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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/Book"><div class="meta-content fm-sec"><div class="iconblock whole_rhythm clearfix no_top_margin"><a href="https://www.nice.org.uk" title="National Institute for Health and Care Excellence (NICE)" class="img_link icnblk_img" ref="pagearea=logo&targetsite=external&targetcat=link&targettype=publisher"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-niceng107er3-lrg.png" alt="Cover of Evidence review for sequencing modalities of RRT" /></a><div class="icnblk_cntnt"><h1 id="_NBK577489_"><span itemprop="name">Evidence review for sequencing modalities of RRT</span></h1><div class="subtitle">Renal replacement therapy and conservative management</div><p><b>Evidence review</b></p><p><i>NICE Guideline, No. 107</i></p><p class="contrib-group"><h4>Authors</h4><span itemprop="author">National Guideline Centre (UK)</span>.</p><div class="half_rhythm">London: <a href="https://www.nice.org.uk" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Institute for Health and Care Excellence (NICE)</span></a>; <span itemprop="datePublished">2018 Oct</span>.<div class="small">ISBN-13: <span itemprop="isbn">978-1-4731-3107-1</span></div></div><div><a href="/books/about/copyright/">Copyright</a> © NICE 2018.</div></div></div></div><div class="body-content whole_rhythm" itemprop="text"><div id="ch3.s1"><h2 id="_ch3_s1_">1. Sequencing for RRT modalities</h2><div id="ch3.s1.1"><h3>1.1. Review question: What is the clinical and cost effectiveness of different sequences of modalities of renal replacement therapy and conservative management for people progressing or who have progressed through the later stages of CKD?</h3></div><div id="ch3.s1.2"><h3>1.2. Introduction</h3><p>This review is designed to determine the clinical and cost effectiveness of different sequences of renal replacement therapy, for example haemodialysis, haemodiafiltration or peritoneal dialysis prior to transplantation.</p></div><div id="ch3.s1.3"><h3>1.3. PICO table</h3><p>For full details see the review protocol in <a href="#ch3.appa">appendix A</a>.</p></div><div id="ch3.s1.4"><h3>1.4. Clinical evidence</h3><div id="ch3.s1.4.1"><h4>1.4.1. Included studies</h4><p>Three studies were included in the review;<a class="bk_pop" href="#ch3.ref13"><sup>13</sup></a><sup>,</sup>
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<a class="bk_pop" href="#ch3.ref30"><sup>30</sup></a><sup>,</sup>
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<a class="bk_pop" href="#ch3.ref31"><sup>31</sup></a> these are summarised in <a class="figpopup" href="/books/NBK577489/table/ch3.tab2/?report=objectonly" target="object" rid-figpopup="figch3tab2" rid-ob="figobch3tab2">Table 2</a> below. Evidence from these studies is summarised in the clinical evidence summary below (<a class="figpopup" href="/books/NBK577489/table/ch3.tab3/?report=objectonly" target="object" rid-figpopup="figch3tab3" rid-ob="figobch3tab3">Table 3</a>).</p><p>A search was conducted for randomised trials and non-randomised studies comparing one modality over another for CKD, where a person received more than one modality of RRT sequentially. The papers identified were all non-randomised. Two papers looked at RRT treatment prior to transplantation, both comparing HD and PD. One looked at RRT treatment following a transplant that is failing, comparing pre-emptive retransplantation with non-pre-emptive retransplantation.</p></div><div id="ch3.s1.4.2"><h4>1.4.2. Excluded studies</h4><p>See the excluded studies list in <a href="#ch3.appi">appendix I</a>.</p></div><div id="ch3.s1.4.3"><h4>1.4.3. Summary of clinical studies included in the evidence review</h4><p>See <a href="#ch3.appd">appendix D</a> for full evidence tables.</p></div><div id="ch3.s1.4.4"><h4>1.4.4. Quality assessment of clinical studies included in the evidence review</h4><p>See <a href="#ch3.appf">appendix F</a> for full GRADE tables.</p></div></div><div id="ch3.s1.5"><h3>1.5. Economic evidence</h3><div id="ch3.s1.5.1"><h4>1.5.1. Included studies</h4><p>1 health economic study with relevant comparisons has been included in this review: it compared switching from HD to PD and PD to HD with HD and PD alone<a class="bk_pop" href="#ch3.ref7"><sup>7</sup></a>; See also the health economic study selection flow chart in <a href="#ch3.appg">appendix G</a>.</p><p>No health economic studies were included that looked at transplant.</p><p>None of the included studies were in children.</p><p>Note that current UK RRT intervention costs are discussed in section 1.5.5.</p></div><div id="ch3.s1.5.2"><h4>1.5.2. Excluded studies</h4><p>No health economic studies that were relevant to this question were excluded due to assessment of limited applicability or methodological limitations.</p><p>See also the health economic study selection flow chart in <a href="#ch3.appg">appendix G</a>.</p></div><div id="ch3.s1.5.3"><h4>1.5.3. Summary of studies included in the economic evidence review</h4></div><div id="ch3.s1.5.4"><h4>1.5.4. Unit costs</h4><p>See <a href="/books/n/niceng107er2/" class="toc-item">Evidence report B: modalities of RRT</a> for current unit costs of RRT.</p></div></div><div id="ch3.s1.6"><h3>1.6. Resource impact</h3><p>No recommendations were made based on this review (<a href="#ch3.s1.8">Section 1.8</a>).</p></div><div id="ch3.s1.7"><h3>1.7. Evidence statements</h3><div id="ch3.s1.7.1"><h4>1.7.1. Clinical evidence statements</h4><p>No evidence for quality of life, mortality, time to failure of RRT form, hospitalisation, preferred place of death, symptom scores and functional measures, psychological distress and mental wellbeing, cognitive impairment, experience of care, growth, malignancy, infections, vascular access issues, dialysis access issues, acute transplant rejection episodes.</p><div id="ch3.s1.7.1.1"><h5>Adults aged 18 to 70</h5><div id="ch3.s1.7.1.1.1"><h5>Transplant after PD vs transplant after HD, NRS</h5><p>No evidence for quality of life, hospitalisation, preferred place of death, symptom scores and functional measures, psychological distress and mental wellbeing, cognitive impairment, experience of care, growth, malignancy, infections, vascular access issues, dialysis access issues, acute transplant rejection episodes.</p><p>No clinical difference was found for mortality in time to event (1 study, very low quality) or relative risk (1 study very low quality) or graft failure in time to event (1 study, very low quality) or relative risk (1 study very low quality).</p></div><div id="ch3.s1.7.1.1.2"><h5>Pre-emptive transplant after transplant vs post-dialysis re-transplant after transplant</h5><p>No evidence for quality of life, hospitalisation, preferred place of death, symptom scores and functional measures, psychological distress and mental wellbeing, cognitive impairment, experience of care, growth, malignancy, infections, vascular access issues, dialysis access issues, acute transplant rejection episodes.</p><p>There was a clinically important harm of pre-emptive transplant for graft failure (1 study, very low quality).</p><p>No clinical difference was found for mortality in time to event (1 study, very low quality) or graft failure in time to event (1 study, very low quality) or relative risk (1 study very low quality).</p></div></div></div><div id="ch3.s1.7.2"><h4>1.7.2. Health economic evidence statements</h4><ul id="ch3.l12"><li id="ch3.lt42" class="half_rhythm"><div>One comparative cost analysis found that people who switched from HD to PD in the first year had lower costs at one year and three years than people who switched from PD to HD in the first year. This was assessed as partially applicable with potentially serious limitations.</div></li></ul></div></div><div id="ch3.s1.8"><h3>1.8. The committee’s discussion of the evidence</h3></div><div id="ch3.s1.9"><h3>1.9. Interpreting the evidence</h3><div id="ch3.s1.9.1"><h4>1.9.1. The outcomes that matter most</h4><p>The committee considered quality of life, mortality, and time to failure of RRT modalities to be critical outcomes and hospitalisation, preferred place of death, symptom scores and functional measures, psychological distress and mental wellbeing, cognitive impairment, experience of care, growth, malignancy, infections, vascular access issues, dialysis access issues and acute transplant rejection episodes to be important outcomes.</p></div><div id="ch3.s1.9.2"><h4>1.9.2. The quality of the evidence</h4><p>No evidence was identified for children under the age of 18 or adults over the age of 70. No evidence was identified for the majority of possible sequences of treatment.</p><p>The only identified evidence was very low quality due to a combination of the non-randomised study design and other sources of risk of bias.</p></div><div id="ch3.s1.9.3"><h4>1.9.3. Benefits and harms</h4><p>The comparison between transplanting after HD and transplanting after PD showed no clinically important difference for the two reported included outcomes (mortality and graft failure). The committee agreed that this was broadly consistent with their experience.</p><p>The comparison between pre-emptive transplant with a failing transplant and transplant after dialysis with a failing transplant showed no clinically important difference for mortality but a clinically important harm of pre-emptive transplant for graft failure. The committee noted that this somewhat contradicted the general benefits of pre-emptive first transplant. While the included study did adjust for the key confounders in the analysis, the committee agreed that there may still be residual confounding factors. There may be people in the pre-emptive group who, had they been given the time to require dialysis, may have accrued other reasons to make transplantation inappropriate. Overall the committee agreed that the evidence certainly did not support recommendations to aim for pre-emptive second transplants in people with failing transplants but it was not strong enough to warrant recommendations against pre-emptive second transplants.</p></div><div id="ch3.s1.9.4"><h4>1.9.4. Cost effectiveness and resource use</h4><p>One economic evaluation was included that compared costs in people who switched from HD to PD and PD to HD in the first year. Costs were lower in the group that switched from HD to PD however this was largely due to lower dialysis costs as PD costs were lower in this analysis. This study was judged partially applicable; in particular Canadian costs may not be applicable and the cost savings in dialysis costs with PD in this setting may not be seen in current UK practice based on current NHS reference costs.</p><p>No economic evidence was identified relating to other sequences.</p></div><div id="ch3.s1.9.5"><h4>1.9.5. Other factors the committee took into account</h4><p>The committee discussed that if renal transplant is unsuitable or cannot be provided for the person with kidney disease in a timely fashion then the over-riding factor of choosing initial dialysis treatment and subsequent switches should be patient preference.”</p></div></div></div><div id="ch3.rl.r1"><h2 id="_ch3_rl_r1_">References</h2><dl class="temp-labeled-list"><dt>1.</dt><dd><div class="bk_ref" id="ch3.ref1">Albrechtsen
