The Concordance between Patients’ Renal Replacement Therapy Choice and Definitive Modality: Is It a Utopia?
Publication Date
October 14, 2015
Journal
PLOS ONE
Authors
Mario Prieto Velasco, Pedro Quiros, Cesar Remon & Spanish Group For The Implementation Of A Shared Decision Making Process For Rrt Choice With Patient Decision Aid Tools
Volume
10
Issue
10
Pages
e0138811
DOI
https://dx.plos.org/10.1371/journal.pone.0138811
Publisher URL
http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0138811
PubMed
http://www.ncbi.nlm.nih.gov/pubmed/26466387
PubMed Central
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4605797
Europe PMC
http://europepmc.org/abstract/MED/26466387
Web of Science
000363183100026
Scopus
84949033825
Mendeley
http://www.mendeley.com/research/concordance-between-patients-renal-replacement-therapy-choice-definitive-modality-it-utopia
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Mendeley | Further Information

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M.", "last_name"=>"Buades", "scopus_author_id"=>"57140433700"}, {"first_name"=>"A.", "last_name"=>"Fernández", "scopus_author_id"=>"56988398400"}, {"first_name"=>"P.", "last_name"=>"Hurtado", "scopus_author_id"=>"57188027500"}, {"first_name"=>"C.", "last_name"=>"Rodríguez", "scopus_author_id"=>"55786432200"}, {"first_name"=>"E.", "last_name"=>"Sánchez", "scopus_author_id"=>"55197100100"}, {"first_name"=>"M. D.", "last_name"=>"Echániz", "scopus_author_id"=>"56989920900"}, {"first_name"=>"C.", "last_name"=>"Muñoz", "scopus_author_id"=>"56486995900"}, {"first_name"=>"J.", "last_name"=>"Rubíes", "scopus_author_id"=>"56989626400"}, {"first_name"=>"P.", "last_name"=>"Quirós", "scopus_author_id"=>"12771500200"}, {"first_name"=>"C.", "last_name"=>"Remón", "scopus_author_id"=>"12770961600"}, {"first_name"=>"A.", "last_name"=>"Tejuca", "scopus_author_id"=>"56989909200"}, {"first_name"=>"F.", "last_name"=>"Vallejo", "scopus_author_id"=>"56989078400"}, {"first_name"=>"F.", "last_name"=>"Barbosa", "scopus_author_id"=>"7005651521"}, {"first_name"=>"M. A.", "last_name"=>"Gerrero", "scopus_author_id"=>"56989751700"}, {"first_name"=>"J. L.", "last_name"=>"Martín", "scopus_author_id"=>"8401029600"}, {"first_name"=>"R.", "last_name"=>"Montes", "scopus_author_id"=>"7006522697"}, {"first_name"=>"A.", "last_name"=>"Pérez", "scopus_author_id"=>"7402509735"}], "year"=>2015, "source"=>"PLoS ONE", "identifiers"=>{"issn"=>"19326203", "scopus"=>"2-s2.0-84949033825", "pmid"=>"26466387", "doi"=>"10.1371/journal.pone.0138811", "pui"=>"607111826", "isbn"=>"1932-6203", "sgr"=>"84949033825"}, "id"=>"779771c3-fea8-3ac4-afd1-cb9c8933da7b", "abstract"=>"INTRODUCTION: It is desirable for patients to play active roles in the choice of renal replacement therapy (RRT). Patient decision aid tools (PDAs) have been developed to allow the patients to choose the option best suited to their individual needs.\\n\\nMATERIAL AND METHODS: An observational, prospective registry was conducted in 26 Spanish hospitals between September 2010 and May 2012. The results of the patients' choice and the definitive RRT modality were registered through the progressive implementation of an Education Process (EP) with PDAs designed to help Chronic Kidney Disease (CKD) patients choose RRT.\\n\\nRESULTS: Patients included in this study: 1044. Of these, 569 patients used PDAs and had made a definitive choice by the end of registration. A total of 88.4% of patients chose dialysis [43% hemodialysis (HD) and 45% peritoneal dialysis (PD)] 3.2% preemptive living-donor transplant (TX), and 8.4% conservative treatment (CT). A total of 399 patients began RRT during this period. The distribution was 93.4% dialysis (53.6% HD; 40% PD), 1.3% preemptive TX and 5.3% CT. The patients who followed the EP changed their mind significantly less often [kappa value of 0.91 (95% CI, 0.86-0.95)] than those who did not follow it, despite starting unplanned treatment [kappa value of 0.85 (95% CI, 0.75-0.95]. A higher agreement between the final choice and a definitive treatment was achieved by the EP and planned patients [kappa value of 0.93 (95% CI, 0.89-0.98)]. Those who did not go through the EP had a much lower index of choosing PD and changed their decision more frequently when starting definitive treatment [kappa value of 0.73 (95% CI, 0.55-0.91)].