Patient registries in the field of rare diseases



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17  



 

Anonymised  data  are  useful  in  allowing  information  sharing  for  research  purposes  with 

minimum risk. Anonymisation techniques should be standardized to ensure their robustness.  

 

Patient  organisations  (or  patients,  when  no  organisation  exists)  should  be  involved  in  the 



elaboration  of  the  consent  form  and  the  consent  form  process  in  order  to  ensure  the  best 

understanding of the information provided. 

 

 

Protection of patient privacy 

 

As  a  principle,  research  use  of  identifiable  patient  information  is  subject  to  legal 

requirements.  The  identifiability  can  be  direct  or  indirect.  Especially  in  the  field  of  RD,  a 

patient with a specific diagnosis, located in a defined place may be easily identified as being 

the  only  one.  It  is  recommended  to  consult  with  the  appropriate  national  authorities  in 

charge of data protection to ensure compliance with requested standards. 



 

 

 



Transparency, oversight and ownership 

 

Transparency 

 

Transparency contributes to public and professional confidence in the scientific integrity and 



validity of registry, and promotes inquiries from other interested parties. Registry developers 

achieve  transparency  by  making  the  PR  objectives,  governance,  eligibility  criteria,  sampling 

and  recruitment  strategies,  general  operating  protocol,  sources  of  data  and  of  funding, 

available to anyone. Creating a website describing all these elements is one way to achieve 

transparency. 

 

Security 

 

Good  security  is  essential  for  legal,  ethical  and  operational  considerations.  It  should  not  be 

underestimated. Security is easier to maintain on a dedicated server, but that also requires a 

backup strategy and an intrusion detection system on the server itself to avoid hackers.  

 

Oversight 

 

The independence of a PR depends more on its governance and the funding conditions than 

on the origin of the funding. Possible governing structures can vary widely depending on the 

project.  The  PR  developer  can  be  the  sole  decision-maker,  but  usually  there  is  a  governing 

board including all stakeholders: the data providers, the patient organisation(s), the funding 

agency,  the  professionals  running  the  PR  (clinical  researchers,  statisticians,  information 

technology  specialists).  It  is  also  desirable  to  appoint  an  independent  advisory  board  to 

provide oversight of registry operations, particularly regarding the scientific independence. 



RDTF Report on patient registries in the field of rare diseases (June 2011) 

 

                                                      



                                                                                                                                

 

18  



 

 

The governing structure has to control that provision is specified to ensure continued care 



of the database under any circumstances. 

 

Ownership 



 

The  concept  of  ownership  does  not  fit  health  information  comfortably  as  it  fails  to 

acknowledge  individual  patient  privacy  interests  in  health  information.  Alternatively,  the 

legal  concept  of  custody  is  useful.  Custodians  have  legal  rights  and  responsibilities,  among 

which to preserve privacy and dignity of individual patients. Custody is also transferable from 

one custodian to another, which is particularly relevant for PR which are long-term projects. 

 

Agreements  about  ownership  of  data  and  access  to  data  should  be  determined  by  multi-



party contracts and not regulated by legislation. Practices should be based on the following 

principles: 

 

The  subject  should  always  be  considered  as  a  primary  controller  of  its  data  and 



information  directly  derived  from  it.  Once  the  information  has  been  processed,  it 

becomes  research  data  (i.e.  data)  unless  there  is  agreed  private  ownership.  The 

processor and/or principle investigator of data should be considered as the guardian 

of the data. As such, it is up to this person to take all the appropriate steps to protect 

the  data,  its  storage,  use  and  access.  It  follows  that  the  researcher  holds  ultimate 

intellectual property with due consideration for benefit sharing data. 

 

Ownership of data implies an actual or potential financial return. A protocol including 



the  donation  of  data  by  the  subject  to  the  researcher  eliminates  the  subjects 

expectation  of  an  individual  compensation,  but  no  the  possibility  of 

commercialisation by the researcher through traditional intellectual property rules. 

 



Use  of  collections  by  third  parties  should  be  allowed  providing  that  there  is  no 

transfer of ownership and that the use is in agreement with the present guidelines. 

 

PR  can  also  receive  Copyright  protection  as  they  satisfy  the  statutory  definition  of  a 



compilation. 

