Abstract

BackgroundDisease registries have the invaluable potential to provide an insight into the natural history of the disease under investigation, to provide useful information (e.g. through health indicators) for planning health care services and to identify suitable groups of patients for clinical trials enrolment. However, the establishment and maintenance of disease registries is a burdensome initiative from economical and organisational points of view and experience sharing on registries management is important to avoid waste of resources. The aim of this paper is to discuss the problems embedded in the institution and management of an international disease registry to warn against common mistakes that can derail the best of intentions: we share the experience of the European Cystic Fibrosis Society Patient Registry, which collects data on almost 30,000 patients from 23 countries.MethodsWe discuss the major problems that researchers often encounter in the creation and management of disease registries: definition of the aims the registry has to reach, definition of the criteria for patients referral to the registry, definition of the information to record, set up of a data quality process, handling of missing data, maintenance of data confidentiality, regulation of data use and dissemination of research results.ResultsWe give examples on how many crucial aspects were solved by the European Cystic Fibrosis Society Patient Registry regarding objectives, inclusion criteria and variables definition, data management, data quality controls, missing data handling, confidentiality maintenance, data use and results dissemination.ConclusionsWe suggest an extensive literature research and discussions in working groups with different stake holders, including patient representatives, on the objectives, inclusion criteria and the information to record. We propose to pilot the recording of few variables and test the applicability of their definition first. The use of a shared electronic platform for data collection that automatically computes derived variables, and automatically performs basic data quality controls is a good data management practice, that also helps in reducing missing data. We found crucial for success the collaboration with existing national and international registries, cystic fibrosis organisations and patients’ associations.

Highlights

  • Disease registries have the invaluable potential to provide an insight into the natural history of the disease under investigation, to provide useful information for planning health care services and to identify suitable groups of patients for clinical trials enrolment

  • They are useful in rare diseases, such as cystic fibrosis (CF), where important research questions cannot be answered without large multicentre studies because of the limited number of patients followed by individual CF centres

  • For a patient registry relying on the patients acceptance of their data being collected, we found it crucial to involve patient representatives very early in the project; for this reason we cooperated closely with CF Europe, the European CF patients’ organisation, who appointed two of their associates as members of the steering group, one of whom is member of the executive committee

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Summary

Introduction

Disease registries have the invaluable potential to provide an insight into the natural history of the disease under investigation, to provide useful information (e.g. through health indicators) for planning health care services and to identify suitable groups of patients for clinical trials enrolment. Disease registries have become essential for the investigation of chronic diseases thanks to their potential to epidemiologically describe the natural history of the disease They are useful in rare diseases, such as cystic fibrosis (CF), where important research questions cannot be answered without large multicentre studies because of the limited number of patients followed by individual CF centres. The importance of disease registries has been acknowledged by EUCERD [3], an EU Committee of experts in rare diseases that discusses policies and recommends activities in collaboration with the EU Commission and Parliament and the Council of Ministers. The difficulty in addressing most of the hurdles is magnified in an international setting, where agreements on data definition are crucial to ensure uniformity of data collection across the participating countries

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