\\n\\nCONCLUSIONS: Free choice, assisted by PDAs, leads to a 50/50 distribution of PD and HD choice and an increase in TX choice. The use of PDAs, even with an unplanned start, achieved a high level of concordance between the chosen and definitive modality.", "link"=>"http://www.mendeley.com/research/concordance-between-patients-renal-replacement-therapy-choice-definitive-modality-it-utopia", "reader_count"=>27, "reader_count_by_academic_status"=>{"Librarian"=>5, "Researcher"=>3, "Student > Doctoral Student"=>1, "Student > Ph. D. Student"=>3, "Student > Postgraduate"=>3, "Student > Master"=>3, "Other"=>4, "Student > Bachelor"=>3, "Lecturer > Senior Lecturer"=>1, "Professor"=>1}, "reader_count_by_user_role"=>{"Librarian"=>5, "Researcher"=>3, "Student > Doctoral Student"=>1, "Student > Ph. D. Student"=>3, "Student > Postgraduate"=>3, "Student > Master"=>3, "Other"=>4, "Student > Bachelor"=>3, "Lecturer > Senior Lecturer"=>1, "Professor"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>1, "Nursing and Health Professions"=>1, "Biochemistry, Genetics and Molecular Biology"=>1, "Mathematics"=>1, "Medicine and Dentistry"=>17, "Agricultural and Biological Sciences"=>1, "Business, Management and Accounting"=>1, "Psychology"=>1, "Social Sciences"=>3}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>17}, "Social Sciences"=>{"Social Sciences"=>3}, "Psychology"=>{"Psychology"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>1}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>1}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>1}, "Mathematics"=>{"Mathematics"=>1}, "Unspecified"=>{"Unspecified"=>1}}, "reader_count_by_country"=>{"Canada"=>2, "Spain"=>1}, "group_count"=>4}

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  • {"files"=>["https://ndownloader.figshare.com/files/2360068", "https://ndownloader.figshare.com/files/2360069"], "description"=>"<div><p>Introduction</p><p>It is desirable for patients to play active roles in the choice of renal replacement therapy (RRT). Patient decision aid tools (PDAs) have been developed to allow the patients to choose the option best suited to their individual needs.</p><p>Material and Methods</p><p>An observational, prospective registry was conducted in 26 Spanish hospitals between September 2010 and May 2012. The results of the patients’ choice and the definitive RRT modality were registered through the progressive implementation of an Education Process (EP) with PDAs designed to help Chronic Kidney Disease (CKD) patients choose RRT.</p><p>Results</p><p>Patients included in this study: 1044. Of these, 569 patients used PDAs and had made a definitive choice by the end of registration. A total of 88.4% of patients chose dialysis [43% hemodialysis (HD) and 45% peritoneal dialysis (PD)] 3.2% preemptive living-donor transplant (TX), and 8.4% conservative treatment (CT). A total of 399 patients began RRT during this period. The distribution was 93.4% dialysis (53.6% HD; 40% PD), 1.3% preemptive TX and 5.3% CT. The patients who followed the EP changed their mind significantly less often [kappa value of 0.91 (95% CI, 0.86–0.95)] than those who did not follow it, despite starting unplanned treatment [kappa value of 0.85 (95% CI, 0.75–0.95]. A higher agreement between the final choice and a definitive treatment was achieved by the EP and planned patients [kappa value of 0.93 (95% CI, 0.89–0.98)]. Those who did not go through the EP had a much lower index of choosing PD and changed their decision more frequently when starting definitive treatment [kappa value of 0.73 (95% CI, 0.55–0.91)].