Search

The United States (U.S.) National Institutes of Health-funded Environmental influences on Child Health Outcomes (ECHO)-wide Cohort was established to conduct high impact, transdisciplinary science to improve child health and development. The cohort is a collaborative research design in which both extant and new data are contributed by over 57,000 children across 69 cohorts. In this review article, we focus on two key challenging issues in the ECHO-wide Cohort: data collection standardization and data harmonization. Data standardization using a Common Data Model and derived analytical variables based on a team science approach should facilitate timely analyses and reduce errors due to data misuse. However, given the complexity of collaborative research designs, such as the ECHO-wide Cohort, dedicated time is needed for harmonization and derivation of analytic variables. These activities need to be done methodically and with transparency to enhance research reproducibility. IMPACT: Many collaborative research studies require data harmonization either prior to analyses or in the analyses of compiled data. The Environmental influences on Child Health Outcomes (ECHO) Cohort pools extant data with new data collection from over 57,000 children in 69 cohorts to conduct high-impact, transdisciplinary science to improve child health and development, and to provide a national database and biorepository for use by the scientific community at-large. We describe the tools, systems, and approaches we employed to facilitate harmonized data for impactful analyses of child health outcomes., (© 2024. The Author(s).)

We used the National Institutes of Health (NIH) criteria for the diagnosis, classification and scoring of chronic GVHD (cGVHD) to reevaluate patients with cGVHD originally diagnosed using classic criteria. We retrieved data from 236 patients diagnosed with cGVHD on the basis of classic criteria. Excluding 20 'liver-alone' patients, we re-categorized 216 patients in keeping with the NIH criteria. Twenty patients were reclassified as having acute GVHD and 196 patients as having cGVHD (170 'classic chronic' (Cl-Ch) and 26 'overlap chronic' (Ov-Ch)). The 5-year GVHD-specific survival (GSS) was significantly different between the two cGVHD subtypes, specifically 87.3% for Cl-Ch vs 70.2% for Ov-Ch (P=0.006). The NIH severity criteria were effective in expecting 5-year GSS rates at both the onset (93.5, 81.3 and 79.7% (P=0.047)) and peak intensity of the disease (100, 89.7 and 78.7% (P=0.004) for the mild, moderate and severe grade, respectively). Multivariate analysis showed that NIH severity criteria were independently significant prognostic factors for GSS (mild vs moderate, HR 4.35, P=0.036; mild vs severe, HR 5.25, P=0.020). Our results support the role of the NIH criteria in classifying cGVHD and in assessing the severity of the disease to predict patient prognosis of cGVHD.