 

Finally, careful attention to the ethical considerations related to the design and operation of 



a  PR,  as  well  as  the  applicable  legal  requirements,  contributes  to  the  success  of  a  PR  and 

ensures  the  realisation  of  its  social  and  scientific  benefits.  A  quality  procedure  should  be 

implemented to ensure the compliance to the present guidelines. 

 

 



 

 

 



 

 

 



 

 

 



 

RDTF Report on patient registries in the field of rare diseases (June 2011) 

 

                                                      



                                                                                                                                

 

19  



 

Bibliography used for establishing this document 

 

1.



 

Gliklich  RE,  Dreyer  NA,  eds.  Registries  for  Evaluating  Patient  Outcomes:  a  user’s 

guide.  AHRQ  Publication  N°.  07-EHC001-1.  Rockville,  MD:  Agency  for  Healthcare 

Research and Quality. April 2007. 

2.

 

Godard  B,  Schmidtke  J,  Cassiman  JJ,  Aymé  S.:  Data  storage  and  DNA  banking  for  



biomedical 

research: 

informed 

consent, 

confidentiality, 

quality 

issues,  

ownership,  return  of  benefits.  A  professional  perspective.  Eur  J  Hum  Genet.  2003 

Dec;11 Suppl 2:S88-122 

3.

 

Report  of  the  EPPOSI  Workshop  “Patient  registries  for  rare  disorders”  18-19  March 



2009 

http://www.epposi.org/upl/1/en/doc/Registries%202009%20final.pdf

  

 

 



The correct form when quoting this document is: 

S.  Aymé,  A.  Kole,  C.  Rodwell  “RDTF  Report  on  Patient  registries  the  field  of  rare  diseases: 

Overview of the issues surrounding the establishment, governance and financing of academic 

registries”, June 2011.  

http://www.eucerd.eu/EUCERD/upload/file/RDTFReportRegistriesJuly2011.pdf

  

 

 



 

Annex 1: Participants at the workshop 13 March 2008 

 

Ségolène Aymé - Leader of RDTF, Director of Orphanet, France 



 

Fabrizia Bignami –Eurordis, France 

 

Jean Donadieu - Centre de référence des histiocytosis, Hôpital Trousseau, France 

 

Laura Fregonese - Stichting Alpha1 International Registry, Leiden University Medical 

Centre (LUMC), Netherlands 

 

Selena  Freisens  -  Senior  European  Registries  and  Expanded  Access  Manager, 

Genzyme Europe B.V., Netherlands 

 

Gemma  Gatta  -Surveillance  of  Rare  Cancers  in  Europe,  Istituto  Nazionale  per  lo 

Studio e la Cura dei Tumori, Italy 

 

Susan Graham - Associate Director Global Medical Affairs, Gaucher Disease, Genzyme 

Europe B.V. 

 

Herwig Jansen - Scientific Institute of Public Health, Belgium 

 

Anna Kole - RDTF Secretariat, France 

 

Odile Kremp- Institut de Veille Sanitaire, Unité Maladies Rares, France  


RDTF Report on patient registries in the field of rare diseases (June 2011) 

 

                                                      



                                                                                                                                

 

20  



 

 

Guglielmo Mariani - International Registry of Factor VII Congenital Deficiencies, 

Hematology and Bone Marrow Transplantation Unit, Italy 

 

Monica  Mazzucato  -  Epidemiology  and  Community  Medicine  Unit  –  Paediatric 

Department, University of Padua, Italy 

  

Christel Nourissier –Eurordis, France 

 

Roberta  Palla  -  A.  Bianchi  Bonomi  Hemophilia  and  Thrombosis  Center,  IRCCS 

Maggiore Hospital Mangiagalli and Regina Elena Foundation, University of Milan,  

Italy 

 

Manuel Posada - Istituto de Investigacion en Enfermedades Rares, Instituto de Salud 



Carlos III, Spain 

 

János Sándor  - National Centre for Healthcare Audit and Improvement, Budapest,   

Hungary 

 

Arrigo  Schieppati  -Mario  Negri  Institute  for  Pharmacological  Research,  Clinical 

Research Centre for Rare Diseases, Italy 

 