</p><p>Conclusions</p><p>Free choice, assisted by PDAs, leads to a 50/50 distribution of PD and HD choice and an increase in TX choice. The use of PDAs, even with an unplanned start, achieved a high level of concordance between the chosen and definitive modality.</p></div>", "links"=>[], "tags"=>["ckd", "choice", "Patient decision aid tools", "hd", "pd", "ep", "kappa value", "rrt", "ci", "pda", "ct", "Chronic kidney disease", "tx"], "article_id"=>1575648, "categories"=>["Biological Sciences"], "users"=>["Mario Prieto-Velasco", "Pedro Quiros", "Cesar Remon"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0138811.s001", "https://dx.doi.org/10.1371/journal.pone.0138811.s002"], "stats"=>{"downloads"=>2, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_The_Concordance_between_Patients_8217_Renal_Replacement_Therapy_Choice_and_Definitive_Modality_Is_It_a_Utopia_/1575648", "title"=>"The Concordance between Patients’ Renal Replacement Therapy Choice and Definitive Modality: Is It a Utopia?", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2015-10-14 04:54:36"}
  • {"files"=>["https://ndownloader.figshare.com/files/2360053"], "description"=>"<p>Description of the Phases of the Education Process.</p>", "links"=>[], "tags"=>["ckd", "choice", "Patient decision aid tools", "hd", "pd", "ep", "kappa value", "rrt", "ci", "pda", "ct", "Chronic kidney disease", "tx"], "article_id"=>1575636, "categories"=>["Biological Sciences"], "users"=>["Mario Prieto-Velasco", "Pedro Quiros", "Cesar Remon"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0138811.g001", "stats"=>{"downloads"=>4, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Description_of_the_Phases_of_the_Education_Process_/1575636", "title"=>"Description of the Phases of the Education Process.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-10-14 04:54:36"}
  • {"files"=>["https://ndownloader.figshare.com/files/2360055"], "description"=>"<p>Abbreviations: CT, conservative treatment; HD, in-center hemodialysis; HHD, home hemodialysis; PD, peritoneal dialysis; and TX, living-donor preemptive transplantation.</p>", "links"=>[], "tags"=>["ckd", "choice", "Patient decision aid tools", "hd", "pd", "ep", "kappa value", "rrt", "ci", "pda", "ct", "Chronic kidney disease", "tx"], "article_id"=>1575638, "categories"=>["Biological Sciences"], "users"=>["Mario Prieto-Velasco", "Pedro Quiros", "Cesar Remon"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0138811.g002", "stats"=>{"downloads"=>0, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Patient_Flow_during_the_registry_period_/1575638", "title"=>"Patient Flow during the registry period.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-10-14 04:54:36"}
  • {"files"=>["https://ndownloader.figshare.com/files/2360057"], "description"=>"<p>The values are expressed as the median and interquartile intervals Q1 –Q3.</p>", "links"=>[], "tags"=>["ckd", "choice", "Patient decision aid tools", "hd", "pd", "ep", "kappa value", "rrt", "ci", "pda", "ct", "Chronic kidney disease", "tx"], "article_id"=>1575640, "categories"=>["Biological Sciences"], "users"=>["Mario Prieto-Velasco", "Pedro Quiros", "Cesar Remon"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0138811.t001", "stats"=>{"downloads"=>1, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Patient_Characteristics_/1575640", "title"=>"Patient Characteristics.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-10-14 04:54:36"}
  • {"files"=>["https://ndownloader.figshare.com/files/2360059"], "description"=>"<p>(*) p value shows the difference between Final Choice and Definitive modality.</p><p>Abbreviations: RRT, renal replacement therapy; HD, in-center hemodialysis; PD, peritoneal dialysis; TX, living-donor preemptive transplantation; and CT, conservative treatment.</p><p>Choice and Definitive Treatment Method.</p>", "links"=>[], "tags"=>["ckd", "choice", "Patient decision aid tools", "hd", "pd", "ep", "kappa value", "rrt", "ci", "pda", "ct", "Chronic kidney disease", "tx"], "article_id"=>1575642, "categories"=>["Biological Sciences"], "users"=>["Mario Prieto-Velasco", "Pedro Quiros", "Cesar Remon"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0138811.t002", "stats"=>{"downloads"=>0, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Choice_and_Definitive_Treatment_Method_/1575642", "title"=>"Choice and Definitive Treatment Method.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-10-14 04:54:36"}
