September 1, 2000
With this newsletter I am proud to announce a landmark in the history of the Collaborative Transplant Study. It is now possible for all participating centers to analyze their own results by means of the CTS website. We will phase in this new feature with several steps. As a first step, you will be able to generate for your own center all graphs that are shown on the website for the general CTS data. When you view a graph on your computer screen, the corresponding analysis for your own center’s data will be performed at the click of a button. In order to activate this feature you will need to enter your special identification code. If you have not yet requested your code, do so now. Please be advised that, for data security reasons, the code can be sent by regular mail only and not by fax or e-mail. The special identification code can be passed on to those members of your team who are authorized to access the results. It is possible for you to change your access code at any time on your screen, however, be sure to guard the valid code in a safe place. Should your code get lost or forgotten, our system programmers will have to be contacted and this will lead to a time-consuming procedure during which you will not be able to access the CTS website. Instructions for changing your access code are given on the web.
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Already, we are working on the second phase which will become available with the next website release on December 1, 2000. With that version, we will provide you with exact Kaplan-Meier statistics as well as log-rank p values. That way, you will be able to use the statistics for your publications.
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For the current access, I would like to add several words of caution and advice:
1) Your analysis will only be valid if you have sent us a recent update on clinical follow up. Obviously, survival statistics based on incomplete reports are not accurate. If your file is not up-to-date, please send an update so that you can perform valid analyses after the next website release in December.
2) It should be understood that you can analyze only those variables for which you provided data. For example, only if the one-year blood pressure values were reported on the one-year pink report forms can you perform an analysis thereof for your center. Likewise, the effect of maintenance immunosuppression can be analyzed only if the immunosuppression questionnaires were completed for your patients. On your printout you may insert the missing values of all variables by hand and we will update your file in order to achieve subsequent valid analyses.
3) Except for the larger centers, the analysis of complicated or rarely occurring factors (such as matching for HLA-A+B+DR or analysis of CMV positive donor organs into CMV negative recipients) will often result in small sample sizes that are not meaningful. This will become obvious when the statistical function is added in December. Please do not overinterpret your own data by just looking at the physical distance between lines. Always also consider the number of patients involved.
4) We advise you to first try the curves which are provided under the category "basicstat". In order to do so, enter the word "basicstat" in the search option "Search for Keywords". This will introduce you to the center-specific analysis and provide you with survival curves that most likely will be meaningful (provided the data status of your patients is good).
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I realize that the introduction of the center-specific analysis capability is a risky step. The main risk is that of erroneous interpretation when results are based on incomplete data. I am therefore intentionally repeating my plea for checking your data status and analyzing only those parts that are well documented. If you see deficiencies on your printout (Sections 2 and 3), correct them by sending us the missing bits of information. That way, you will be able to run fully valid analyses after the next general update.
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We would appreciate your feedback concerning your experience with the new analysis function. Modifications may be necessary in order to adapt the program to your needs. Only if you relate your personal experience to us can we respond. Thank you for your cooperation.
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In future, we will attempt to provide you with more flexibility. Eventually, the specific selection of all variables should be possible on a remote basis. Another planned feature is a free adjustment of the x and y axes. However, these steps can be realized only after a solidly performing system has been established which is accepted by all study participants.
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Because we have been completely absorbed with the development of the new network feature, we ask for your understanding that this newsletter does not contain any scientific result analyses.
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The next shipping date for the DNA project is
November 27 or 28, 2000
We request the shipment of frozen samples (buffy coat, pieces of spleen, or DNA) obtained from pairs of recipients and donors. Kidney, heart and liver transplants are of interest for this project. Well over 2.000 samples were sent in during the last shipping cycle. A great word of thanks for your continued support!
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We all need time to pause and reflect after the Rome Congress. One thing has become clear: The CTS is as useful as ever. The focus of attention is turning increasingly to longterm outcome, and new immunosuppressants must be carefully evaluated against the background of established treatment protocols. Although controlled trials and single-center studies clearly will remain pivotal for setting new trends, the final answer concerning a new treatment strategy is derived from multicenter data. This has been the experience of the past and it will remain so in the future. Your continued contribution to the international study is therefore very important and highly appreciated.
Sincerely yours,