Proactive identification of rare diseases: lessons from hereditary angioedema diagnosis using electronic medical records

Abstract Background Diagnosing rare diseases traditionally requires patients to endure lengthy and challenging journeys to find specialists familiar with their conditions. This study advocates a paradigm shift in rare disease diagnosis, moving from patients seeking physicians to physicians actively...

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Main Authors: Xue Wang, Huizhen Jiang, Ziyang Huang, Chao Dong, Weiguo Zhu, Shuyang Zhang, Yuxiang Zhi
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Orphanet Journal of Rare Diseases
Subjects:
Online Access:https://doi.org/10.1186/s13023-025-03882-2
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author Xue Wang
Huizhen Jiang
Ziyang Huang
Chao Dong
Weiguo Zhu
Shuyang Zhang
Yuxiang Zhi
author_facet Xue Wang
Huizhen Jiang
Ziyang Huang
Chao Dong
Weiguo Zhu
Shuyang Zhang
Yuxiang Zhi
author_sort Xue Wang
collection DOAJ
description Abstract Background Diagnosing rare diseases traditionally requires patients to endure lengthy and challenging journeys to find specialists familiar with their conditions. This study advocates a paradigm shift in rare disease diagnosis, moving from patients seeking physicians to physicians actively identifying patients. Using hereditary angioedema (HAE) as an example, we demonstrate how this approach, supported by electronic medical records (EMRs), enables proactive care for patients with rare diseases. Our EMR system incorporates a free-text search engine to screen for patients with potential HAE based on clinical symptoms and laboratory tests. Search terms include recurrent skin edema, abdominal pain, laryngeal edema, and/or decreased C4 levels. Suspected cases are followed up by telephone calls from trained physicians, inviting patients to undergo confirmatory C1-INH and C4 testing and genetic testing to ensure accurate diagnosis and appropriate treatment. Results Of 2,689 patients who met the screening criteria, 3,441 records were analyzed. Ninety-five patients had already been diagnosed with HAE. After excluding those with a known etiology for edema or characteristics inconsistent with HAE, three patients with unexplained cutaneous edema, abdominal pain, and/or laryngeal edema were included in the final screening. Laboratory tests confirmed HAE in all three, highlighting the effectiveness of this proactive approach. Conclusions This study underscores the transformative potential of EMRs in diagnosing rare diseases. By shifting the responsibility of identifying rare diseases from patients to healthcare professionals, we expedite diagnosis and exemplify the spirit of service in medicine, ensuring patients with rare diseases receive timely and effective care.
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spelling doaj-art-027cf9e4577b461c8c1fd152f0044ff02025-08-20T03:46:21ZengBMCOrphanet Journal of Rare Diseases1750-11722025-07-012011910.1186/s13023-025-03882-2Proactive identification of rare diseases: lessons from hereditary angioedema diagnosis using electronic medical recordsXue Wang0Huizhen Jiang1Ziyang Huang2Chao Dong3Weiguo Zhu4Shuyang Zhang5Yuxiang Zhi6Department of Allergy & Clinical Immunology, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, National Clinical Research Center for Immunologic DiseasesDepartment of Information Center, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesDepartment of Information Center, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesDepartment of Information Center, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesDepartment of Primary Care and Family Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Allergy & Clinical Immunology, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, National Clinical Research Center for Immunologic DiseasesAbstract Background Diagnosing rare diseases traditionally requires patients to endure lengthy and challenging journeys to find specialists familiar with their conditions. This study advocates a paradigm shift in rare disease diagnosis, moving from patients seeking physicians to physicians actively identifying patients. Using hereditary angioedema (HAE) as an example, we demonstrate how this approach, supported by electronic medical records (EMRs), enables proactive care for patients with rare diseases. Our EMR system incorporates a free-text search engine to screen for patients with potential HAE based on clinical symptoms and laboratory tests. Search terms include recurrent skin edema, abdominal pain, laryngeal edema, and/or decreased C4 levels. Suspected cases are followed up by telephone calls from trained physicians, inviting patients to undergo confirmatory C1-INH and C4 testing and genetic testing to ensure accurate diagnosis and appropriate treatment. Results Of 2,689 patients who met the screening criteria, 3,441 records were analyzed. Ninety-five patients had already been diagnosed with HAE. After excluding those with a known etiology for edema or characteristics inconsistent with HAE, three patients with unexplained cutaneous edema, abdominal pain, and/or laryngeal edema were included in the final screening. Laboratory tests confirmed HAE in all three, highlighting the effectiveness of this proactive approach. Conclusions This study underscores the transformative potential of EMRs in diagnosing rare diseases. By shifting the responsibility of identifying rare diseases from patients to healthcare professionals, we expedite diagnosis and exemplify the spirit of service in medicine, ensuring patients with rare diseases receive timely and effective care.https://doi.org/10.1186/s13023-025-03882-2Proactive diagnosisElectronic medical recordsHereditary angioedemaRare diseases
spellingShingle Xue Wang
Huizhen Jiang
Ziyang Huang
Chao Dong
Weiguo Zhu
Shuyang Zhang
Yuxiang Zhi
Proactive identification of rare diseases: lessons from hereditary angioedema diagnosis using electronic medical records
Orphanet Journal of Rare Diseases
Proactive diagnosis
Electronic medical records
Hereditary angioedema
Rare diseases
title Proactive identification of rare diseases: lessons from hereditary angioedema diagnosis using electronic medical records
title_full Proactive identification of rare diseases: lessons from hereditary angioedema diagnosis using electronic medical records
title_fullStr Proactive identification of rare diseases: lessons from hereditary angioedema diagnosis using electronic medical records
title_full_unstemmed Proactive identification of rare diseases: lessons from hereditary angioedema diagnosis using electronic medical records
title_short Proactive identification of rare diseases: lessons from hereditary angioedema diagnosis using electronic medical records
title_sort proactive identification of rare diseases lessons from hereditary angioedema diagnosis using electronic medical records
topic Proactive diagnosis
Electronic medical records
Hereditary angioedema
Rare diseases
url https://doi.org/10.1186/s13023-025-03882-2
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