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HT. Effect of dialysis modality on transplantation outcome in living-donor renal transplantation. Nephro-Urology Monthly. 2011; 3(4):202–207</div></dd><dt>3.</dt><dd><div class="bk_ref" id="ch3.ref3">Binaut
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BM. Antigen-independent determinants of cadaveric kidney transplant failure. JAMA. 1996; 276(21):1732–1736 [<a href="https://pubmed.ncbi.nlm.nih.gov/8940321" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8940321</span></a>]</div></dd><dt>7.</dt><dd><div class="bk_ref" id="ch3.ref7">Chui
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et al. Patient survival after renal transplantation: I. The impact of dialysis pre-transplant. Kidney International. 1998; 53(3):767–72 [<a href="https://pubmed.ncbi.nlm.nih.gov/9507225" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9507225</span></a>]</div></dd><dt>9.</dt><dd><div class="bk_ref" id="ch3.ref9">de Jonge
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JG. Sequential renal transplants. Some surgical and immunological implications on management of the first homograft. Surgery. 1976; 79(3):262–267 [<a href="https://pubmed.ncbi.nlm.nih.gov/769212" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 769212</span></a>]</div></dd><dt>13.</dt><dd><div class="bk_ref" id="ch3.ref13">Goldfarb-Rumyantzev
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|
||
et al. Comparative analysis of immunophenotypic abnormalities in cellular immunity of uremic patients undergoing either hemodialysis or continuous ambulatory peritoneal dialysis. Renal Failure. 2005; 27(3):279–282 [<a href="https://pubmed.ncbi.nlm.nih.gov/15957543" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15957543</span></a>]</div></dd><dt>15.</dt><dd><div class="bk_ref" id="ch3.ref15">Iles-Smith
|
||
H, Curwell
|
||
J, Gokal
|
||
R. Comparative evaluation of CAPD and PD-plus effectiveness. Edtna-Erca Journal. 1999; 25(3):27–9 [<a href="https://pubmed.ncbi.nlm.nih.gov/10786491" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10786491</span></a>]</div></dd><dt>16.</dt><dd><div class="bk_ref" id="ch3.ref16">Jimenez
|
||
C, Manrique
|
||
A, Morales
|
||
JM, Andres
|
||
A, Ortuno
|
||
T, Abradelo
|
||
M
|
||
et al. Influence of dialysis modality on complications and patient and graft survival after pancreas-kidney transplantation. Transplantation Proceedings. 2008; 40(9):2999–3000 [<a href="https://pubmed.ncbi.nlm.nih.gov/19010172" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19010172</span></a>]</div></dd><dt>17.</dt><dd><div class="bk_ref" id="ch3.ref17">Johnston
|
||
O, Rose
|
||
CL, Gill
|
||
JS. Risks and benefits of preemptive second kidney transplantation. Transplantation. 2013; 95(5):705–710 [<a href="https://pubmed.ncbi.nlm.nih.gov/23503503" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23503503</span></a>]</div></dd><dt>18.</dt><dd><div class="bk_ref" id="ch3.ref18">Koc
|
||
Y, Unsal
|
||
A, Basturk
|
||
T, Sakaci
|
||
T, Ahbap-Dal
|
||
E, Sinangil
|
||
A
|
||
et al. Is there impact of mortality prior hemodialysis therapy in peritoneal dialysis patients? Nefrologia. 2012; 32(3):335–342 [<a href="https://pubmed.ncbi.nlm.nih.gov/22508142" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22508142</span></a>]</div></dd><dt>19.</dt><dd><div class="bk_ref" id="ch3.ref19">Kostro
|
||
JZ, Hellmann
|
||
A, Kobiela
|
||
J, Skora
|
||
I, Lichodziejewska-Niemierko
|
||
M, Debska-Slizien
|
||
A
|
||
et al. Quality of life after kidney transplantation: A prospective study. Transplantation Proceedings. 2016; 48(1):50–4 [<a href="https://pubmed.ncbi.nlm.nih.gov/26915842" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26915842</span></a>]</div></dd><dt>20.</dt><dd><div class="bk_ref" id="ch3.ref20">Lorent
|
||
M, Giral
|
||
M, Pascual
|
||
M, Koller
|
||
MT, Steiger
|
||
J, Trebern-Launay
|
||
K
|
||
et al. Mortality prediction after the first year of kidney transplantation: An observational study on two European cohorts. PloS One. 2016; 11(5):e0155278 [<a href="/pmc/articles/PMC4859488/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4859488</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27152510" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27152510</span></a>]</div></dd><dt>21.</dt><dd><div class="bk_ref" id="ch3.ref21">Nadeau-Fredette
|
||
AC, Bargman
|
||
JM, Chan
|
||
CT. Clinical outcome of home hemodialysis in patients with previous peritoneal dialysis exposure: evaluation of the integrated home dialysis model. Peritoneal Dialysis International. 2015; 35(3):316–23 [<a href="/pmc/articles/PMC4443990/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4443990</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24584602" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24584602</span></a>]</div></dd><dt>22.</dt><dd><div class="bk_ref" id="ch3.ref22">National Institute for Health and Clinical Excellence. The guidelines manual. London. National Institute for Health and Clinical Excellence, 2012. Available from: <a href="http://www.nice.org.uk/article/pmg6/" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>.nice.org.uk/article/pmg6/</a> [<a href="https://pubmed.ncbi.nlm.nih.gov/27905714" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27905714</span></a>]</div></dd><dt>23.</dt><dd><div class="bk_ref" id="ch3.ref23">Odor-Morales
|
||
A, Castorena
|
||
G, Jimeno
|
||
C, Pena
|
||
JC, Bordes
|
||
J, de la Rosa
|
||
C
|
||
et al. Hemodialysis or continuous ambulatory peritoneal dialysis before transplantation: prospective comparison of clinical and hemodynamic outcome. Transplantation Proceedings. 1987; 19(1 Pt 3):2197–9 [<a href="https://pubmed.ncbi.nlm.nih.gov/3079075" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 3079075</span></a>]</div></dd><dt>24.</dt><dd><div class="bk_ref" id="ch3.ref24">Opelz
|
||
G. Success rate and impact of HLA matching on kidney graft survival in highly immunized recipients. Collaborative Transplant Study. Transplant International. 1992; 5:(Suppl 1):S601–603 [<a href="https://pubmed.ncbi.nlm.nih.gov/14628740" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 14628740</span></a>]</div></dd><dt>25.</dt><dd><div class="bk_ref" id="ch3.ref25">Organisation for Economic Co-operation and Development (OECD). Purchasing power parities (PPP). Available from: <a href="http://www.oecd.org/std/prices-ppp/" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>.oecd.org/std/prices-ppp/</a> Last accessed: 13/12/2017.</div></dd><dt>26.</dt><dd><div class="bk_ref" id="ch3.ref26">Persijn
|
||
GG, D’Amaro
|
||
J, Rood
|
||
JJ. Pretransplant blood transfusions and long-term renal allograft survival. Lancet. 1984; 2(8410):1043–4 [<a href="https://pubmed.ncbi.nlm.nih.gov/6149426" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 6149426</span></a>]</div></dd><dt>27.</dt><dd><div class="bk_ref" id="ch3.ref27">Resende
|
||
L, Guerra
|
||
J, Santana
|
||
A, Mil-Homens
|
||
C, Abreu
|
||
F, da Costa
|
||
AG. Influence of dialysis duration and modality on kidney transplant outcomes. Transplantation Proceedings. 2009; 41(3):837–9 [<a href="https://pubmed.ncbi.nlm.nih.gov/19376365" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19376365</span></a>]</div></dd><dt>28.</dt><dd><div class="bk_ref" id="ch3.ref28">Rigo
|
||
DH, Ziraldo
|
||
L, Di Monte
|
||
L, Jimenez
|
||
MP, Giotto
|
||
AP, Gutierrez
|
||
L
|
||
et al. Preemptive kidney transplantation: experience in two centers. Transplantation Proceedings. 2011; 43(9):3355–8 [<a href="https://pubmed.ncbi.nlm.nih.gov/22099795" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22099795</span></a>]</div></dd><dt>29.</dt><dd><div class="bk_ref" id="ch3.ref29">Schold
|
||
JD, Meier-Kriesche
|
||
HU. Which renal transplant candidates should accept marginal kidneys in exchange for a shorter waiting time on dialysis?
|
||
Clinical Journal of the American Society of Nephrology. 2006; 1(3):532–538 [<a href="https://pubmed.ncbi.nlm.nih.gov/17699256" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17699256</span></a>]</div></dd><dt>30.</dt><dd><div class="bk_ref" id="ch3.ref30">Schwenger
|
||
V, Dohler
|
||
B, Morath
|
||
C, Zeier
|
||
M, Opelz
|
||
G. The role of pretransplant dialysis modality on renal allograft outcome. Nephrology Dialysis Transplantation. 2011; 26(11):3761–6 [<a href="https://pubmed.ncbi.nlm.nih.gov/21427080" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21427080</span></a>]</div></dd><dt>31.</dt><dd><div class="bk_ref" id="ch3.ref31">Snyder
|
||
JJ, Kasiske
|
||
BL, Gilbertson
|
||
DT, Collins
|
||
AJ. A comparison of transplant outcomes in peritoneal and hemodialysis patients. Kidney International. 2002; 62(4):1423–1430 [<a href="https://pubmed.ncbi.nlm.nih.gov/12234315" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12234315</span></a>]</div></dd><dt>32.</dt><dd><div class="bk_ref" id="ch3.ref32">Traynor
|
||
JP, Thomson
|
||
PC, Simpson
|
||
K, Ayansina
|
||
DT, Prescott
|
||
GJ, Mactier
|
||
RA. Comparison of patient survival in non-diabetic transplant-listed patients initially treated with haemodialysis or peritoneal dialysis. Nephrology, Dialysis, Transplantation. 2011; 26(1):245–52 [<a href="https://pubmed.ncbi.nlm.nih.gov/20659905" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20659905</span></a>]</div></dd><dt>33.</dt><dd><div class="bk_ref" id="ch3.ref33">Van Den Berg-Loonen
|
||
EM, Billen
|
||
EVA, Voorter
|
||
CEM, Van Heurn
|
||
LWE, Claas
|
||
FHJ, Van Hooff
|
||
JP
|
||
et al. Clinical relevance of pretransplant donor-directed antibodies detected by single antigen beads in highly sensitized renal transplant patients. Transplantation. 2008; 85(8):1086–1090 [<a href="https://pubmed.ncbi.nlm.nih.gov/18431226" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18431226</span></a>]</div></dd><dt>34.</dt><dd><div class="bk_ref" id="ch3.ref34">West
|
||
JC, Bisordi
|
||
JE, Squiers
|
||
EC, Latsha
|
||
R, Miller
|
||
J, Kelley
|
||
SE. Length of time on dialysis prior to renal transplantation is a critical factor affecting patient survival after allografting. Transplant International. 1992; 5:(Suppl 1):S148–150 [<a href="https://pubmed.ncbi.nlm.nih.gov/14621760" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 14621760</span></a>]</div></dd><dt>35.</dt><dd><div class="bk_ref" id="ch3.ref35">Zhou
|
||
YC, Cecka
|
||
