Defining Natural History: Assessment of the Ability of College Students to Aid in Characterizing Clinical Progression of Niemann-Pick Disease, Type C

PLOS ONE, October 2011

21984891

Jenny Shin, Katrina Epperson, Nicole M. Yanjanin, Jennifer Albus, Laura Borgenheimer, Natalie Bott, Erin Brennan, Daniel Castellanos, Melissa Cheng, Michael Clark, Margaret Devany, Courtney Ensslin, Nina Farivari, Shanik Fernando, Lauren Gabriel, Rani Gallardo, Moriah Castleman, Olimpia Gutierrez, Allison Herschel, Sarah Hodge, Anne Horst, Mary Howard, Evan James, Lindsey Jones, Mary Kearns, Mary Kelly, Christine Kim, Kinzie Kiser, Gregory Klazura, Chris Knoedler, Emily Kolbus, Lauren Lange, Joan Lee, Eileena Li, Wei Lu, Andrew Luttrell, Emily Ly, Katherine McKeough, Brianna McSorley, Catherine Miller, Sean Mitchell, Abbey Moon, Kevin Moser, Shane O'Brien, Paula Olivieri, Aaron Patzwahl, Marie Pereira, Craig Pymento, Erin Ramelb, Bryce Ramos, Teresa Raya, Stephen Riney, Geoff Roberts, Mark Robertshaw, Frannie Rudolf, Samuel Rund, Stephanie Sansone, Lindsay Schwartz, Ryan Shay, Edwin Siu, Timothy Spear, Catherine Tan, Marisa Truong, Mairaj Uddin, Jennifer VanTrieste, Omar Veloz, Elizabeth White, Forbes D. Porter, Kasturi Haldar

Niemann-Pick Disease, type C (NPC) is a fatal, neurodegenerative, lysosomal storage disorder. It is a rare disease with broad phenotypic spectrum and variable age of onset. These issues make it difficult to develop a universally accepted clinical outcome measure to assess urgently needed therapies. To this end, clinical investigators have defined emerging, disease severity scales. The average time from initial symptom to diagnosis is approximately 4 years. Further, some patients may not travel to specialized clinical centers even after diagnosis. We were therefore interested in investigating whether appropriately trained, community-based assessment of patient records could assist in defining disease progression using clinical severity scores. In this study we evolved a secure, step wise process to show that pre-existing medical records may be correctly assessed by non-clinical practitioners trained to quantify disease progression. Sixty-four undergraduate students at the University of Notre Dame were expertly trained in clinical disease assessment and recognition of major and minor symptoms of NPC. Seven clinical records, randomly selected from a total of thirty seven used to establish a leading clinical severity scale, were correctly assessed to show expected characteristics of linear disease progression. Student assessment of two new records donated by NPC families to our study also revealed linear progression of disease, but both showed accelerated disease progression, relative to the current severity scale, especially at the later stages. Together, these data suggest that college students may be trained in assessment of patient records, and thus provide insight into the natural history of a disease.