# Undiagnosed diseases network clinical site

> **NIH NIH U01** · CHILDREN'S HOSP OF PHILADELPHIA · 2020 · $550,000

## Abstract

Undiagnosed diseases and rare diseases occur without respect to age, geography, socioeconomic status or
level of education. They are frustratingly hard to define scientifically and to classify needs, yet rare diseases
affect 30 million people in the USA and the undiagnosed are as yet uncounted. The 2016 census found 42
million people living in the NY/NJ/PA/DE mid-Atlantic region, accounting for 13% of the USA population. We
see a need for a UDN Clinical Site based on population and our accounting of >100 children and >100 adults
who appear at our institutions yearly with undiagnosed conditions. Referrals to CHOP/UPENN reflect a larger
catchment area than just the four-state area and support our pivotal thesis that the regional need is high and
we are poised to deliver expertise, coordinated care, and technology to benefit these patients. The modern
approach to hospital-based diagnosis, wherein individual clinical teams propose and test organ or system-
specific diagnostic concepts, has several limitations. It fails to take advantage of the full clinical abilities of an
institution and efficiently use advanced sequencing, bioinformatic strategies, and synergies from collective
thinking. The UDN program has brought a collaborative approach to address the needs of the undiagnosed
patient population and to mitigate these shortfalls. We propose to utilize technology in a manner that benefits
the patient while being respectful of financial constraints and clinician time. This application proposes a Clinical
Site operating as part of the UDN that utilizes work flows optimized by the existing UDN with potential
efficiencies and strategies for sustainability that may be useful broadly. Aim 1 describes our organization and
patient flow that incorporates document management and infrastructure elements. In Aim 2, the evaluation of
patients with exome sequencing that has not been informative or who are suspected of a non-Mendelian
disorder will be specifically assessed. In Aim 3, strategies for sustainability will be piloted including improved
data capture during patient evaluations, a bioinformatic approach to environmental exposures, a “Human
Knockout Screening Core” approach and strategies for the education of future diagnostic physicians. Patients
with a recognized disease will have a short stay focused on education and resource identification. Most
patients will be stable, but lack diagnosis, and will have a weeklong evaluative inpatient stay typically within our
Clinical and Translational Research Center. During the stay, we will perform additional studies and develop a
follow-up plan. Acutely ill patients, newborns, and fetuses can be evaluated using stabilization and
management in an inpatient critical care unit. Our proposal is directly relevant to the NIH mission since it uses
applied knowledge to enhance health, lengthen life and reduce illness and disability in a unique and vulnerable
patient population. The proposed Clinical Site has valuable exp...

## Key facts

- **NIH application ID:** 9987680
- **Project number:** 5U01HG010219-03
- **Recipient organization:** CHILDREN'S HOSP OF PHILADELPHIA
- **Principal Investigator:** Daniel James Rader
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $550,000
- **Award type:** 5
- **Project period:** 2018-09-20 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9987680

## Citation

> US National Institutes of Health, RePORTER application 9987680, Undiagnosed diseases network clinical site (5U01HG010219-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9987680. Licensed CC0.

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