JM. Sensitization in renal transplantation. Clinical Transplants. 1991:313–323 [<a href="https://pubmed.ncbi.nlm.nih.gov/1820127" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1820127</span></a>]</div></dd></dl></div><div id="appendixes.appgroup3"><h2 id="_appendixes_appgroup3_">Appendices</h2><div id="ch3.appa"><h3>Appendix A. Review protocols</h3><div id="ch3.appa.tab1" class="table"><h3><span class="label">Table 6</span><span class="title">Review protocol: Sequences of modalities of RRT and conservative management</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577489/table/ch3.appa.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch3.appa.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Field</th><th id="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Content</th></tr></thead><tbody><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Review question</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">What is the clinical and cost effectiveness of different sequences of modalities of renal replacement therapy and conservative management for people who are progressing or have progressed through to later stages of CKD?</td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Type of review question</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention</td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Objective of the review</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparing the clinical and cost effectiveness of various modalities of RRT after failing previous modalities.</td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – population / disease / condition / issue / domain</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>People requiring RRT for CKD, who have received more than one modality of RRT sequentially, either because the earlier modality was considered to have failed, or because they received one modality while waiting for another (e.g. receiving dialysis prior to receiving a kidney transplant). Studies will be included where the majority meet one of these criteria. Studies will be downgraded for indirectness if >25% are RRT naïve. Definition of modality failure to be determined by studies.</p>
|
||
<p>Stratified by:
|
||
<ul id="ch3.l13"><li id="ch3.lt43" class="half_rhythm"><div>Previously modality</div></li><li id="ch3.lt44" class="half_rhythm"><div>Age (<2, 2 to <18, 18 to <70, ≥70)</div></li><li id="ch3.lt45" class="half_rhythm"><div>DM vs no DM</div></li><li id="ch3.lt46" class="half_rhythm"><div>BAME vs non-BAME</div></li><li id="ch3.lt47" class="half_rhythm"><div>Unplanned starters vs planned starters</div></li></ul></p>
|
||
</td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – interventions</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>Two RRT modalities received sequentially. RRT modalities are:</p>
|
||
<p>Haemodialysis (HD) – including home or in centre, 3 days a week or more frequently, haemodialysis or haemodiafiltration</p>
|
||
<p>Peritoneal dialysis (PD) – including CAPD, assisted PD or APD/CCPD</p>
|
||
<p>Transplant (TPx) – including live donor or deceased, pre-emptive or reactive</p>
|
||
<p>Conservative management</p>
|
||
</td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – comparator(s) / control or reference (gold) standard</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>Any modality or sub-modality vs any other, including where the comparison is between the first modality in a sequence (e.g. HD vs PD before transplantation), the second modality in a sequence (e.g. HD vs PD after transplantation) or between two sequences (e.g. HD then PD vs PD then HD)</p>
|
||
<p>Studies comparing multiple sequences of RRT will also be included (for example HD then PD vs PD then HD)</p>
|
||
</td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes and prioritisation</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>Critical
|
||
<ul id="ch3.l14"><li id="ch3.lt48" class="half_rhythm"><div>Patient, family/carer health-related quality of life (continuous)</div></li><li id="ch3.lt49" class="half_rhythm"><div>Mortality (dichotomous and time to event)</div></li><li id="ch3.lt50" class="half_rhythm"><div>Time to failure of RRT form (time to event)</div></li></ul>
|
||
Important
|
||
<ul id="ch3.l15"><li id="ch3.lt51" class="half_rhythm"><div>Hospitalisation (rates or continuous)</div></li><li id="ch3.lt52" class="half_rhythm"><div>Preferred place of death (dichotomous)</div></li><li id="ch3.lt53" class="half_rhythm"><div>Symptom scores and functional measures (continuous)</div></li><li id="ch3.lt54" class="half_rhythm"><div>Psychological distress and mental wellbeing (continuous)</div></li><li id="ch3.lt55" class="half_rhythm"><div>Cognitive impairment (dichotomous)</div></li><li id="ch3.lt56" class="half_rhythm"><div>Patient, family and carer experience of care (continuous)</div></li><li id="ch3.lt57" class="half_rhythm"><div>Growth (continuous)</div></li><li id="ch3.lt58" class="half_rhythm"><div>Malignancy (dichotomous)</div></li><li id="ch3.lt59" class="half_rhythm"><div>Adverse events
|
||
<ul id="ch3.l16" class="circle"><li id="ch3.lt60" class="half_rhythm"><div>Infections (dichotomous)</div></li><li id="ch3.lt61" class="half_rhythm"><div>Vascular access issues (dichotomous)</div></li><li id="ch3.lt62" class="half_rhythm"><div>Dialysis access issues (dichotomous)</div></li><li id="ch3.lt63" class="half_rhythm"><div>Acute transplant rejection episodes (dichotomous)</div></li></ul></div></li></ul>
|
||
Strategy:</p>
|
||
<p>When outcomes are reported at multiple timepoints, the later timepoints will be prioritised. Mortality and hospitalisation must be reported after at least 6 months of the intervention under investigation. All other outcomes must be reported after at least 1 month of the intervention under investigation.</p>
|
||
<p>For the outcomes of quality of life, symptom scores/functional measures, psychological distress/mental wellbeing and experience of care – any validated measure will be accepted.</p>
|
||
<p>Absolute MIDs of 30 per 1000 will be used for mortality and modality failure. Absolute MIDs of 100 per 1000 will be used for all other outcomes dichotomous outcomes. Where relative MIDs are required (if absolute effects are unavailable), 0.90 to 1.11 will be used for mortality and modality failure. The default relative MIDs of 0.8 to 1.25 will be used for all other dichotomous outcomes. Default continuous MIDs of 0.5x SD will be used for all continuous outcomes, except where published, validated MIDs exist.</p>
|
||
</td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – study design</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RCTs will be prioritised. If insufficient evidence is found for any specified comparisons non-randomised studies will be considered but only if outcomes are adjusted for the following key confounders:
|
||
<ul id="ch3.l17"><li id="ch3.lt64" class="half_rhythm"><div>Age</div></li><li id="ch3.lt65" class="half_rhythm"><div>Health at baseline</div></li><li id="ch3.lt66" class="half_rhythm"><div>Co-morbidities</div></li><li id="ch3.lt67" class="half_rhythm"><div>Ethnicity</div></li></ul></td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Other inclusion exclusion criteria</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>Any studies where the RRT is being delivered for acute kidney injury, not in the context of chronic kidney disease, will be excluded.</p>
|
||
<p>Any studies where the RRT is being delivered in a level 2 or 3 care setting, will be excluded.</p>
|
||
</td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Proposed sensitivity / subgroup analysis, or meta-regression</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>People with a BMI ≥30 vs BMI <30</p>
|
||
<p>Aged ≥80 vs aged <80</p>
|
||
<p>T1DM vs T2DM</p>
|
||
<p>Sub-modalities (for intermodality comparisons)</p>
|
||
<p>Nocturnal vs diurnal HD</p>
|
||
</td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Selection process – duplicate screening / selection / analysis</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">A sample of at least 10% of the abstract lists were double-sifted by a senior research fellow and discrepancies rectified, with committee input where consensus could not be reached, for more information please see the separate Methods report for this guideline.</td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data management (software)</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<ul id="ch3.l18"><li id="ch3.lt68" class="half_rhythm"><div>Pairwise meta-analyses were performed using Cochrane Review Manager (RevMan5).</div></li><li id="ch3.lt69" class="half_rhythm"><div>GRADEpro was used to assess the quality of evidence for each outcome.</div></li><li id="ch3.lt70" class="half_rhythm"><div>Endnote was used for bibliography, citations, sifting and reference management.</div></li></ul>
|
||
</td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Information sources – databases and dates</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>Clinical search databases to be used: Medline, Embase, Cochrane Library</p>
|
||
<p>Date: All years</p>
|
||
<p>Health economics search databases to be used: Medline, Embase, NHSEED, HTA</p>
|
||
<p>Date: Medline, Embase from 2014</p>
|
||
<p>NHSEED, HTA – all years</p>
|
||
<p>Language: Restrict to English only</p>
|
||
<p>Supplementary search techniques: backward citation searching</p>
|
||
<p>Key papers: Not known</p>
|
||
</td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Identify if an update</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not an update</td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Author contacts</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<a href="https://www.nice.org.uk/guidance/indevelopment/gid-ng10019" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>.nice.org<wbr style="display:inline-block"></wbr>.uk/guidance/indevelopment/gid-ng10019</a>
|
||
</td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Highlight if amendment to previous protocol</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not an amendment</td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Search strategy – for one database</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see <a href="#ch3.appb">appendix B</a></td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data collection process – forms / duplicate</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">A standardised evidence table format will be used, and published as appendices of the evidence report.</td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Data items – define all variables to be collected</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see evidence tables in <a href="#ch3.appd">Appendix D</a> (clinical evidence tables) or <a href="#ch3.apph">H</a> (health economic evidence tables).</td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Methods for assessing bias at outcome / study level</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>Standard study checklists were used to critically appraise individual studies. For details please see section 6.2 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a></p>
|
||
<p>The risk of bias across all available evidence was evaluated for each outcome using an adaptation of the ‘Grading of Recommendations Assessment, Development and Evaluation (GRADE) toolbox’ developed by the international GRADE working group <a href="http://www.gradeworkinggroup.org/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">http://www<wbr style="display:inline-block"></wbr>.gradeworkinggroup.org/</a></p>
|
||
</td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Criteria for quantitative synthesis</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see section 6.4 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>.</td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Methods for quantitative analysis – combining studies and exploring (in)consistency</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see the separate Methods report for this guideline.</td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Meta-bias assessment – publication bias, selective reporting bias</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see section 6.2 of <a href="https://www.nice.org.uk/article/pmg20/chapter/6-Reviewing-research-evidence#assessing-the-quality-of-the-evidence" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>.</td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Confidence in cumulative evidence</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see sections 6.4 and 9.1 of <a href="https://www.nice.org.uk/article/pmg20/chapter/1-Introduction-and-overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>.</td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Rationale / context – what is known</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see the introduction to the evidence review.</td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Describe contributions of authors and guarantor</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>A multidisciplinary committee developed the evidence review. The committee was convened by the National Guideline Centre (NGC) and chaired by Jan Dudley in line with section 3 of <a href="https://www.nice.org.uk/article/pmg20/chapter/1%20Introduction%20and%20overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>.</p>
|
||
<p>Staff from NGC undertook systematic literature searches, appraised the evidence, conducted meta-analysis and cost-effectiveness analysis where appropriate, and drafted the evidence review in collaboration with the committee. For details please see <a href="https://www.nice.org.uk/article/pmg20/chapter/1-Introduction-and-overview" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Developing NICE guidelines: the manual</a>.</p>
|
||
</td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Sources of funding / support</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NGC is funded by NICE and hosted by the Royal College of Physicians.</td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Name of sponsor</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NGC is funded by NICE and hosted by the Royal College of Physicians.</td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Roles of sponsor</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NICE funds NGC to develop guidelines for those working in the NHS, public health and social care in England.</td></tr><tr><td headers="hd_h_ch3.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">PROSPERO registration number</td><td headers="hd_h_ch3.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not registered</td></tr></tbody></table></div></div><div id="ch3.appa.tab2" class="table"><h3><span class="label">Table 7</span><span class="title">Health economic review protocol</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577489/table/ch3.appa.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch3.appa.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_ch3.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Review question</th><th id="hd_h_ch3.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">All questions – health economic evidence</th></tr></thead><tbody><tr><td headers="hd_h_ch3.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<b>Objectives</b>
|
||
</td><td headers="hd_h_ch3.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">To identify economic studies relevant to any of the review questions.</td></tr><tr><td headers="hd_h_ch3.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<b>Search criteria</b>
|
||
</td><td headers="hd_h_ch3.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<ul id="ch3.l19"><li id="ch3.lt71" class="half_rhythm"><div>Populations, interventions and comparators must be as specified in the individual review protocol above.</div></li><li id="ch3.lt72" class="half_rhythm"><div>Studies must be of a relevant economic study design (cost-utility analysis, cost-effectiveness analysis, cost-benefit analysis, cost-consequences analysis, comparative cost analysis).</div></li><li id="ch3.lt73" class="half_rhythm"><div>Studies must not be a letter, editorial or commentary, or a review of economic evaluations. (Recent reviews will be ordered although not reviewed; the bibliographies will be checked for relevant studies, which will then be ordered.)</div></li><li id="ch3.lt74" class="half_rhythm"><div>Unpublished reports will not be considered unless submitted as part of a call for evidence.</div></li><li id="ch3.lt75" class="half_rhythm"><div>Studies must be in English.</div></li></ul>
|
||
</td></tr><tr><td headers="hd_h_ch3.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<b>Search strategy</b>
|
||
</td><td headers="hd_h_ch3.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">An economic study search will be undertaken using population-specific terms and an economic study filter – see <a href="#ch3.appb.s2">Appendix B.2</a> Health economics literature search strategy.</td></tr><tr><td headers="hd_h_ch3.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<b>Review strategy</b>
|
||
</td><td headers="hd_h_ch3.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>Studies not meeting any of the search criteria above will be excluded. Studies published before 2001, abstract-only studies and studies from non-OECD countries or the USA will also be excluded.</p>
|
||
<p>Each remaining study will be assessed for applicability and methodological limitations using the NICE economic evaluation checklist which can be found in <a href="#ch3.appg">Appendix G</a> of the 2012 NICE guidelines manual.<a class="bk_pop" href="#ch3.ref22"><sup>22</sup></a> Each included study is summarised in an economic evidence profile and an evidence table. Any excluded studies are detailed in the excluded studies table with the reason for exclusion in <a href="#ch3.appi">Appendix I</a>.</p>
|
||
<p><b>Inclusion and exclusion criteria</b>
|
||
<ul id="ch3.l20"><li id="ch3.lt76" class="half_rhythm"><div>If a study is rated as both ‘Directly applicable’ and with ‘Minor limitations’ then it will be included in the guideline.</div></li><li id="ch3.lt77" class="half_rhythm"><div>If a study is rated as either ‘Not applicable’ or with ‘Very serious limitations’ then it will usually be excluded from the guideline.</div></li><li id="ch3.lt78" class="half_rhythm"><div>If a study is rated as ‘Partially applicable’, with ‘Potentially serious limitations’ or both then there is discretion over whether it should be included.</div></li></ul>
|
||
<b>Where there is discretion</b></p>
|
||
<p>The health economist will make a decision based on the relative applicability and quality of the available evidence for that question, in discussion with the Committee if required. The ultimate aim is to include economic studies that are helpful for decision-making in the context of the guideline and the current NHS setting. If several studies are considered of sufficiently high applicability and methodological quality that they could all be included, then the health economist, in discussion with the Committee if required, may decide to include only the most applicable studies and to selectively exclude the remaining studies. For example, if a high quality study from a UK perspective is available a similar study from another country’s perspective may be excluded.</p>
|
||
<p>The health economist will be guided by the following hierarchies.</p>
|
||
<p><i>Setting:</i>
|
||
<ul id="ch3.l21"><li id="ch3.lt79" class="half_rhythm"><div>UK NHS (most applicable).</div></li><li id="ch3.lt80" class="half_rhythm"><div>OECD countries with predominantly public health insurance systems (for example, France, Germany, Sweden).</div></li><li id="ch3.lt81" class="half_rhythm"><div>OECD countries with predominantly private health insurance systems (for example, Switzerland).</div></li><li id="ch3.lt82" class="half_rhythm"><div>Studies set in non-OECD countries or in the USA will have been excluded before being assessed for applicability and methodological limitations.</div></li></ul>
|
||
<i>Economic study type:</i>
|
||
<ul id="ch3.l22"><li id="ch3.lt83" class="half_rhythm"><div>Cost-utility analysis (most applicable).</div></li><li id="ch3.lt84" class="half_rhythm"><div>Other type of full economic evaluation (cost-benefit analysis, cost-effectiveness analysis, cost-consequences analysis).</div></li><li id="ch3.lt85" class="half_rhythm"><div>Comparative cost analysis.</div></li><li id="ch3.lt86" class="half_rhythm"><div>Non-comparative cost analyses including cost-of-illness studies will have been excluded before being assessed for applicability and methodological limitations.</div></li></ul>
|
||
<i>Year of analysis:</i>
|
||
<ul id="ch3.l23"><li id="ch3.lt87" class="half_rhythm"><div>The more recent the study, the more applicable it will be.</div></li><li id="ch3.lt88" class="half_rhythm"><div>Studies published in 2001 or later but that depend on unit costs and resource data entirely or predominantly from before 2001 will be rated as ‘Not applicable’.</div></li><li id="ch3.lt89" class="half_rhythm"><div>Studies published before 2001 will have been excluded before being assessed for applicability and methodological limitations.</div></li></ul>
|
||
<i>Quality and relevance of effectiveness data used in the economic analysis:</i>
|
||
<ul id="ch3.l24"><li id="ch3.lt90" class="half_rhythm"><div>The more closely the clinical effectiveness data used in the economic analysis matches with the outcomes of the studies included in the clinical review the more useful the analysis will be for decision-making in the guideline.</div></li><li id="ch3.lt91" class="half_rhythm"><div>The following will be rated as ‘Very serious limitations’ and excluded: economic analyses undertaken as part of clinical studies that are excluded from the clinical review; economic models where relative treatment effects are based entirely on studies that are excluded from the clinical review; comparative costing analyses that only look at the cost of delivering dialysis (as current UK NHS reference costs are considered a more relevant estimate of this for the guideline); within-trial economic analyses based on non-randomised studies that do not meet the minimum adjustment criteria outlined in the main review protocol.</div></li></ul></p>
