A5014136648- Chronic Kidney Disease and Diabetes
- Dialysis and Renal Disease Management
- Health Systems, Economic Evaluations, Quality of Life
- Blood Pressure and Hypertension Studies
- Renal and Vascular Pathologies
- Meta-analysis and systematic reviews
- Acute Kidney Injury Research
- Advanced Causal Inference Techniques
- Organ Donation and Transplantation
- Statistical Methods in Clinical Trials
- Central Venous Catheters and Hemodialysis
- Renal Transplantation Outcomes and Treatments
- Healthcare cost, quality, practices
- Vascular Procedures and Complications
- COVID-19 and healthcare impacts
- Liver Disease Diagnosis and Treatment
- Sepsis Diagnosis and Treatment
- Atrial Fibrillation Management and Outcomes
- Palliative Care and End-of-Life Issues
- Statistical Methods and Inference
- Heart Failure Treatment and Management
- COVID-19 Clinical Research Studies
- Acute Ischemic Stroke Management
- Artificial Intelligence in Healthcare
- Patient-Provider Communication in Healthcare
Leiden University Medical Center
2016-2024
Parnassia Groep
2024
Haga Hospital
2021
Prediction research is a distinct field of epidemiologic research, which should be clearly separated from aetiological research. Both prediction and aetiology make use multivariable modelling, but the underlying aim interpretation results are very different. Aetiology aims at uncovering causal effect specific risk factor on an outcome, adjusting for confounding factors that selected based pre-existing knowledge relations. In contrast, accurately predicting outcome using multiple predictors...
In this paper we study approaches for dealing with treatment when developing a clinical prediction model. Analogous to the estimand framework recently proposed by European Medicines Agency trials, propose 'predictimand' of different questions that may be interest predicting risk in relation started after baseline. We provide formal definition estimands matching these questions, give examples settings which each is useful and discuss appropriate estimators including their assumptions....
Significance Statement Most kidney failure prediction models have been developed and validated in cohorts of patients with a wide range disease severity, without accounting for the competing risk death. Models recommended by guidelines, currently used clinic, not undergone head-to-head comparison. This study provides comprehensive external validation tools two advanced CKD, taking death into account. that predict over longer time frame 5 years overestimate due to In eight-variable 2-year...
Thorough validation is pivotal for any prediction model before it can be advocated use in medical practice. For time-to-event outcomes such as breast cancer recurrence, death from other causes a competing risk. Model performance measures must account events. In this article, we present comprehensive yet accessible overview of event setting, including the calculation and interpretation statistical calibration, discrimination, overall error, clinical usefulness by decision curve analysis. All...
While American nephrology societies recommend using the 2021 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) estimated glomerular filtration rate (eGFR) equation without a Black race coefficient, it is unknown how this would impact disease distribution, prognosis and kidney failure risk prediction in predominantly White non-US populations.We studied 1.6 million Stockholm adults with serum/plasma creatinine measurements between 2007 2019. We calculated changes eGFR...
Objectives To assess the difference in completeness of reporting and methodological conduct published prediction models before after publication Transparent Reporting a multivariable model for Individual Prognosis Or Diagnosis (TRIPOD) statement. Methods In seven general medicine journals with highest impact factor, we compared quality methodology studies between 2012 2014 (pre-TRIPOD) 2016 2017 (post-TRIPOD). For articles post-TRIPOD period, examined whether there was improved (1) citing...
ABSTRACT Background Risk-based thresholds for arteriovenous (AV) access creation has been proposed to aid vascular planning. We aimed assess the clinical impact of implementing Kidney Failure Risk Equation (KFRE) referral. Methods A total 16 102 nephrology-referred chronic kidney disease (CKD) patients from Swedish Renal Registry 2008–18 were included. The KFRE was calculated repeatedly, and timing identified when risk exceeded several pre-defined and/or estimated glomerular filtration rate...
Bleeding risk scores have been created to identify patients with an increased bleeding risk, which could also be useful in dialysis patients. However, the predictive performances of these are unknown. Therefore, aim this study was validate existing patients.A cohort 1745 incident prospectively followed for 3 years during events were registered. We evaluated discriminative performance Hypertension, Abnormal kidney and liver function, Stroke, Bleeding, Labile INR, Elderly Drugs or alcohol...
Understanding the mechanisms underlying differences in renal decline between men and women may improve sex-specific clinical monitoring management. To this end, we aimed to compare slope of function older chronic kidney disease (CKD) Stages 4 5, taking into account informative censoring related risks mortality dialysis initiation.
Abstract Background External validation of prognostic models is necessary to assess the accuracy and generalizability model new patients. If are validated in a setting which competing events occur, these risks should be accounted for when comparing predicted observed outcomes. Methods We discuss existing measures calibration discrimination that incorporate time-to-event models. These methods illustrated using clinical-data example concerning prediction kidney failure population with advanced...
While developing prediction models has become quite popular both in nephrology and medicine general, most have not been implemented clinical practice on a larger scale. This should be no surprise, as the majority of published shown to poorly reported often developed using inappropriate methods. The main problems identified relate either too few candidate predictors (based univariable P < 0.05) or many (for number events), resulting performing models. Guidelines how develop test model all...
Conservative care (CC) may be a valid alternative to dialysis for certain older patients with advanced chronic kidney disease (CKD). A model that predicts patient prognosis on both treatment pathways could of value in shared decision-making. Therefore, the aim is develop prediction tool mortality risk same and CC from time decision.CKD Stage 4/5 aged ≥70 years, treated at single centre Netherlands, were included between 2004 2016. Predictors collected decision selected based literature an...
Predicting the timing and occurrence of kidney replacement therapy (KRT), cardiovascular events, death among patients with advanced chronic disease (CKD) is clinically useful relevant. We aimed to externally validate a recently developed CKD G4+ risk calculator for these outcomes assess its potential clinical impact in guiding vascular access placement.We included 1517 from European Quality (EQUAL) study, multicentre prospective cohort study nephrology-referred aged ≥65 years. Model...
Background. Monitoring of renal function is important in patients with chronic kidney disease progressing towards end-stage failure, both for timing the start replacement therapy and determining prognosis on dialysis. Thus far, studies associations between estimated glomerular filtration rate (eGFR) measurements pre-dialysis stage mortality dialysis have shown no or even inverse relations, which may result from poor validity serum creatinine-based estimation equations patients. As decline be...
ObjectivesMaintenance of independence is a challenge for nursing home residents whose pain often substantial. The objective this study was to explore the relationship between perception and care dependency in population Dutch residents.DesignProspective cohort study.Setting participantsDutch aged 65 or older, excluding with severe cognitive impairment.MethodsThe Numeric Rating Scale (NRS) used rate from 0 10 half-point increments Care Dependency (CDS) measure dependency, scores ranging 15...
IntroductionTransplant clinicians may disagree on whether or not to accept a deceased donor kidney offer. We investigated the interobserver variability between transplant nephrologists regarding organ acceptance and use of prediction model impacted their decisions.MethodsWe developed an observational online survey with six real-life cases kidneys offered waitlisted recipient. Per case, were asked estimate risk adverse outcome they would offer for this patient, patient own choice, how certain...