Page 19 - 2018_10-Haematologica-web

Editorials
of the center, the degree of experience, and professional background. The use of the App was, however, time con- suming for the HCPs who had not used it before the study. Despite this limiting factor, they found it useful and reported that they would be willing to use it in their daily practice.
Thus, this well-performed randomized study demon- strates that the eGVHD App provides superior accuracy and reliability for GvHD assessment compared to usual care, even for experienced physicians.4 The improvement can mainly be explained by the use of the most up-to- date guidelines, the limitation of physician’s subjectivity during the evaluation, and the fact that the e-tool pro- vides pictures and definitions of GvHD features that help physicians to better categorize GvHD symptoms.
The need for harmonization in the diagnosis and scor- ing of GvHD has been recognized for many years and several other attempts have been made to improve this by the use of electronic tools7,8 but generally without suc- cess. The eGVHD App is available everywhere (www.uzleuven.be/egvhd) and could be used by any practi- tioner. The App could be of particular interest to HPCs with limited GvHD experience and can also be used for training. It remains to be seen whether the use of the eGVHD App, by improving the grading of GvHD in daily practice, could have an impact on clinical decisions and transplant outcomes.
In the era of fast developing electronic devices and of 'big-data' analyses, the eGVHD App represents the first e-tool to be made widely available with the potential to improve the quality of GvHD data in clinical research.
Such an App should be implemented in clinical trials aiming to evaluate and treat GvHD after allogeneic HSCT, as well as in large-scale transplant data bases.
References
1. Atkinson K, Horowitz MM, Biggs JC, Gale RP, Rimm AA, Bortin MM. The clinical diagnosis of acute graft-versus-host disease: a diversity of views amongst marrow transplant centers. Bone Marrow Transplant. 1988;3(1):5-10.
2. WeisdorfDJ,HurdD,CarterS,etal.Prospectivegradingofgraft-ver- sus-host disease after unrelated donor marrow transplantation: a grading algorithm versus blinded expert panel review. Biol Blood Marrow Transplant. 2003;9(8):512-518.
3. Schoemans H, Goris K, Durm RV, et al. Development, preliminary usability and accuracy testing of the EBMT 'eGVHD App' to support GvHD assessment according to NIH criteria-a proof of concept. Bone Marrow Transplant. 2016;51(8):1062-1065.
4. Schoemans HM, Goris K, Van Durm R, Fieuws S, et al. The eGVHD App has the potential to improve the accuracy of graft-versus-host disease assessment: a multicenter randomized controlled trial. Haematologica 2018; 103(10):1698-1707.
5. Glucksberg H, Storb R, Fefer A, et al. Clinical manifestations of graft- versus-host disease in human recipients of marrow from HL-A- matched sibling donors. Transplantation. 1974;18(4):295-304.
6. JagasiaMH,GreinixHT,AroraM,etal.NationalInstitutesofHealth Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: I. The 2014 Diagnosis and Staging Working Group report. Biol Blood Marrow Transplant. 2015;21(3):389-401.
7. Levine JE, Hogan WJ, Harris AC, et al. Improved accuracy of acute graft-versus-host disease staging among multiple centers. Best Pract Res Clin Haematol. 2014;27(3-4):283-287.
8. Dierov D, Ciolino C, Fatmi S, et al. Establishing a standardized sys- tem to capture chronic graft-versus-host disease (GVHD) data in accordance to the national institutes (NIH) consensus criteria. Bone Marrow Transplant. 2017;52(Suppl 1):S102.
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