|
||
</td></tr></tbody></table></div></div></div><div id="ch3.appb"><h3>Appendix B. Literature search strategies</h3><div id="ch3.appb.s1"><h4>B.1. Clinical search literature search strategy</h4><p>The literature searches for this review are detailed below and complied with the methodology outlined in Developing NICE guidelines: the manual 2014, updated 2017 <a href="https://www.nice.org.uk/guidance/pmg20/resources/developing-nice-guidelines-the-manual-pdf-72286708700869" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www.nice.org.uk/guidance/pmg20/resources/developing-nice-guidelines-the-manual-pdf-72286708700869</a></p><p><i>For more detailed information, please see the</i> Methodology Review.</p><p>Searches were constructed using a PICO framework where population (P) terms were combined with Intervention (I) and in some cases Comparison (C) terms. Outcomes (O) are rarely used in search strategies for interventions as these concepts may not be well described in title, abstract or indexes and therefore difficult to retrieve. Search filters were applied to the search where appropriate.</p><div id="ch3.appb.tab1" class="table"><h3><span class="label">Table 8</span><span class="title">Database date parameters and filters used</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577489/table/ch3.appb.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch3.appb.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_ch3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Database</th><th id="hd_h_ch3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dates searched</th><th id="hd_h_ch3.appb.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Search filter used</th></tr></thead><tbody><tr><td headers="hd_h_ch3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Medline (OVID)</td><td headers="hd_h_ch3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1946 – 11 December 2017</td><td headers="hd_h_ch3.appb.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>Exclusions</p>
|
||
<p>Randomised controlled trials</p>
|
||
<p>Systematic review studies</p>
|
||
<p>Observational studies</p>
|
||
</td></tr><tr><td headers="hd_h_ch3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Embase (OVID)</td><td headers="hd_h_ch3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1974 – 11 December 2017</td><td headers="hd_h_ch3.appb.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>Exclusions</p>
|
||
<p>Randomised controlled trials</p>
|
||
<p>Systematic review studies</p>
|
||
<p>Observational studies</p>
|
||
</td></tr><tr><td headers="hd_h_ch3.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The Cochrane Library (Wiley)</td><td headers="hd_h_ch3.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>Cochrane Reviews to 2017 Issue 12 of12</p>
|
||
<p>CENTRAL to 2017 Issue 11 of12</p>
|
||
<p>DARE, and NHSEED to 2015 Issue 2 of 4</p>
|
||
<p>HTA to 2016 Issue 4 of 4</p>
|
||
</td><td headers="hd_h_ch3.appb.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td></tr></tbody></table></div></div><ol id="ch3.l25"><li id="ch3.lt92" class="half_rhythm"><div class="half_rhythm">Line 81 (Medline) and line 75 (Embase) were added to the search strategy to reduce the number of items retrieved for observational studies as the overall results from the search were very large.</div><div class="half_rhythm">This was checked to ensure that relevant studies were not excluded.</div></li></ol><div id="ch3.appb.tab2" class="table"><h3><span class="title">Medline (Ovid) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577489/table/ch3.appb.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch3.appb.tab2_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Renal Replacement Therapy/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((renal or kidney) adj2 replace*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(hemodiafilt* or haemodiafilt* or (biofilt* adj1 acetate-free)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(hemodialys* or haemodialys*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((kidney* or renal) adj3 (transplant* or graft*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">capd.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">dialys*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(artificial adj1 kidney*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1-8</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 9 to English language</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">news/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp historical article/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Anecdotes as Topic/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">comment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case report/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or comment*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/11-18</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial/ or random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19 not 20</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animals/ not humans/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Animals, Laboratory/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp animal experiment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp animal model/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Rodentia/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or mice).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/21-27</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10 not 28</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">controlled clinical trial.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomi#ed.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">placebo.ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">drug therapy.fs.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomly.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">trial.ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">groups.ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/30-37</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Clinical Trials as topic.sh.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">trial.ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/30-33,35,39-40</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Meta-Analysis/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Meta-Analysis as Topic/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(meta analy* or metanaly* or metaanaly* or meta regression).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((systematic* or evidence*) adj3 (review* or overview*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(reference list* or bibliograph* or hand search* or manual search* or relevant journals).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(search strategy or search criteria or systematic search or study selection or data extraction).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">48.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(search* adj4 literature).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(medline or pubmed or cochrane or embase or psychlit or psyclit or psychinfo or psycinfo or cinahl or science citation index or bids or cancerlit).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cochrane.jw.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">51.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((multiple treatment* or indirect or mixed) adj2 comparison*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">52.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/42-51</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29 and (41 or 52)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Renal Replacement Therapy/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((renal or kidney*) adj2 replace*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">56.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(hemodiafilt* or haemodiafilt* or haemofilt* or hemofilt*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">57.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(hemodialys* or haemodialys*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">58.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((kidney* or renal or pre-empt* or preempt*) adj3 (transplant* or graft*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">59.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(capd or apd or ccpd or dialys*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">60.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/54-59</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">61.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">62.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">63.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">news/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">64.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp historical article/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">65.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Anecdotes as Topic/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">66.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">comment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">67.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case report/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">68.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or comment*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">69.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/61-68</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">70.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial/ or random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">71.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">147 not 148</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">72.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animals/ not humans/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">73.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Animals, Laboratory/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">74.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animal Experimentation/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">75.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Models, Animal/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">76.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Rodentia/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">77.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or mice).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">78.