Reporting of 'dialysis adequacy' as an outcome in randomised trials conducted in adults on haemodialysis

Autor: Sanne Steyaert, Wim Van Biesen, Els Holvoet, Simon Malfait, Evi V. Nagler
Rok vydání: 2018
Předmět:
CHRONIC KIDNEY-DISEASE
medicine.medical_treatment
030232 urology & nephrology
Social Sciences
Pathology and Laboratory Medicine
Toxicology
law.invention
SINGLE-POOL KT/V
REMOVAL
0302 clinical medicine
Cognition
Randomized controlled trial
QUALITY-OF-LIFE
law
Outcome Assessment
Health Care
Medicine and Health Sciences
Urea
Toxins
Psychology
030212 general & internal medicine
UREMIC TOXINS
Fatigue
Randomized Controlled Trials as Topic
DIALYZERS
Dialysis adequacy
Multidisciplinary
Organic Compounds
VARIABLE-VOLUME
Chemistry
Treatment Outcome
Nephrology
Physical Sciences
Medicine
Engineering and Technology
Hemodialysis
Thematic analysis
Research Article
Biotechnology
Adult
medicine.medical_specialty
Drug Research and Development
Catheters
Science
Decision Making
Toxic Agents
MEDLINE
Bioengineering
Research and Analysis Methods
PATIENT
PROTEIN DIET
03 medical and health sciences
Quality of life (healthcare)
Signs and Symptoms
Renal Dialysis
Diagnostic Medicine
Medical Dialysis
medicine
Humans
Clinical Trials
Intensive care medicine
Dialysis
Pharmacology
business.industry
Organic Chemistry
Chemical Compounds
Cognitive Psychology
Biology and Life Sciences
Randomized Controlled Trials
Clinical trial
Health Care
Quality of Life
Cognitive Science
Medical Devices and Equipment
UREA
Clinical Medicine
business
Neuroscience
Zdroj: PLoS ONE
PLoS ONE, Vol 14, Iss 2, p e0207045 (2019)
PLOS ONE
ISSN: 1932-6203
Popis: Background : Clinical trials are most informative for evidence-based decision-making when they consistently measure and report outcomes of relevance to stakeholders, especially patients, clinicians, and policy makers. However, sometimes terminology used is interpreted differently by different stakeholders, which might lead to confusion during shared decision making. The construct dialysis adequacy is frequently used, suggesting it is an important outcome both for health care professionals as for patients. Objective : To assess the scope and consistency of the construct dialysis adequacy as reported in ran-domised controlled trials in hemodialysis, and evaluate whether these align to the insights and understanding of this construct by patients. Methods : To assess scope and consistency of dialysis adequacy by professionals, we performed a systematic review searching the Cochrane Central Register of Controlled Trials (CENTRAL) up to July 2017. We identified all randomised controlled trails (RCT) including patients on hemodialysis and reporting dialysis adequacy, adequacy or adequacy of dialysis and extracted and classified all reported outcomes. To explore interpretation and meaning of the construct of adequacy by patients, we conducted 11 semi-structured interviews with HD patients using thematic analysis. Belgian registration number B670201731001. Findings : From the 31 included trials, we extracted and classified 98 outcome measures defined by the authors as adequacy of dialysis, of which 94 (95%) were biochemical, 3 (3%) non-biochemical surrogate and 2 (2%) patient-relevant. The three most commonly reported measures were all biochemical. None of the studies defined adequacy of dialysis as a patient relevant outcome such as survival or quality of life. Patients had a substantially different understanding of the construct dialysis adequacy than the biochemical interpretation reported in the literature. Being alive, time spent while being on dialysis, fatigue and friendliness of staff were the most prominent themes that patients linked to the construct of dialysis adequacy. Conclusion : Adequacy of dialysis as reported in the literature refers to biochemical outcome measures, most of which are not related with patient relevant outcomes. For patients, adequate dialysis is a dialysis that enables them to spend as much quality time in their life as possible.
Databáze: OpenAIRE
Externí odkaz: