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Klinisk og genetisk evaluering af individer med udiagnosticerede lidelser gennem netværket for udiagnosticerede sygdomme

Klinisk og genetisk evaluering af patienter med udiagnosticerede lidelser gennem netværket for udiagnosticerede sygdomme

Without an explanation for severe and sometimes life-threatening symptoms, patients and their families are left in a state of unknown. Many individuals find themselves being passed from physician to physician, undergoing countless and often repetitive tests in the hopes of finding answers and insight about what the future may hold. This long and arduous journey to find a diagnosis does not end for many patients- the Office of Rare Diseases Research (ORDR) notes that 6% of individuals seeking their assistance have an undiagnosed disorder. In 2008, the National Institutes of Health (NIH) Undiagnosed Diseases Program (UDP) was established with the goal of providing care and answers for these individuals with mysterious conditions who have long eluded diagnosis. The NIH UDP is a joint venture of the NIH ORDR, the National Human Genome Research Institute Intramural Research Program (NHGRI-IRP), and the NIH Clinical Research Center (CRC) (1-3). The goals of the NIH UDP are to: (1) provide answers for patients with undiagnosed diseases; (2) generate new knowledge about disease mechanisms; (3) assess the application of new approaches to phenotyping and the use of genomic technologies; and (4) identify potential therapeutic targets, if possible. To date, the UDP has evaluated 3300 medical records and admitted 750 individuals with rare and undiagnosed conditions to the NIH Clinical Center. The NIH UDP has identified more than 70 rare disease diagnoses and several new conditions. The success of the NIH UDP prompted the NIH Common Fund to support the establishment of a network of medical research centers, the Undiagnosed Diseases Network (UDN), for fiscal years 2013-2020. The clinical sites will perform extensive phenotyping, genetic analyses, and functional studies of potential disease-causing variants. The testing performed on patients involves medically indicated studies intended to help reach a diagnosis, as well as research investigations that include a skin biopsy, blood draws, and DNA analysis. In addition, the UDN will further the goals of the UDP by permitting the sharing of personally identifiable phenotypic and genotypic information within the network. By sharing participant information and encouraging collaboration, the UDN hopes to improve the understanding of rare conditions and advance the diagnostic process and care for individuals with undiagnosed diseases.

Studieoversigt

Status

Rekruttering

Betingelser

Detaljeret beskrivelse

Without an explanation for severe and sometimes life-threatening symptoms, patients and their families are left in a state of unknown. Many individuals find themselves being passed from physician to physician, undergoing countless and often repetitive tests in the hopes of finding answers and insight about what the future may hold. This long and arduous journey to find a diagnosis does not end for many patients- the Office of Rare Diseases Research (ORDR) notes that 6% of individuals seeking their assistance have an undiagnosed disorder. In 2008, the National Institutes of Health (NIH) Undiagnosed Diseases Program (UDP) was established with the goal of providing care and answers for these individuals with mysterious conditions who have long eluded diagnosis. The NIH UDP is a joint venture of the NIH ORDR, the National Human Genome Research Institute Intramural Research Program (NHGRI-IRP), and the NIH Clinical Research Center (CRC) (1-3). The goals of the NIH UDP are to: (1) provide answers for patients with undiagnosed diseases; (2) generate new knowledge about disease mechanisms; (3) assess the application of new approaches to phenotyping and the use of genomic technologies; and (4) identify potential therapeutic targets, if possible.1-3 Prior to formation of the Undiagnosed Diseases Network (UDN), the UDP had evaluated 3300 medical records, admitted 750 individuals with rare and undiagnosed conditions to the NIH, and identified more than 70 rare disease diagnoses and several new conditions. The success of the NIH UDP prompted the NIH Common Fund to support the establishment of a network of medical research centers, the UDN, for fiscal years 2013-2022. The clinical sites perform extensive phenotyping, genetic analyses, and functional studies of potential disease-causing variants. The testing performed on patients involves medically indicated studies intended to help reach a diagnosis, as well as research investigations that include a skin biopsy, blood draws, and DNA analysis. In addition, the UDN is furthering the goals of the UDP by permitting the sharing of personally identifiable phenotypic and genotypic information within the network. By sharing participant information and encouraging collaboration, the UDN hopes to improve the understanding of rare conditions and advance the diagnostic process and care for individuals with undiagnosed diseases.