Stuart Tanner - EuroWilson Coordinator, University of Sheffield, United Kingdom 

 

Annalisa Trama - Centro Nazionale Malattie Rare, Istituto Superiore di Sanità, Italy 

 

Ha Trang - Coordinator of Centre of Reference for Ondine Syndrome, Hôpital Robert 

Debré, France 

 

 



Other contributors to the report in addition to workshop participants 

 

Helen Dolk - EUROCAT 

Tsveta Schyns - European Network for Research on Alternating Hemiplegia 

Liesbeth Siderius

 

- Stichting Shwachman Syndrome Support Netherlands



 

 

 

 

 



 

 

 



 

 

 



 

RDTF Report on patient registries in the field of rare diseases (June 2011) 

 

                                                      



                                                                                                                                

 

21  



 

Annex 2: List of rare disease registries in Europe 

 

Orphanet Report Series on Disease Registries in Europe (January 2011) 



http://www.orpha.net/orphacom/cahiers/docs/GB/Registries.pdf

  


Disease Registries in Europe

 

O

rphanet Report Series



Rare Diseases 

collection

January 2011

www.orpha.net

HEALTH-F2-2008-201230


2

http://www.orpha.net/orphacom/cahiers/docs/GB/Registries.pdf

Orphanet Report Series - Disease Registries in Europe - January 2011



Methodology 3

Summary 4

1- Distribution of registries by country 

4

2- Distribution of registries by coverage 

5

3- Distribution of registries by institution 

5

4- Network registries 

5

Distribution of registries by country 

6

European registries 

28

International registries 

30

Network registries 

31

Table of contents

3

http://www.orpha.net/orphacom/cahiers/docs/GB/Registries.pdf

Orphanet Report Series - Disease Registries in Europe - January 2011

Patient registries and databases constitute key instruments to develop clinical research in the field of rare 

diseases (RD), to improve patient care and healthcare planning. They are the only way to pool data in order 

to achieve a sufficient sample size for epidemiological and/or clinical research. They are vital to assess 

the feasibility of clinical trials, to facilitate the planning of appropriate clinical trials and to support the 

enrolment of patients.

Registries of patients treated with orphan drugs are particularly relevant as they allow the gathering of 

evidence on the effectiveness of the treatment and on its possible side effects, keeping in mind that mar-

keting authorisation is usually granted at a time when evidence is still limited although already somewhat 

convincing.

This report gather the information collected by Orphanet so far, regarding systematic collections of data for 

a specific disease or a group of diseases.

The concept of coverage (regional, national, european or international) that is associated with patient 

registries reflects the area of collection of a single physical database, to which several clinical entities are 

contributing.

The notion of networks corresponds to the relationship existing between several databases (or patient 

registries),  whether a  coordinating database exists or not.

Cancer registries are listed only if they belong to the network RARECARE or focus on a rare form of cancer.

American registries are listed only if they cover the European area and focus on a rare disease uncollected 

in Europe.

For any questions or comments, please contact us: 



 

