The eGVHD App has the potential to improve the accuracy of graft versus host disease assessment: a multicenter randomized controlled trial.

The eGVHD App has the potential to improve the accuracy of graft versus host disease assessment: a multicenter randomized controlled trial.

Haematologica. 2018 Jun 14;:

Authors: Schoemans HM, Goris K, Van Durm R, Fieuws S, De Geest S, Pavletic SZ, Im A, Wolff D, Lee SJ, Greinix H, Duarte RF, Poiré X, Selleslag D, Lewalle P, Kerre T, Graux C, Baron F, Maertens JA, Dobbels F, EBMT Transplantation Complications Working Party

Abstract
Graft-versus-host disease assessment has been shown to be a challenge for healthcare professionals, leading to the development of the eGVHD App (www.uzleuven.be/egvhd). In this study, we formally evaluated the accuracy of using the App compared to traditional assessment methods to assess graft-versus-host disease. Our national multicenter randomized controlled trial involved seven Belgian transplantation centers and 78 healthcare professionals selected using a two-stage convenience sampling approach between January and April 2017. Using a 1:1 randomization stratified by profession, healthcare professionals were assigned to use either the App ("APP&") or their usual graft-versus-host disease assessment aids ("No APP") to assess the diagnosis and severity score of ten expert-validated clinical vignettes. Our main outcome measure was the difference in accuracy for graft-versus-host disease severity scoring between both groups. The odds of being correct were 6.14 (95% CI: 2.83-13.34) and 6.29 (95% CI: 4.32-9.15) times higher in favor of the "APP" group for diagnosis and scoring, respectively (p<0.001). App-assisted graft-versus-host disease severity scoring was significantly superior for both acute and chronic graft-versus-host disease, with an Odds Ratio of 17.89 and 4.34 respectively (p<0.001) and showed a significantly increased inter-observer agreement compared to standard practice. Despite a mean increase of 24 minutes (95% CI: 20.45-26.97) in time needed to score the whole graft-versus-host disease test package in the"APP" group (p<0.001), usability feedback was positive. The eGVHD App showed superior graft-versus-host disease assessment accuracy compared to standard practice and has the potential to improve the quality of outcome data registration in allogeneic stem cell transplantation.

PMID: 29903762 [PubMed - as supplied by publisher]