Undersøgelsestype

Observationel

Tilmelding (Anslået)

20000

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

    • Alabama
      • Birmingham, Alabama, Forenede Stater, 35233
        • Rekruttering
        • University of Alabama at Birmingham
        • Kontakt:
      • Huntsville, Alabama, Forenede Stater, 35806
        • Afsluttet
        • HudsonAlpha Institute for Biotechnology, Inc.
    • California
      • Los Angeles, California, Forenede Stater, 90095
        • Rekruttering
        • University of California, Los Angeles
        • Kontakt:
      • Orange, California, Forenede Stater, 92668
        • Rekruttering
        • University of California, Irvine Medical Center
        • Kontakt:
      • Stanford, California, Forenede Stater, 94305
        • Rekruttering
        • Leland Stanford Junior University
        • Kontakt:
      • Stanford, California, Forenede Stater, 94305
        • Rekruttering
        • Stanford Hospital and Clinics
        • Kontakt:
      • Stanford, California, Forenede Stater, 94020
        • Afsluttet
        • Lucile Salter Packard Children's Hospital at Stanford
      • Stanford, California, Forenede Stater, 94305-5584
        • Rekruttering
        • Stanford University
        • Kontakt:
    • District of Columbia
      • Washington D.C., District of Columbia, Forenede Stater, 20010
    • Florida
      • Miami, Florida, Forenede Stater, 33136
        • Rekruttering
        • University of Miami Miller School of Medicine
        • Kontakt:
    • Illinois
      • Chicago, Illinois, Forenede Stater, 60611
        • Ikke rekrutterer endnu
        • Lurie Children s Hospital
        • Kontakt:
    • Indiana
      • Indianapolis, Indiana, Forenede Stater, 46202-5262
        • Rekruttering
        • Indiana University
        • Kontakt:
          • Stephane Ware, M.D.
          • Telefonnummer: 317-274-8938
          • E-mail: stware@iu.edu
    • Maryland
      • Bethesda, Maryland, Forenede Stater, 20892
        • Rekruttering
        • National Institutes of Health Clinical Center
        • Kontakt:
          • For more information at the NIH Clinical Center contact Office of Patient Recruitment (OPR)
          • Telefonnummer: TTY dial 711 800-411-1222
          • E-mail: ccopr@nih.gov
    • Massachusetts
      • Boston, Massachusetts, Forenede Stater, 02115
        • Rekruttering
        • Brigham and Women's Hospital
        • Kontakt:
      • Boston, Massachusetts, Forenede Stater, 02114
        • Rekruttering
        • Massachusetts General Hospital
        • Kontakt:
      • Boston, Massachusetts, Forenede Stater, 02115
      • Boston, Massachusetts, Forenede Stater, 02115
        • Ikke rekrutterer endnu
        • Harvard U Faculty of Medicine
        • Kontakt:
      • Boston, Massachusetts, Forenede Stater, 02115
        • Afsluttet
        • Harvard T.H. Chan School of Public Health
    • Minnesota
      • Rochester, Minnesota, Forenede Stater, 55905
    • Missouri
      • St Louis, Missouri, Forenede Stater, 63110
        • Rekruttering
        • Washington University in St. Louis
        • Kontakt:
    • New York
      • New York, New York, Forenede Stater, 10013
        • Aktiv, ikke rekrutterende
        • New York Genome Center
    • North Carolina
      • Durham, North Carolina, Forenede Stater, 27710
        • Rekruttering
        • Duke University Health System
        • Kontakt:
    • Oregon
      • Eugene, Oregon, Forenede Stater, 97403
        • Ikke rekrutterer endnu
        • University of Oregon
        • Kontakt:
      • Portland, Oregon, Forenede Stater, 97201-3098
        • Afsluttet
        • Oregon Health Sciences University
    • Pennsylvania
      • Philadelphia, Pennsylvania, Forenede Stater, 19104
        • Rekruttering
        • Children's Hospital of Philadelphia
        • Kontakt:
      • Philadelphia, Pennsylvania, Forenede Stater, 19104-6056
    • Tennessee
      • Nashville, Tennessee, Forenede Stater, 37232
        • Rekruttering
        • Vanderbilt University Medical Center
        • Kontakt:
    • Texas
      • Houston, Texas, Forenede Stater, 77030
        • Rekruttering
        • Baylor College of Medicine
        • Kontakt:
          • Brendan Lee, M.D.
          • Telefonnummer: 713-798-8835
          • E-mail: blee@bcm.edu
    • Utah
      • Salt Lake City, Utah, Forenede Stater, 84112
    • Washington
      • Richland, Washington, Forenede Stater, 99354
        • Afsluttet
        • Pacific Northwest National Laboratory
      • Seattle, Washington, Forenede Stater, 98195
        • Rekruttering
        • University of Washington
        • Kontakt:
          • Gail Jarvik, M.D.
          • Telefonnummer: Not Listed
          • E-mail: pair@uw.edu
      • Seattle, Washington, Forenede Stater, 98101
    • Wisconsin
      • Milwaukee, Wisconsin, Forenede Stater, 53226
        • Rekruttering
        • Medical College of Wisconsin