contact.orphanet@inserm.fr

Methodology

4

http://www.orpha.net/orphacom/cahiers/docs/GB/Registries.pdf

Orphanet Report Series - Disease Registries in Europe - January 2011



Summary

1- Distribution of registries by country

CouNTRy

REgIoNal

NaTIoNal

EuRopEaN global

NoT 

DEfINED

ToTal

AT - Austria

1

12

2



0

0

15



BE - Belgium

2

16



1

1

0



20

BG - Bulgaria

0

4

0



0

0

4



CH - Switzerland

1

5



1

2

0



9

CY - Cyprus

0

1

0



0

0

1



CZ - Czech Republic

0

4



0

0

0



4

DE - Germany

4

57

20



5

0

86



DK - Denmark

1

3



0

0

0



4

EE - Estonia

0

2

0



0

0

2



ES - Spain

4

25



3

0

0



32

FI - Finland

0

5

0



0

0

5



FR - France

17

92



11

1

1



122

GR - Greece

0

2

0



0

0

2



HR - Croatia

0

1



0

0

0



1

HU - Hungary

0

3

0



0

0

3



IE - Ireland

4

6



0

0

0



10

IL - Israel

0

2

0



0

0

2



IS - Iceland

0

2



0

0

0



2

IT - Italy

9

35

2



5

0

51



LT - Lithuania

0

1



0

0

0



1

LU - Luxembourg

0

1

0



0

0

1



LV - Latvia

0

1



0

0

0



1

MK - Republic of Macedonia

0

1

0



0

0

1



MT - Malta

0

1



0

0

0



1

NL - Netherlands

1

6

3



5

0

15



NO - Norway

0

3



1

0

0



4

PL - Poland

3

6

0



0

0

9



PT - Portugal

1

8



0

0

0



9

RO - Romania

0

2

0



0

0

2



RS - Serbia

0

4



0

0

0



4

SE - Sweden

0

15

0



3

0

18



SI - Slovenia

0

2



0

0

0



2

SK - Slovakia

0

2

0



0

0

2



TR - Turkey

0

4



0

0

0



4

UA - Ukraine

0

1

0



0

0

1



UK - United Kingdom

13

38



6

1

0



58

US - United States of America

0

0

0



6

0

6



TOTAL

61

373



50

29

1



514

5

http://www.orpha.net/orphacom/cahiers/docs/GB/Registries.pdf

Orphanet Report Series - Disease Registries in Europe - January 2011



2- Distribution of registries by coverage

3- Distribution of registries by institution

INSTITuTIoN

NuMbER of REgISTRIES

ACADEMIC


490

PATIENT ORGANISATION

8

PRIVATE COMPANY



16

TOTAL


514

NETWoRKS

NuMbER of NETWoRKS

TOTAL


9

4- Network registries

CoVERagE

NuMbER of REgISTRIES

REGIONAL


61

NATIONAL


373

EUROPEAN


50

GLOBAL


29

NOT DEFINED

1

TOTAL


514

6

http://www.orpha.net/orphacom/cahiers/docs/GB/Registries.pdf

Orphanet Report Series - Disease Registries in Europe - January 2011



Distribution of registries by country

aT - auSTRIa (15 registries)

ENglISh labEl of ThE aCTIVITy

CoVERagE

INSTITuTIoN

Austrian acromegaly registry

National

Academia


Austrian alpha-1 antitrypsin deficiency registry - 

contributes to the Alpha One International Registry (AIR)

National

Academia


Austrian brain tumor registry

National


Academia

Austrian cancer registry - contributes to the RARECARE 

project

National


Academia

Austrian chronic myeloid leukemia registry

National

Academia


Austrian cystic fibrosis patient registry - contributes to the 

EUROCARE CF registry

National

Academia


Austrian Haemophilia Registry

National


Academia

Austrian Huntington disease registry

National

Academia


Austrian myeloma registry

National


Academia

Austrian registry for inborn errors of metabolism

National

Academia


Austrian severe chronic neutropenia patient registry - 

contributes to the SCN international registry (SCNIR)

National

Academia


EMSA-SG: central patient registry of the European multiple 

system atrophy network

European

Academia


ENRAH: European alternating hemiplegia and rare 

epilepsies registry in childhood

European

Academia


MDS: Austrian myelodysplastic syndromes patient registry

National


Academia

Styrian registry of congenital anomalies - contributes to 

the EUROCAT network

Regional


Academia

bE - bElgIuM (20 registries)

ENglISh labEl of ThE aCTIVITy

CoVERagE

INSTITuTIoN

ACROBEL: the Belgian registry on acromegaly, epidemiology 

and quality of care

National


Academia

Antwerpen registry of congenital anomalies - contributes 

to the EUROCAT network

Regional


Academia

Belgian alpha-1 antitrypsin deficiency registry - 

contributes to the Alpha One International Registry (AIR)

National


Academia

Belgian cystic fibrosis patient registry (BMR-RBM) - 

contributes to the EUROCARE CF and the ECFS registries

National


Academia

Belgian familial adenomatous polyposis registry

National

Academia


Belgian Neuromuscular Disease Registry

National


Academia

Belgian patient database for Wilson disease - contributes 

to the EuroWilson registry

National


Academia

Belgian patient registry for Duchenne and Becker muscular 

dystrophy - part of the TREAT-NMD network

National


Academia

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