An international Delphi survey helped develop consensus-based core outcome domains for trials in peritoneal dialysis.
Adolescent
Adult
Aged
Consensus
Decision Making, Shared
Delphi Technique
Female
Humans
Kidney Failure, Chronic
/ therapy
Male
Middle Aged
Outcome Assessment, Health Care
/ standards
Peritoneal Dialysis
/ adverse effects
Quality of Life
Randomized Controlled Trials as Topic
/ standards
Surveys and Questionnaires
Young Adult
core outcome sets
kidney disease
outcomes
patient-centered care
peritoneal dialysis
trials
Journal
Kidney international
ISSN: 1523-1755
Titre abrégé: Kidney Int
Pays: United States
ID NLM: 0323470
Informations de publication
Date de publication:
09 2019
09 2019
Historique:
received:
12
12
2018
revised:
21
02
2019
accepted:
14
03
2019
pubmed:
16
6
2019
medline:
21
10
2020
entrez:
16
6
2019
Statut:
ppublish
Résumé
Shared decision-making about clinical care options in end-stage kidney disease is limited by inconsistencies in the reporting of outcomes and the omission of patient-important outcomes in trials. Here we generated a consensus-based prioritized list of outcomes to be reported during trials in peritoneal dialysis (PD). In an international, online, three-round Delphi survey, patients/caregivers and health professionals rated the importance of outcomes using a 9-point Likert scale (with 7-9 indicating critical importance) and provided comments. Using a Best-Worst Scale (BWS), the relative importance of outcomes was estimated. Comments were analyzed thematically. In total, 873 participants (207 patients/caregivers and 666 health professionals) from 68 countries completed round one, 629 completed round two and 530 completed round three. The top outcomes were PD-related infection, membrane function, peritoneal dialysis failure, cardiovascular disease, death, catheter complications, and the ability to do usual activities. Compared with health professionals, patients/caregivers gave higher priority to six outcomes: blood pressure (mean difference, 0.4), fatigue (0.3), membrane function (0.3), impact on family/friends (0.1), peritoneal thickening (0.1) and usual activities (0.1). Four themes were identified that underpinned the reasons for ratings: contributing to treatment longevity, preserving quality of life, escalating morbidity, and irrelevant and futile information and treatment. Patients/caregivers and health professionals gave highest priority to clinical outcomes. In contrast to health professionals, patients/caregivers gave higher priority to lifestyle-related outcomes including the impact on family/friends and usual activities. Thus, prioritization will inform a core outcome set to improve the consistency and relevance of outcomes for trials in PD.
Identifiants
pubmed: 31200941
pii: S0085-2538(19)30340-0
doi: 10.1016/j.kint.2019.03.015
pmc: PMC6961705
mid: NIHMS1546494
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
699-710Subventions
Organisme : NIDDK NIH HHS
ID : K23 DK103972
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2019 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.
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