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

1 måned til 100 år (Barn, Voksen, Ældre voksen)

Tager imod sunde frivillige

Ja

Køn, der er berettiget til at studere

Alle

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

Individuals with undiagnosed conditions

Beskrivelse

  • INCLUSION CRITERIA:

Ideal participants for tier 2-4 evaluations include individuals with:

  • One or more objective findings pertinent to the phenotype for which a case was submitted.
  • No diagnosis despite evaluation by specialists who assessed the patient for the objective finding(s).
  • Agreement for the storage and sharing of information and biomaterials, in an identified fashion amongst the UDN centers, and in a de-identified fashion to research sites beyond the network.

Participants unable to consent can be enrolled.

EXCLUSION CRITERIA:

Individuals who are unlikely to be assigned to tier 2-4 evaluations include those with:

  • Reported symptoms with no relevant objective findings.
  • A diagnosis explaining objective findings.
  • A diagnosis suggested on record review.
  • Unwillingness to share data.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Observationsmodeller: CASE_ONLY
  • Tidsperspektiver: PROSPECTIVE

Kohorter og interventioner

Gruppe / kohorte
Undiagnosed disorders

Patients with rare, undiagnosed disorders.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Create an integrated and collaborative research community across multiple clinical sites and between laboratory and clinical investigators prepared to investigate the pathophysiology of these new and rare diseases, the impact of the diagnostic p...
Tidsramme: Day 1-5 and followup

Create an integrated and collaborative research community across multiple clinical sites and between laboratory and clinical investigators prepared to investigate the pathophysiology of these new and rare diseases, the impact of the diagnostic process on patients and families, and share this understanding to identify improved options for optimal patient management.

Day 1-5 and followup
Facilitate research into the etiology of undiagnosed diseases, by collecting and sharing standardized, high-quality clinical and laboratory data including genotyping, phenotyping, and documentation of environmental exposures
Tidsramme: Day 1-5 and followup

Facilitate research into the etiology of undiagnosed diseases, by collecting and sharing standardized, high-quality clinical and laboratory data including genotyping, phenotyping, and documentation of environmental exposures.

Day 1-5 and followup
Improve the level of diagnosis and care for patients with undiagnosed diseases through the development of common and site-specific protocols designed by an enlarged community of investigators
Tidsramme: Day 1-5 and followup

Improve the level of diagnosis and care for patients with undiagnosed diseases through the development of common and site-specific protocols designed by an enlarged community of investigators.

Day 1-5 and followup

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Efterforskere

  • Ledende efterforsker: William A Gahl, M.D., National Human Genome Research Institute (NHGRI)

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

16. september 2015

Primær færdiggørelse (Anslået)

16. september 2099

Studieafslutning (Anslået)

31. december 2099

Datoer for studieregistrering

Først indsendt

19. maj 2015

Først indsendt, der opfyldte QC-kriterier

19. maj 2015

Først opslået (Anslået)

21. maj 2015

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

3. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

2. november 2026

Sidst verificeret

28. oktober 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • 150130
  • 15-HG-0130

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ingen

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .