95% CI 4.32–9.15), P < 0.001
- Assessment of GvHD was significantly better in the App group: aGvHD OR = 17.89 (95% CI 8.47–37.79) and cGvHD OR = 4.34 (95% CI 2.79–6.74), respectively, P < 0.001
- Inter-observer agreement in the App group and the UM group: 0.46 (95% CI, 0.23–0.68) vs12 (95% CI, 0.03–0.21), P = 0.003
Doctor Schoemans concluded by stating that “using the eGvHD App showed superior accuracy and reliability for GvHD assessment compared to usual care. The eGvHD app has therefore the potential to improve the quality of GvHD data in clinical research and practice.”
