| Review article: Patient-level outcomes: the missing link. | |
| | |
MedLine Citation:
|
PMID: 19563387 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Treatment of chronic kidney disease (CKD) may be life-saving, but can disrupt every aspect of a patient's life and the lives of family members. Many patients with CKD are elderly with significant comorbidities and sometimes therapies to improve survival may be less important than those that improve or maintain quality of life. In this setting, patient-level benefits become particularly important goals of therapy. Randomized controlled trials (RCT) are also essential to justify expensive therapies, such as medications used in the treatment of CKD mineral and bone disorders. Surprisingly, data to support the efficacy of these drugs for patient-level outcomes remains limited. In fact, fewer RCT are conducted in renal medicine than in any other medical specialty and reliance is often placed on association data and the assessment of intermediate and biochemical end-points. While some of these may prove to be valid surrogates for clinically important outcomes, some may not. Inclusion of patient-level outcomes in clinical research provides a missing link that can inform a more comprehensive approach to clinical practice and patient care. Incorporating measures of health-related quality of life into clinical trials can make outcomes more relevant and may be relatively simple. This paper provides examples of reliable, validated instruments to measure health-related quality of life domains and functional status, together with practical instructions for their use. Most could be incorporated into RCT of CKD mineral and bone disorder treatments. Inclusion of outcomes that are perceived by patients to be significant should become standard practice in renal medicine and in clinical renal research. |
| | |
Authors:
|
Denise V O'Shaughnessy; Grahame J Elder |
Related Documents
:
|
17643607 - Quality of life before and after major lung resection for lung cancer: a prospective fo... 20637137 - Psychometric properties of the international wellbeing index in community-dwelling olde... 8589317 - Aspects of quality of life in hemodialysis patients. 11392607 - Granulocyte-colony stimulating factor in the prevention of postoperative infectious com... 12067867 - Epidural bolus injection with alkalinized lidocaine improves blockade of the first sacr... 292537 - A prospective study of the rehabilitation of the above-knee amputee with rigid dressing... |
Publication Detail:
|
Type: Journal Article; Review |
Journal Detail:
|
Title: Nephrology (Carlton, Vic.) Volume: 14 ISSN: 1440-1797 ISO Abbreviation: Nephrology (Carlton) Publication Date: 2009 Jun |
Date Detail:
|
Created Date: 2009-06-30 Completed Date: 2009-09-18 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9615568 Medline TA: Nephrology (Carlton) Country: Australia |
Other Details:
|
Languages: eng Pagination: 443-51 Citation Subset: IM |
Affiliation:
|
Renal Resource Centre, Sydney Dialysis Centre, Darling Point, Sydney, New South Wales, Australia. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Comorbidity Health Status Indicators* Humans Quality of Life* Renal Insufficiency, Chronic / mortality*, therapy* Renal Osteodystrophy / mortality, therapy Risk Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Review article: Managing bone complications after kidney transplantation.
Next Document: Telomere length and progression of diabetic nephropathy in patients with type 1 diabetes.