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Published in: Orphanet Journal of Rare Diseases 1/2012

Open Access 01-12-2012 | Research

The treatable intellectual disability APP www.treatable-id.org: A digital tool to enhance diagnosis & care for rare diseases

Authors: Clara D M van Karnebeek, Roderick F A Houben, Mirafe Lafek, Wynona Giannasi, Sylvia Stockler

Published in: Orphanet Journal of Rare Diseases | Issue 1/2012

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Abstract

Background

Intellectual disability (ID) is a devastating and frequent condition, affecting 2-3% of the population worldwide. Early recognition of treatable underlying conditions drastically improves health outcomes and decreases burdens to patients, families and society. Our systematic literature review identified 81 such inborn errors of metabolism, which present with ID as a prominent feature and are amenable to causal therapy. The WebAPP translates this knowledge of rare diseases into a diagnostic tool and information portal.

Methods & results

Freely available as a WebAPP via http://​www.​treatable-id.​org and end 2012 via the APP store, this diagnostic tool is designed for all specialists evaluating children with global delay / ID and laboratory scientists. Information on the 81 diseases is presented in different ways with search functions: 15 biochemical categories, neurologic and non-neurologic signs & symptoms, diagnostic investigations (metabolic screening tests in blood and urine identify 65% of all IEM), therapies & effects on primary (IQ/developmental quotient) and secondary outcomes, and available evidence For each rare condition a ‘disease page’ serves as an information portal with online access to specific genetics, biochemistry, phenotype, diagnostic tests and therapeutic options. As new knowledge and evidence is gained from expert input and PubMed searches this tool will be continually updated. The WebAPP is an integral part of a protocol prioritizing treatability in the work-up of every child with global delay / ID. A 3-year funded study will enable an evaluation of its effectiveness.