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/72-77</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">79.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">60 not 78</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">80.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 79 to English language</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">81.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(mycophenolic acid or azathioprine or sirolimus or everolimus or tacrolimus or cyclosporin* or steroid or calcineurin inhibitor or anaemi* or anemi* or vitamin d or immunosuppres*).ti.<a class="bk_pop" href="#ch3.ref1"><sup>1</sup></a></td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">82.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">80 not 81</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">83.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Epidemiologic studies/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">84.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Observational study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">85.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Cohort studies/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">86.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(cohort adj (study or studies or analys* or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">87.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((follow up or observational or uncontrolled or non randomi#ed or epidemiologic*) adj (study or studies or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">88.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((longitudinal or retrospective or prospective or cross sectional) and (study or studies or review or analys* or cohort* or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">89.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Controlled Before-After Studies/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">90.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Historically Controlled Study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">91.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interrupted Time Series Analysis/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">92.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(before adj2 after adj2 (study or studies or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">93.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/83-92</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">94.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Registries/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">95.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Management Audit/ or Clinical Audit/ or Nursing Audit/ or Medical Audit/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">96.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(registry or registries).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">97.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(audit or audits or auditor or auditors or auditing or auditable).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">98.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/94-97</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">99.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">93 or 98</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">100.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">82 and 99</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">101.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">100 not 53</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">102.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53 or 101</td></tr></tbody></table></div></div><div id="ch3.appb.tab3" class="table"><h3><span class="title">Embase (Ovid) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577489/table/ch3.appb.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch3.appb.tab3_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp *renal replacement therapy/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((renal or kidney) adj2 replace*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(hemodiafilt* or haemodiafilt* or (biofilt* adj1 acetate-free)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(hemodialys* or haemodialys*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((kidney* or renal) adj3 (transplant* or graft*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">capd.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">dialys*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(artificial adj1 kidney*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1-8</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 9 to English language</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter.pt. or letter/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">note.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case report/ or case study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or comment*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/11-15</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial/ or random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16 not 17</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animal/ not human/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">nonhuman/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animal Experiment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Experimental Animal/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animal model/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Rodent/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or mice).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/18-25</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10 not 26</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">factorial*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(crossover* or cross over*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((doubl* or singl*) adj blind*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(assign* or allocat* or volunteer* or placebo*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">crossover procedure/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">single blind procedure/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">double blind procedure/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/28-36</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">systematic review/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">meta-analysis/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(meta analy* or metanaly* or metaanaly* or meta regression).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((systematic or evidence) adj3 (review* or overview*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(reference list* or bibliograph* or hand search* or manual search* or relevant journals).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(search strategy or search criteria or systematic search or study selection or data extraction).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(search* adj4 literature).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(medline or pubmed or cochrane or embase or psychlit or psyclit or psychinfo or psycinfo or cinahl or science citation index or bids or cancerlit).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cochrane.jw.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((multiple treatment* or indirect or mixed) adj2 comparison*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">48.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/38-47</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27 and (37 or 48)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*renal replacement therapy/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">51.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((renal or kidney*) adj2 replace*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">52.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(hemodiafilt* or haemodiafilt* or haemofilt* or hemofilt*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(hemodialys* or haemodialys*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((kidney* or renal or pre-empt* or preempt*) adj3 (transplant* or graft*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(capd or apd or ccpd or dialys*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">56.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/50-55</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">57.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter.pt. or letter/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">58.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">note.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">59.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">60.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case report/ or case study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">61.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or comment*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">62.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/57-61</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">63.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial/ or random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">64.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">62 not 63</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">65.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animal/ not human/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">66.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">nonhuman/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">67.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animal Experiment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">68.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Experimental Animal/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">69.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animal model/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">70.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Rodent/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">71.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or mice).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">72.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/64-71</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">73.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">56 not 72</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">74.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 73 to English language</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">75.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(mycophenolic acid or azathioprine or sirolimus or everolimus or tacrolimus or cyclosporin* or steroid or calcineurin inhibitor or anaemi* or anemi* or vitamin d or immunosuppres*).ti.