Development of Common Data Elements for Use in Chiari Malformation Type I Clinical Research: An NIH/NINDS Project

Abstract

The management of Chiari I malformation (CMI) is controversial because treatment methods vary and treatment decisions rest on incomplete understanding of its complex symptom patterns, etiologies, and natural history. Validity of studies that attempt to compare treatment of CMI has been limited because of variable terminology and methods used to describe study subjects. The goal of this project was to standardize terminology and methods by developing a comprehensive set of Common Data Elements (CDEs), data definitions, case report forms (CRFs), and outcome measure recommendations for use in CMI clinical research, as part of the CDE project at the National Institute of Neurological Disorders and Stroke (NINDS) of the US National Institutes of Health. A working group, comprising over 30 experts, developed and identified CDEs, template CRFs, data dictionaries, and guidelines to aid investigators starting and conducting CMI clinical research studies. The recommendations were compiled, internally reviewed, and posted online for external public comment. In October 2016, version 1.0 of the CMI CDE recommendations became available on the NINDS CDE website. The recommendations span these domains: Core Demographics/Epidemiology; Presentation/Symptoms; Co-Morbidities/Genetics; Imaging; Treatment; and Outcome. Widespread use of CDEs could facilitate CMI clinical research trial design, data sharing, retrospective analyses, and consistent data sharing between CMI investigators around the world. Updating of CDEs will be necessary to keep them relevant and applicable to evolving research goals for understanding CMI and its treatment.

Correlation of a new hydrodynamic index with other effective indexes in Chiari I malformation patients with different associations

“…Neural/dural structures in the craniocervical junction of patients suffering from CM-I often undergo compression with appearance of some clinical symptoms in the patients. Hence, symptom assessment is highly critical in these patients 5 . These clinical symptoms are used in many studies as an index for assessing patients’ health conditions 5 – 7 .…”

“…Hence, symptom assessment is highly critical in these patients 5 . These clinical symptoms are used in many studies as an index for assessing patients’ health conditions 5 – 7 . Hwever, it is difficult to diagnose, manage, and choose the appropriate treatment strategy for the patients only based on their symptoms, since many symptoms of this disease are often associated with pain and are common in the various associations and conditions of CM-I 8 , 9 .…”

Emergency Department Visits Following Suboccipital Decompression for Adult Chiari Malformation Type I

“…CM-1 was defined as at least 3 mm of tonsillar tip herniation beyond the foramen magnum on sagittal MRI in combination with symptoms attributable to CM-1 including headache, neck pain, weakness, paresthesias, imbalance, diplopia, tinnitus, or dysphagia. 12 Exclusion criteria included patients with connective tissue disease or basilar invagination, as well as pediatric patients (<18 years) and patients with prior treatment.…”

Chiari malformation and syringomyelia

“…A more standardized approach to Chiari research, allowing for comparison of data, is the aim of the NIH-sponsored Common Data Elements project. 51…”