System of Criteria for Treatment Evaluation of Acromegaly in Bulgaria

Abstract

Acromegaly is a rare endocrine disorder caused by excessive and longstanding secretion of growth hormone (GH) by the pituitary somatotroph and resulting from this overproduction of insulin-like growth factor-1 hormone (IGF-1) by the liver. There are few registers and rather limited clinical data about acromegaly treatment. The analysis of acromegaly data is rarely subject to a system of criteria for evaluating acromegaly treatment. The novelty of this paper is that it presents a real- life practice case study about the implementation results of such a system in Bulgaria. The case study analysis illustrates a clinical information approach to manage thousands of records in the Bulgarian Acromegaly Database. The here reported results provide evidence about the difficulties in maintaining both GH and IGF-1 levels inside their reference values in acromegaly treatment. Ongoing research extends the evaluation results by enabling semantic interoperability between acromegaly databases based on openEHR specification.

Keywords: Acromegaly; Growth Hormone; Insulin-like Growth Factor-1; case study; clinical informatics; endocrine disease; evaluation; treatment.