<a class="bk_pop" href="#ch3.ref1"><sup>1</sup></a></td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">76.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">74 not 75</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">77.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Clinical study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">78.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Observational study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">79.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">family study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">80.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">longitudinal study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">81.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">retrospective study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">82.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">prospective study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">83.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cohort analysis/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">84.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">follow-up/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">85.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cohort*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">86.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">84 and 85</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">87.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(cohort adj (study or studies or analys* or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">88.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((follow up or observational or uncontrolled or non randomi#ed or epidemiologic*) adj (study or studies or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">89.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((longitudinal or retrospective or prospective or cross sectional) and (study or studies or review or analys* or cohort* or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">90.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(before adj2 after adj2 (study or studies or data)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">91.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/77-83,86-90</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">92.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">register/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">93.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">medical audit/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">94.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(registry or registries).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">95.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(audit or audits or auditor or auditors or auditing or auditable).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">96.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/92-95</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">97.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">91 or 96</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">98.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">76 and 97</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">99.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">98 not 49</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">100.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49 or 99</td></tr></tbody></table></div></div><div id="ch3.appb.tab4" class="table"><h3><span class="title">Cochrane Library (Wiley) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577489/table/ch3.appb.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch3.appb.tab4_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH descriptor: [Renal Replacement Therapy] explode all trees</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((renal or kidney*) near/2 replace*):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(hemodiafilt* or haemodiafilt* or haemofilt* or hemofilt*):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(hemodialys* or haemodialys*):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((kidney* or renal or pre-empt* or preempt*) near/3 (transplant* or graft*)):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(capd or apd or ccpd or dialys*):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(biofilt* near/1 acetate-free):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(artificial near/1 kidney*):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(or #1-#8)</td></tr></tbody></table></div></div></div><div id="ch3.appb.s2"><h4>B.2. Health Economics literature search strategy</h4><p>Health economic evidence was identified by conducting a broad search relating to renal replacement therapy population in NHS Economic Evaluation Database (NHS EED – this ceased to be updated after March 2015) and the Health Technology Assessment database (HTA) with no date restrictions. NHS EED and HTA databases are hosted by the Centre for Research and Dissemination (CRD). Additional searches were run on Medline and Embase for health economics.</p><div id="ch3.appb.tab5" class="table"><h3><span class="label">Table 9</span><span class="title">Database date parameters and filters used</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577489/table/ch3.appb.tab5/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch3.appb.tab5_lrgtbl__"><table><thead><tr><th id="hd_h_ch3.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Database</th><th id="hd_h_ch3.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dates searched</th><th id="hd_h_ch3.appb.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Search filter used</th></tr></thead><tbody><tr><td headers="hd_h_ch3.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Medline & Embase</td><td headers="hd_h_ch3.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2014 – 11 December 2017</td><td headers="hd_h_ch3.appb.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Exclusions</p>
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<p>Health economics studies</p>
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</td></tr><tr><td headers="hd_h_ch3.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Centre for Research and Dissemination (CRD)</td><td headers="hd_h_ch3.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">HTA & NHS EED- Inception – 11 December 2017</td><td headers="hd_h_ch3.appb.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td></tr></tbody></table></div></div><div id="ch3.appb.tab6" class="table"><h3><span class="title">Medline (Ovid) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577489/table/ch3.appb.tab6/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch3.appb.tab6_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Renal Replacement Therapy/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((renal or kidney) adj2 replace*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(hemodiafilt* or haemodiafilt* or (biofilt* adj1 acetate-free)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(hemodialys* or haemodialys*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((kidney* or renal) adj3 (transplant* or graft*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">capd.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">dialys*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(artificial adj1 kidney*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1-8</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 9 to English language</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">news/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp historical article/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Anecdotes as Topic/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">comment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case report/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or comment*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/11-18</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial/ or random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19 not 20</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animals/ not humans/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Animals, Laboratory/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp animal experiment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp animal model/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Rodentia/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or mice).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/21-27</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10 not 28</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Economics/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Value of life/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp “Costs and Cost Analysis”/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Economics, Hospital/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Economics, Medical/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Economics, Nursing/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Economics, Pharmaceutical/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp “Fees and Charges”/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Budgets/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">budget*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cost*.ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(economic* or pharmaco?economic*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(price* or pricing*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(cost* adj2 (effective* or utilit* or benefit* or minimi* or unit* or estimat* or variable*)).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(financ* or fee or fees).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(value adj2 (money or monetary)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/30-45</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29 and 46</td></tr></tbody></table></div></div><div id="ch3.appb.tab7" class="table"><h3><span class="title">Embase (Ovid) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577489/table/ch3.appb.tab7/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch3.appb.tab7_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp renal replacement therapy/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((renal or kidney) adj2 replace*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(hemodiafilt* or haemodiafilt* or (biofilt* adj1 acetate-free)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(hemodialys* or haemodialys*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((kidney* or renal) adj3 (transplant* or graft*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">capd.