  • {"files"=>["https://ndownloader.figshare.com/files/2360061"], "description"=>"<p>* p<0.001 compared with Educated Patients.</p><p>Abbreviations: RRT, renal replacement treatments; CT, conservative treatment; HD, in-center hemodialysis; PD, peritoneal dialysis; and TX, living-donor preemptive transplantation.</p><p>Definitive Treatment Method According to Whether the Patients Followed an Education Process or not.</p>", "links"=>[], "tags"=>["ckd", "choice", "Patient decision aid tools", "hd", "pd", "ep", "kappa value", "rrt", "ci", "pda", "ct", "Chronic kidney disease", "tx"], "article_id"=>1575644, "categories"=>["Biological Sciences"], "users"=>["Mario Prieto-Velasco", "Pedro Quiros", "Cesar Remon"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0138811.t003", "stats"=>{"downloads"=>0, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Definitive_Treatment_Method_According_to_Whether_the_Patients_Followed_an_Education_Process_or_not_/1575644", "title"=>"Definitive Treatment Method According to Whether the Patients Followed an Education Process or not.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-10-14 04:54:36"}
  • {"files"=>["https://ndownloader.figshare.com/files/2360062"], "description"=>"<p>Abbreviations: CT, conservative treatment; HD, in-center hemodialysis; PD, peritoneal dialysis; and TX, living-donor preemptive transplantation.</p><p>Concordance between the Final Choice and the Definitive Method with and without an Education Process.</p>", "links"=>[], "tags"=>["ckd", "choice", "Patient decision aid tools", "hd", "pd", "ep", "kappa value", "rrt", "ci", "pda", "ct", "Chronic kidney disease", "tx"], "article_id"=>1575645, "categories"=>["Biological Sciences"], "users"=>["Mario Prieto-Velasco", "Pedro Quiros", "Cesar Remon"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0138811.t004", "stats"=>{"downloads"=>1, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Concordance_between_the_Final_Choice_and_the_Definitive_Method_with_and_without_an_Education_Process_/1575645", "title"=>"Concordance between the Final Choice and the Definitive Method with and without an Education Process.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-10-14 04:54:36"}
  • {"files"=>["https://ndownloader.figshare.com/files/2360063"], "description"=>"<p>Abbreviations: CT, conservative treatment; HD, in-center hemodialysis; PD, peritonealdialysis; and TX, living-donor preemptive transplantation.</p><p>Concordance between the Final Choice and the Definitive Method with and without an Education Process in patients with a planned or an unplanned start.</p>", "links"=>[], "tags"=>["ckd", "choice", "Patient decision aid tools", "hd", "pd", "ep", "kappa value", "rrt", "ci", "pda", "ct", "Chronic kidney disease", "tx"], "article_id"=>1575646, "categories"=>["Biological Sciences"], "users"=>["Mario Prieto-Velasco", "Pedro Quiros", "Cesar Remon"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0138811.t005", "stats"=>{"downloads"=>0, "page_views"=>14, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Concordance_between_the_Final_Choice_and_the_Definitive_Method_with_and_without_an_Education_Process_in_patients_with_a_planned_or_an_unplanned_start_/1575646", "title"=>"Concordance between the Final Choice and the Definitive Method with and without an Education Process in patients with a planned or an unplanned start.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-10-14 04:54:36"}

PMC Usage Stats | Further Information

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Relative Metric

{"start_date"=>"2015-01-01T00:00:00Z", "end_date"=>"2015-12-31T00:00:00Z", "subject_areas"=>[]}
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