Conclusions

For rare diseases, a field for which financial and scientific resources are particularly scarce, knowledge translation challenges are abundant. With this WebAPP technology is capitalized to raise awareness for rare treatable diseases and their common presenting clinical feature of ID, with the potential to improve health outcomes. This innovative digital tool is designed to motivate health care providers to search actively for treatable causes of ID, and support an evidence-based approach to rare metabolic diseases. In our current –omics world with continuous information flow, the effective synthesis of data into accessible, clinical knowledge has become ever more essential to bridge the gap between research and care.
Appendix
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Literature
1.
go back to reference Luckasson R, Reeve A: Naming, defining, and classifying in mental retardation. Ment Retard. 2001, 39: 47-52. 10.1352/0047-6765(2001)039<0047:NDACIM>2.0.CO;2.CrossRefPubMed Luckasson R, Reeve A: Naming, defining, and classifying in mental retardation. Ment Retard. 2001, 39: 47-52. 10.1352/0047-6765(2001)039<0047:NDACIM>2.0.CO;2.CrossRefPubMed
2.
go back to reference Shevell M: Present conceptualization of early childhood neurodevelopmental disabilities. J Child Neurol. 2010, 25: 120-126. 10.1177/0883073809336122.CrossRefPubMed Shevell M: Present conceptualization of early childhood neurodevelopmental disabilities. J Child Neurol. 2010, 25: 120-126. 10.1177/0883073809336122.CrossRefPubMed
3.
go back to reference Jansen DE, Krol B, Groothoff JW, Post D: People with intellectual disability and their health problems: a review of comparative studies. J Intellect Disabil Res. 2004, 48: 93-102. 10.1111/j.1365-2788.2004.00483.x.CrossRefPubMed Jansen DE, Krol B, Groothoff JW, Post D: People with intellectual disability and their health problems: a review of comparative studies. J Intellect Disabil Res. 2004, 48: 93-102. 10.1111/j.1365-2788.2004.00483.x.CrossRefPubMed
4.
go back to reference Oeseburg B, Jansen DEMC, Groothoff JW, Dijkstra GJ, Reijneveld SA: Emotional and behavioural problems in adolescents with intellectual disability with and without chronic diseases. J Intellect Disabil Res. 2010, 54: 81-99. 10.1111/j.1365-2788.2009.01231.x.CrossRefPubMed Oeseburg B, Jansen DEMC, Groothoff JW, Dijkstra GJ, Reijneveld SA: Emotional and behavioural problems in adolescents with intellectual disability with and without chronic diseases. J Intellect Disabil Res. 2010, 54: 81-99. 10.1111/j.1365-2788.2009.01231.x.CrossRefPubMed
5.
go back to reference Shevell M: Global developmental delay and mental retardation or intellectual disability: conceptualization, evaluation, and etiology. Pediatr Clin N Am. 2008, 55: 1071-1084. 10.1016/j.pcl.2008.07.010.CrossRef Shevell M: Global developmental delay and mental retardation or intellectual disability: conceptualization, evaluation, and etiology. Pediatr Clin N Am. 2008, 55: 1071-1084. 10.1016/j.pcl.2008.07.010.CrossRef
6.
go back to reference Meerding WJ, Bonneux L, Polder JJ, Koopmanschap MA, van der Maas PJ: Demographic and epidemiological determinants of healthcare costs in Netherlands: cost of illness study. BMJ. 1998, 317: 111-117. 10.1136/bmj.317.7151.111.PubMedCentralCrossRefPubMed Meerding WJ, Bonneux L, Polder JJ, Koopmanschap MA, van der Maas PJ: Demographic and epidemiological determinants of healthcare costs in Netherlands: cost of illness study. BMJ. 1998, 317: 111-117. 10.1136/bmj.317.7151.111.PubMedCentralCrossRefPubMed
7.
go back to reference van Karnebeek CDM, Scheper FY, Abeling NG, Alders M, Barth PG, Hoovers JMN, Koevoets C, Wanders RJ, Hennekam RC: Etiology of mental retardation in children referred to a tertiary care center: A prospective study. Am J Ment Retard. 2005, 110: 253-267. 10.1352/0895-8017(2005)110[253:EOMRIC]2.0.CO;2.CrossRefPubMed van Karnebeek CDM, Scheper FY, Abeling NG, Alders M, Barth PG, Hoovers JMN, Koevoets C, Wanders RJ, Hennekam RC: Etiology of mental retardation in children referred to a tertiary care center: A prospective study. Am J Ment Retard. 2005, 110: 253-267. 10.1352/0895-8017(2005)110[253:EOMRIC]2.0.CO;2.CrossRefPubMed
8.
go back to reference Moeschler J: Genetic evaluation of intellectual disabilities. Semin Ped Neurol. 2008, 15: 2-9. 10.1016/j.spen.2008.01.002.CrossRef Moeschler J: Genetic evaluation of intellectual disabilities. Semin Ped Neurol. 2008, 15: 2-9. 10.1016/j.spen.2008.01.002.CrossRef
9.
go back to reference van Karnebeek CDM, Jansweijer MCE, Leenders AGE, Offringa M, Hennekam RCM: Diagnostic investigations in individuals with mental retardation: a systematic literature review. Eur J Hum Genet. 2005, 13: 6-25. 10.1038/sj.ejhg.5201279.CrossRefPubMed van Karnebeek CDM, Jansweijer MCE, Leenders AGE, Offringa M, Hennekam RCM: Diagnostic investigations in individuals with mental retardation: a systematic literature review. Eur J Hum Genet. 2005, 13: 6-25. 10.1038/sj.ejhg.5201279.CrossRefPubMed
