Medical College of Wisconsin
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Consensus among bone marrow transplanters for diagnosis, grading and treatment of chronic graft-versus-host disease. Committee of the International Bone Marrow Transplant Registry. Bone Marrow Transplant 1989 May;4(3):247-54 PMID: 2659110

Pubmed ID

2659110

Abstract

A questionnaire comprised of a series of clinical vignettes illustrating potential difficulties in diagnosis, grading and treatment of chronic graft-versus-host disease (GVHD) was completed by 65 bone marrow transplant physicians from 51 transplant centers worldwide. The concordance index (CI) for responses to each question was calculated using the formula CI = 2p-1, where p was the percentage agreement among respondents. Possible responses ranged from 0 (no agreement) to 1.00 (perfect agreement). Responses indicated moderate (CI = 0.55), high (CI = 0.88) and moderate (CI = 0.54) agreement among transplanters for diagnosis, grading and treatment of chronic GVHD, respectively. Disagreement was observed in (1) diagnosis of uncommon manifestations of chronic GVHD; (2) in interpretation of symptoms which occur less than 2 months after transplant; (3) in interpretation of persistent stable symptoms; and (4) in deciding whether to treat chronic GVHD limited to skin. The results point to potential problem areas in designing and interpreting clinical trials to prevent or treat chronic GVHD and highlight the need for improved diagnostic criteria.

Author List

Atkinson K, Horowitz MM, Gale RP, Lee MB, Rimm AA, Bortin MM

Author

Mary M. Horowitz MD, MS Center Director, Professor in the Medicine department at Medical College of Wisconsin




Scopus

2-s2.0-0024412271   143 Citations

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Bone Marrow Transplantation
Child
Chronic Disease
Data Collection
Female
Graft vs Host Disease
Humans
Male
Surveys and Questionnaires
jenkins-FCD Prod-297 dff1a717c492f00bf6291286365f1f4fe95208f1