Background: Technique survival, also reported with negative connotations as technique failure or transfer from peritoneal dialysis to haemodialysis, has been identified by patients, caregivers and health professionals as a critically important outcome to be reported in all trials. However, there is wide variation in how peritoneal dialysis technique survival is defined, measured and reported, leading to difficulty in comparing or consolidating results.
Methods: We conducted an online international consensus workshop to establish a core outcome measure of technique survival. Discussions were analysed thematically.
Results: Fifty-five participants including 14 patients and caregivers from 13 countries took part in facilitated breakout discussions using video-conferencing. The following themes were identified: capturing important aspects of the outcome (requiring a core event to define the outcome, distinguishing temporary from permanent events, recognising heterogeneous experiences of transfers), adopting appropriate neutral nomenclature (conveying with clarity, avoiding negative connotations), and ensuring feasibility and applicability (capturing data relevant to clinical and research settings, ease of adoption). The suggested definitions for the core outcome measure were 'the event of a transfer to haemodialysis', or 'discontinuation of peritoneal dialysis'. Applying the principles described within the workshop, defining the outcome measure as a 'transfer to haemodialysis' was preferable.
Conclusions: It is proposed that the core outcome of technique survival is redefined as 'transfer to haemodialysis' and that its components are standardised using simple, neutral terminology Components considered important by stakeholders included recording the reasons for transfer from peritoneal dialysis, and focussing on permanent events whilst ensuring the outcome remains easy to implement.
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http://dx.doi.org/10.1177/08968608241287684 | DOI Listing |
CHEST Crit Care
December 2024
Division of Pulmonary, Allergy, and Critical Care (G. L. A.), University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; the Division of Pulmonary and Critical Care Medicine (S. M. S.), University of Rochester Medical Center, Rochester, NY; the Department of Anaesthesia and Critical Care (A. R., Z. F., and M. T. D. S.), Greys Hospital, KwaZulu-Natal Department of Health, the Department of Anaesthesia and Critical Care (J. I.), Harry Gwala Regional Hospital, KwaZulu-Natal Department of Health, Pietermaritzburg, the Department of Anaesthesia and Critical Care (R. D. W. and M. T. D. S.), School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa; the Faculty Medicine and Pharmacy (R. D. W.), Vrije Universiteit Brussel (VUB), Brussels, Belgium; and the Department of Intensive Care (R. D. W.), John Radcliffe Hospital, Oxford University Trust Hospitals, Oxford, England.
Background: A proposed new global definition of ARDS seeks to update the Berlin definition and account for nonintubated ARDS and ARDS diagnoses in resource-variable settings.
Research Question: How do ARDS epidemiologic characteristics change with operationalizing the new global definition of ARDS in a resource-limited setting?
Study Design And Methods: We performed a real-use retrospective cohort study among adult patients meeting criteria for the Berlin definition of ARDS or the global definition of ARDS at ICU admission in two public hospitals in the KwaZulu-Natal Department of Health, South Africa, from January 2017 through June 2022.
Results: Among 5,760 adults (aged ≥ 18 years) admitted to the ICU, 2,027 patients (35.
Front Oncol
December 2024
Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
Background: For esophageal squamous cell carcinoma (ESCC), universally accepted pathological criteria for classification by differentiation degree are lacking. Tumor budding, single-cell invasion, and nuclear grade, recognized as prognostic factors in other carcinomas, have rarely been investigated for their correlation with differentiation and prognosis in ESCC. This study aims to determine if pathological findings can predict differentiation degree and prognosis in ESCC.
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December 2024
Institute for Head and Neck Studies and Education, University of Birmingham, Birmingham, United Kingdom.
Background: The limitations of the traditional TNM system have spurred interest in multivariable models for personalized prognostication in laryngeal and hypopharyngeal cancers (LSCC/HPSCC). However, the performance of these models depends on the quality of data and modelling methodology, affecting their potential for clinical adoption. This systematic review and meta-analysis (SR-MA) evaluated clinical predictive models (CPMs) for recurrence and survival in treated LSCC/HPSCC.
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December 2024
Division of Critical Care and Pulmonary Medicine, Department of Pediatrics, St Jude Children's Research Hospital, Memphis, TN, United States.
Introduction: Central nervous system (CNS) tumors are the second most prevalent malignant neoplasms in childhood, with surgical resection as the primary therapeutic approach. The immediate postoperative period following CNS tumor resection requires intensive care to mitigate complications associated with high morbidity and mortality.
Objective: The primary aim of this study is to comprehensively describe the postoperative complications observed in pediatric patients who underwent primary CNS tumor resection and were subsequently admitted to the pediatric intensive care unit (PICU) at Hospital Universitario Fundación Valle del Lili in Colombia.
Background Fragility fractures, often caused by osteoporosis, are a major public health concern among the growing population of the United Kingdom (UK). In addition to being a major source of illness and mortality, the rising incidence of osteoporosis places a heavy strain on healthcare systems if it is not adequately managed. In order to lower the risk of additional fractures, current guidelines place a strong emphasis on the timely evaluation and treatment of fragility fractures.
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