10.
go back to reference Manning M, Hudgins L: Professional Practice and Guidelines Committee: Array-based technology and recommendations for utilization in medical genetics practice for detection of chromosomal abnormalities. Genet Med. 2010, 12: 742-745. 10.1097/GIM.0b013e3181f8baad.PubMedCentralCrossRefPubMed Manning M, Hudgins L: Professional Practice and Guidelines Committee: Array-based technology and recommendations for utilization in medical genetics practice for detection of chromosomal abnormalities. Genet Med. 2010, 12: 742-745. 10.1097/GIM.0b013e3181f8baad.PubMedCentralCrossRefPubMed
11.
go back to reference Michelson DJ, Shevell MI, Sherr EH, Moeschler JB, Gropman AL, Ashwal S: Evidence report: genetic and metabolic testing on children with global developmental delay: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 2011, 77: 1629-1635. 10.1212/WNL.0b013e3182345896.CrossRefPubMed Michelson DJ, Shevell MI, Sherr EH, Moeschler JB, Gropman AL, Ashwal S: Evidence report: genetic and metabolic testing on children with global developmental delay: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 2011, 77: 1629-1635. 10.1212/WNL.0b013e3182345896.CrossRefPubMed
12.
go back to reference Shevell M: Metabolic evaluation in neurodevelopmental disabilities. Ann Neurol. 2008, 65: 483-484.CrossRef Shevell M: Metabolic evaluation in neurodevelopmental disabilities. Ann Neurol. 2008, 65: 483-484.CrossRef
13.
go back to reference van Karnebeek CDM, Stockler S: Treatable inborn errors of metabolism causing intellectual disability: a systematic literature review. Mol Genet Metab. 2012, 105: 368-381. 10.1016/j.ymgme.2011.11.191.CrossRefPubMed van Karnebeek CDM, Stockler S: Treatable inborn errors of metabolism causing intellectual disability: a systematic literature review. Mol Genet Metab. 2012, 105: 368-381. 10.1016/j.ymgme.2011.11.191.CrossRefPubMed
14.
go back to reference Graham ID, Tetroe J, KT Theories Group: Planned action theories. In Knowledge Translation in Health Care: Moving from Evidence to Practice. Edited by: Straus SE, Tetroe JM, Graham ID. 2009, Wiley-Blackwel, Oxford, 185-195. Graham ID, Tetroe J, KT Theories Group: Planned action theories. In Knowledge Translation in Health Care: Moving from Evidence to Practice. Edited by: Straus SE, Tetroe JM, Graham ID. 2009, Wiley-Blackwel, Oxford, 185-195.
15.
go back to reference Patton MQ: Utilization-Focused Evaluation 4th edition. Sage Publishing, Los Angeles; 2008. Patton MQ: Utilization-Focused Evaluation 4th edition. Sage Publishing, Los Angeles; 2008.
16.
go back to reference Hunter D, Killoran A: Towards an evidence-based APProach to tackling health inequalities: the English experience. Health Educ J. 2004, 63: 7-14. 10.1177/001789690406300103.CrossRef Hunter D, Killoran A: Towards an evidence-based APProach to tackling health inequalities: the English experience. Health Educ J. 2004, 63: 7-14. 10.1177/001789690406300103.CrossRef
17.
go back to reference Woolf S: The meaning of translational research and why it matters. JAMA. 2008, 299: 211-213. 10.1001/jama.2007.26.PubMed Woolf S: The meaning of translational research and why it matters. JAMA. 2008, 299: 211-213. 10.1001/jama.2007.26.PubMed
18.
go back to reference Straus SE, Brouwers M, Johnson D, Lavis JN, Légaré F, Majumdar SR, McKibbon KA, Sales AE, Stacey D, Klein G, Grimshaw J: KT Canada Strategic Training Initiative in Health Research (STIHR): Core competencies in the science and practice of knowledge translation: description of a Canadian strategic training initiative. Implement Sci. 2011, 6: 127-10.1186/1748-5908-6-127.PubMedCentralCrossRefPubMed Straus SE, Brouwers M, Johnson D, Lavis JN, Légaré F, Majumdar SR, McKibbon KA, Sales AE, Stacey D, Klein G, Grimshaw J: KT Canada Strategic Training Initiative in Health Research (STIHR): Core competencies in the science and practice of knowledge translation: description of a Canadian strategic training initiative. Implement Sci. 2011, 6: 127-10.1186/1748-5908-6-127.PubMedCentralCrossRefPubMed
Metadata
Title
The treatable intellectual disability APP www.treatable-id.org: A digital tool to enhance diagnosis & care for rare diseases
Authors
Clara D M van Karnebeek
Roderick F A Houben
Mirafe Lafek
Wynona Giannasi
Sylvia Stockler
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Orphanet Journal of Rare Diseases / Issue 1/2012
Electronic ISSN: 1750-1172
DOI
https://doi.org/10.1186/1750-1172-7-47

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