Clinical decision support to improve blood pressure control in hemodialysis patients: a nonrandomized controlled trial.

Background: Computer-based clinical decision support aims to improve the quality of patient care. The utility of decision support for improving blood pressure control in hemodialysis patients is unknown.

Methods: This was a nonrandomized controlled trial of adult patients receiving chronic in-center hemodialysis during the period of April 1, 2005, to September 30, 2006, in 1 of the 2 major university-based renal programs in Alberta, Canada.

Effect of frequent nocturnal hemodialysis vs conventional hemodialysis on left ventricular mass and quality of life: a randomized controlled trial.

Context: Morbidity and mortality rates in hemodialysis patients remain excessive. Alterations in the delivery of dialysis may lead to improved patient outcomes.

Objective: To compare the effects of frequent nocturnal hemodialysis vs conventional hemodialysis on change in left ventricular mass and health-related quality of life over 6 months.

Expert-type knowledge structure in medical students is associated with increased odds of diagnostic success.

Background: The relation between knowledge structure and diagnostic performance is unclear. Similarly, variables affecting knowledge structure are poorly understood.

Purpose: The 1st objective was to examine the relation between concepts in knowledge structure and diagnostic performance.

Can concept sorting provide a reliable, valid and sensitive measure of medical knowledge structure?

Context: Evolution from novice to expert is associated with the development of expert-type knowledge structure. The objectives of this study were to examine reliability and validity of concept sorting (ConSort) as a measure of static knowledge structure and to determine the relationship between concepts in static knowledge structure and concepts used during diagnostic reasoning.

Method: ConSort was used to identify static knowledge concepts and analysis of think-aloud protocols was used to identify dynamic knowledge concepts (used during diagnostic reasoning).

One-year mortality in critically ill patients by severity of kidney dysfunction: a population-based assessment.

Background: Kidney dysfunction in the intensive care unit (ICU) results in increased morbidity, mortality, and health care costs; however, long-term mortality has not been described across strata of severity in kidney dysfunction.

Methods: The primary objective is to describe and assess factors associated with 1-year mortality in critically ill patients stratified by severity of kidney dysfunction during admission to the ICU. Kidney dysfunction is defined by peak serum creatinine values and stratified by: (1) no dysfunction (creatinine < 1.

Prognosis for long-term survival and renal recovery in critically ill patients with severe acute renal failure: a population-based study.

Introduction: Severe acute renal failure (sARF) is associated with considerable morbidity, mortality and use of healthcare resources; however, its precise epidemiology and long-term outcomes have not been well described in a non-specified population.

Methods: Population-based surveillance was conducted among all adult residents of the Calgary Health Region (population 1 million) admitted to multidisciplinary and cardiovascular surgical intensive care units between May 1 1999 and April 30 2002. Clinical records were reviewed and outcome at 1 year was assessed.

Severe bloodstream infections: a population-based assessment.

Objective: Although bloodstream infection commonly results in critical illness, population-based studies of the epidemiology of severe bloodstream infection are lacking. We sought to define the incidence and microbiology of severe bloodstream infection (bloodstream infection associated with intensive care unit admission within 48 hrs) and assess risk factors for acquisition and death.

Design: Population-based surveillance cohort.

Why patients with ESRD do not select self-care dialysis as a treatment option.

Background: In-center hemodialysis is the most prevalent (and resource-intense) form of dialysis in North America despite many patients being capable of performing dialysis themselves. The purpose of this study is to describe reasons in-center hemodialysis patients choose not to perform self-care dialysis and identify variables associated with a negative attitude toward self-care dialysis.

Methods: We conducted a cross-sectional survey (return rate, 83%) of prevalent in-center hemodialysis patients and combined this with demographic and comorbidity data obtained from our prospectively maintained database.

Dialysis adequacy and health related quality of life in hemodialysis patients.

Patients with end-stage renal disease have significant impairments in health related quality of life (HRQOL). The determinants of HRQOL, including the effect of dialysis adequacy, have not been well studied. This study was designed to investigate whether dialysis adequacy is associated with HRQOL in hemodialysis patients.