dyscerne: developing clinical management guidelines for selected dysmorphic syndromes

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POSTER PRESENTATION Open Access DYSCERNE: developing clinical management guidelines for selected dysmorphic syndromes Pam Griffiths 1* , Kate Strong 1 , Sara Gardner 1 , Ruth Day 1 , Caroline Harrison 1 , Kerr Bronwyn 1 , Kay Metcalfe 1 , Han Brunner 3 , Dian Donnai 1 , Bruno Dallapiccola 4 , Koenraad Devriendt 2 , Malgorzata Krajewska-Walasek 6 , Nicole Philip 5 , Jill Clayton-Smith 1 From 5th European Conference on Rare Diseases (ECRD 2010) Krakow, Poland. 13-15 May 2010 The DYSCERNE Network of Centres of Expertise for dysmorphology (http://www.dyscerne.org), is developing clinical management guidelines for Williams (WS), Angelman (AS), Noonan (NS) and Kabuki (KS) syn- dromes. An initial scoping exercise identified these con- ditions as rare, complex, multi-system disorders, for which it was felt that affected patients, families and health/social care professionals would benefit from access to up-to-date evidence based management guidelines. Published evidence from which to develop manage- ment recommendations for these conditions is very lim- ited, and devising a systematic and robust methodology has been challenging. Our approach is based on the Scottish Intercollegiate Guidelines Network (SIGN) method, which we modified placing more emphasis on expert opinion and consensus, whilst maintaining sys- tematic rigour and transparency of processes. The development process includes: - Identification of key management issues by guideline group leaders. - Targeted, systematic literature searches using PubMed. - Review, identification and grading of results by panel of invited experts. - Consensus meetings at which experts present, dis- cuss and agree recommendations. - Initial drafting of guideline document which is circu- lated amongst experts and stakeholders for comments. - Amendments incorporated and guidelines finalised. - Guidelines piloted and evaluated. - International dissemination. The process has involved 49 experts from 8 countries reviewing between them, over 1000 papers. The WS guidelines are currently being piloted in 20 centres, by paediatricians and geneticists. The first draft of AS guidelines has been circulated for feedback. Consensus meetings for NS and KS will be held very shortly. The finished guidelines will be available from the DYS- CERNE website. Author details 1 University of Manchester, The Nowgen Centre, University of Manchester, M13 9WU, UK. 2 Center for Human Genetics, Herestraat 49, B-3000 Leuven, Belgium. 3 Radboud University Nijmegen Medical Center, Department of Human Genetics 417, Geert Grooteplein 20, 6525GA, Nijmegen, The Netherlands. 4 Istituto C.S.S. MENDEL, Unitadi Neurogenetica, Viale Regina Margherita 261, 00198 Roma, Italy. 5 Département de Génétique Médicale, Hôpital de la Timone Enfant, 13385 Marseille cedex5, France. 6 Department of Medical Genetics, The Childrens Memorial Health Institute, Al. Dzieci Polskich 20, Warsaw 04-730, Poland. Published: 19 October 2010 doi:10.1186/1750-1172-5-S1-P20 Cite this article as: Griffiths et al.: DYSCERNE: developing clinical management guidelines for selected dysmorphic syndromes. Orphanet Journal of Rare Diseases 2010 5(Suppl 1):P20. *Correspondence: [email protected] 1 University of Manchester, The Nowgen Centre, University of Manchester, M13 9WU, UK Full list of author information is available at the end of the article Griffiths et al. Orphanet Journal of Rare Diseases 2010, 5(Suppl 1):P20 http://www.ojrd.com/content/5/S1/P20 © 2010 Griffiths et al; licensee BioMed Central Ltd.

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POSTER PRESENTATION Open Access

DYSCERNE: developing clinical managementguidelines for selected dysmorphic syndromesPam Griffiths1*, Kate Strong1, Sara Gardner1, Ruth Day1, Caroline Harrison1, Kerr Bronwyn1, Kay Metcalfe1,Han Brunner3, Dian Donnai1, Bruno Dallapiccola4, Koenraad Devriendt2, Malgorzata Krajewska-Walasek6,Nicole Philip5, Jill Clayton-Smith1

From 5th European Conference on Rare Diseases (ECRD 2010)Krakow, Poland. 13-15 May 2010

The DYSCERNE Network of Centres of Expertise fordysmorphology (http://www.dyscerne.org), is developingclinical management guidelines for Williams (WS),Angelman (AS), Noonan (NS) and Kabuki (KS) syn-dromes. An initial scoping exercise identified these con-ditions as rare, complex, multi-system disorders, forwhich it was felt that affected patients, families andhealth/social care professionals would benefit fromaccess to up-to-date evidence based managementguidelines.Published evidence from which to develop manage-

ment recommendations for these conditions is very lim-ited, and devising a systematic and robust methodologyhas been challenging. Our approach is based on theScottish Intercollegiate Guidelines Network (SIGN)method, which we modified placing more emphasis onexpert opinion and consensus, whilst maintaining sys-tematic rigour and transparency of processes.The development process includes:- Identification of key management issues by guideline

group leaders.- Targeted, systematic literature searches using

PubMed.- Review, identification and grading of results by panel

of invited experts.- Consensus meetings at which experts present, dis-

cuss and agree recommendations.- Initial drafting of guideline document which is circu-

lated amongst experts and stakeholders for comments.

- Amendments incorporated and guidelines finalised.- Guidelines piloted and evaluated.- International dissemination.The process has involved 49 experts from 8 countries

reviewing between them, over 1000 papers. The WSguidelines are currently being piloted in 20 centres, bypaediatricians and geneticists. The first draft of ASguidelines has been circulated for feedback. Consensusmeetings for NS and KS will be held very shortly. Thefinished guidelines will be available from the DYS-CERNE website.

Author details1University of Manchester, The Nowgen Centre, University of Manchester,M13 9WU, UK. 2Center for Human Genetics, Herestraat 49, B-3000 Leuven,Belgium. 3Radboud University Nijmegen Medical Center, Department ofHuman Genetics 417, Geert Grooteplein 20, 6525GA, Nijmegen, TheNetherlands. 4Istituto C.S.S. MENDEL, Unita’ di Neurogenetica, Viale ReginaMargherita 261, 00198 Roma, Italy. 5Département de Génétique Médicale,Hôpital de la Timone Enfant, 13385 Marseille cedex5, France. 6Department ofMedical Genetics, The Children’s Memorial Health Institute, Al. Dzieci Polskich20, Warsaw 04-730, Poland.

Published: 19 October 2010

doi:10.1186/1750-1172-5-S1-P20Cite this article as: Griffiths et al.: DYSCERNE: developing clinicalmanagement guidelines for selected dysmorphic syndromes. OrphanetJournal of Rare Diseases 2010 5(Suppl 1):P20.

*Correspondence: [email protected] of Manchester, The Nowgen Centre, University of Manchester,M13 9WU, UKFull list of author information is available at the end of the article

Griffiths et al. Orphanet Journal of Rare Diseases 2010, 5(Suppl 1):P20http://www.ojrd.com/content/5/S1/P20

© 2010 Griffiths et al; licensee BioMed Central Ltd.