Recurrent respiratory papillomatosis (RRP) is characterised by benign wart-like growths in the respiratory tract caused by the human papillomavirus (HPV). These warts vary in size and grow quickly, causing voice changes and airway obstruction. Whilst the condition is rare, RRP is more common and aggressive in children. There is currently no curative treatment for HPV, therefore RRP is managed by maintaining a safe airway and a serviceable voice by repeated surgery to remove the growths. A lack of specific diagnostic codes prevents reliable case ascertainment of RRP from routine administrative databases such as Hospital Episode Statistics. In 2017 a cross-sectional survey identified 918 RRP patients in the UK, half of whom had received surgical intervention for RRP in the previous 12 months with 16 different interventions. Randomised controlled trials for RRP interventions are difficult due to the rarity of the disease, variation in severity and progression and non-standard care across the NHS. Consequently, there is a lack of definitive efficacy and safety evidence. The only national guidance for RRP interventions is "Radiofrequency cold ablation for respiratory papillomatosis" (NICE IPG434, 2017) which recommended further data collection due to lack of evidence. However, due to the wide variation in RRP management across the NHS, clinical opinion favoured that any data collection should include a comparison of safety and efficacy of all RRP interventions in order to advise which improved patient outcomes and quality of life. To address lack of evidence, and inform the future care of RRP patients, we developed a registry and used it to collect real-world data from patients receiving treatment for RRP in NHS hospitals across the UK. The purpose of this paper is to share lessons learned from this national data collection exercise to inform future clinical registry development.
Keywords: Recurrent respiratory papillomatosis (RRP) clinical registry development.
Recurrent Respiratory Papillomatosis (RRP) causes wart-like growths in the airway, which make it difficult to breathe and speak. There is no known cure. Patients have their symptoms checked at hospital visits, and may need repeated surgical procedures to remove the growths and manage their symptoms. Different hospitals use a variety of different methods to manage RRP, and no one knows which methods work the best. We set up a registry to collect information from hospitals across the UK to understand more about which treatments for RRP work best for which patients. We learned a lot from the process of setting up and running this national data collection. The purpose of this paper is to share this learning to support the development of future clinical registries within the UK.
Copyright: © 2023 Sims A et al.