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">dialys*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(artificial adj1 kidney*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1-8</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 9 to English language</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter.pt. or letter/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">note.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case report/ or case study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or comment*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/11-15</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled trial/ or random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16 not 17</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animal/ not human/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">nonhuman/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animal Experiment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Experimental Animal/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animal model/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Rodent/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or mice).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/18-25</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10 not 26</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*health economics/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp *economic evaluation/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp *health care cost/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp *fee/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">budget/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">funding/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">budget*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cost*.ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(economic* or pharmaco?economic*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(price* or pricing*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(cost* adj2 (effective* or utilit* or benefit* or minimi* or unit* or estimat* or variable*)).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(financ* or fee or fees).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(value adj2 (money or monetary)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/28-40</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27 and 41</td></tr></tbody></table></div></div><div id="ch3.appb.tab8" class="table"><h3><span class="title">NHS EED and HTA (CRD) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577489/table/ch3.appb.tab8/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch3.appb.tab8_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH DESCRIPTOR Renal Replacement Therapy EXPLODE ALL TREES</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(((renal or kidney) adj2 replace*))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((hemodiafilt* or haemodiafilt* or (biofilt* adj1 acetate-free)))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((hemodialys* or haemodialys*))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(((kidney* or renal) adj3 (transplant* or graft*)))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(capd)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(dialys*)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((artificial adj1 kidney*))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8</td></tr></tbody></table></div></div></div></div><div id="ch3.appc"><h3>Appendix C. Clinical evidence selection</h3><div id="ch3.appc.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%201.%20Flow%20chart%20of%20clinical%20study%20selection%20for%20the%20review%20of%20Sequencing%20for%20RRT%20modalities.&p=BOOKS&id=577489_ch3appcf1.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK577489/bin/ch3appcf1.jpg" alt="Figure 1. Flow chart of clinical study selection for the review of Sequencing for RRT modalities." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 1</span><span class="title">Flow chart of clinical study selection for the review of Sequencing for RRT modalities</span></h3></div></div><div id="ch3.appd"><h3>Appendix D. Clinical evidence tables</h3><p id="ch3.appd.et1"><a href="/books/NBK577489/bin/ch3-appd-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (224K)</span></p></div><div id="ch3.appe"><h3>Appendix E. Forest plots</h3><div id="ch3.appe.s1"><h4>E.1. Peritoneal dialysis (PD) prior to transplant vs Haemodialysis (HD) prior to a transplant</h4><div id="ch3.appe.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%202.%20Death%20after%20transplant%20(time%20to%20event)%20%02013%20follow-up%205y.&p=BOOKS&id=577489_ch3appef1.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK577489/bin/ch3appef1.jpg" alt="Figure 2. Death after transplant (time to event) – follow-up 5y." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 2</span><span class="title">Death after transplant (time to event) – follow-up 5y</span></h3></div><div id="ch3.appe.fig2" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%203.%20Death%20after%20transplant%20(risk)%20%02013%20follow-up%20up%20to%205y.&p=BOOKS&id=577489_ch3appef2.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK577489/bin/ch3appef2.jpg" alt="Figure 3. Death after transplant (risk) – follow-up up to 5y." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 3</span><span class="title">Death after transplant (risk) – follow-up up to 5y</span></h3></div><div id="ch3.appe.fig3" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%204.%20Graft%20failure%20(time%20to%20event)%20%02013%20follow-up%205y.&p=BOOKS&id=577489_ch3appef3.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK577489/bin/ch3appef3.jpg" alt="Figure 4. Graft failure (time to event) – follow-up 5y." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 4</span><span class="title">Graft failure (time to event) – follow-up 5y</span></h3></div><div id="ch3.appe.fig4" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%205.%20Graft%20failure%20(risk)%20%02013%20follow-up%20up%20to%205y.&p=BOOKS&id=577489_ch3appef4.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK577489/bin/ch3appef4.jpg" alt="Figure 5. Graft failure (risk) – follow-up up to 5y." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 5</span><span class="title">Graft failure (risk) – follow-up up to 5y</span></h3></div></div><div id="ch3.appe.s2"><h4>E.2. Pre-emptive transplant for failing transplant vs Dialysis then transplant for failing transplant</h4><div id="ch3.appe.fig5" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%206.%20Death%20after%20retransplant%20(time%20to%20event)%20%02013%20up%20to%2010y.&p=BOOKS&id=577489_ch3appef5.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK577489/bin/ch3appef5.jpg" alt="Figure 6. Death after retransplant (time to event) – up to 10y." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 6</span><span class="title">Death after retransplant (time to event) – up to 10y</span></h3></div><div id="ch3.appe.fig6" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%207.%20Graft%20failure%20(time%20to%20event)%20%02013%20up%20to%2010y.&p=BOOKS&id=577489_ch3appef6.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK577489/bin/ch3appef6.jpg" alt="Figure 7. Graft failure (time to event) – up to 10y." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 7</span><span class="title">Graft failure (time to event) – up to 10y</span></h3></div></div></div><div id="ch3.appf"><h3>Appendix F. GRADE tables</h3><div id="ch3.appf.tab1" class="table"><h3><span class="label">Table 10</span><span class="title">Peritoneal dialysis (PD) prior to transplant vs Haemodialysis (HD) prior to a transplant</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577489/table/ch3.appf.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch3.appf.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_ch3.appf.tab1_1_1_1_1" colspan="7" rowspan="1" style="text-align:center;vertical-align:middle;">Quality assessment</th><th id="hd_h_ch3.appf.tab1_1_1_1_2" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">No of patients</th><th id="hd_h_ch3.appf.tab1_1_1_1_3" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">
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<p>Effect</p>
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<p>PD vs HD</p>
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</th><th id="hd_h_ch3.appf.tab1_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch3.appf.tab1_1_1_1_4" style="text-align:center;vertical-align:middle;">Quality</th><th id="hd_h_ch3.appf.tab1_1_1_1_5" rowspan="2" colspan="1" headers="hd_h_ch3.appf.tab1_1_1_1_5" style="text-align:center;vertical-align:middle;">Importance</th></tr><tr><th headers="hd_h_ch3.appf.tab1_1_1_1_1" id="hd_h_ch3.appf.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No of studies</th><th headers="hd_h_ch3.appf.tab1_1_1_1_1" id="hd_h_ch3.appf.tab1_1_1_2_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Design</th><th headers="hd_h_ch3.appf.tab1_1_1_1_1" id="hd_h_ch3.appf.tab1_1_1_2_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Risk of bias</th><th headers="hd_h_ch3.appf.tab1_1_1_1_1" id="hd_h_ch3.appf.tab1_1_1_2_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Inconsistency</th><th headers="hd_h_ch3.appf.tab1_1_1_1_1" id="hd_h_ch3.appf.tab1_1_1_2_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Indirectness</th><th headers="hd_h_ch3.appf.tab1_1_1_1_1" id="hd_h_ch3.appf.tab1_1_1_2_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Imprecision</th><th headers="hd_h_ch3.appf.tab1_1_1_1_1" id="hd_h_ch3.appf.tab1_1_1_2_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Other considerations</th><th headers="hd_h_ch3.appf.tab1_1_1_1_2" id="hd_h_ch3.appf.tab1_1_1_2_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Peritoneal dialysis (PD) prior to transplant</th><th headers="hd_h_ch3.appf.tab1_1_1_1_2" id="hd_h_ch3.appf.tab1_1_1_2_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Haemodialysis (HD) prior to a transplant</th><th headers="hd_h_ch3.appf.tab1_1_1_1_3" id="hd_h_ch3.appf.tab1_1_1_2_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Relative (95% CI)</th><th headers="hd_h_ch3.appf.tab1_1_1_1_3" id="hd_h_ch3.appf.tab1_1_1_2_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Absolute</th></tr></thead><tbody><tr><th headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_1 hd_h_ch3.appf.tab1_1_1_2_2 hd_h_ch3.appf.tab1_1_1_2_3 hd_h_ch3.appf.tab1_1_1_2_4 hd_h_ch3.appf.tab1_1_1_2_5 hd_h_ch3.appf.tab1_1_1_2_6 hd_h_ch3.appf.tab1_1_1_2_7 hd_h_ch3.appf.tab1_1_1_1_2 hd_h_ch3.appf.tab1_1_1_2_8 hd_h_ch3.appf.tab1_1_1_2_9 hd_h_ch3.appf.tab1_1_1_1_3 hd_h_ch3.appf.tab1_1_1_2_10 hd_h_ch3.appf.tab1_1_1_2_11 hd_h_ch3.appf.tab1_1_1_1_4 hd_h_ch3.appf.tab1_1_1_1_5" id="hd_b_ch3.appf.tab1_1_1_1_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Death after transplant (time to event) (follow-up 0-5 years)</th></tr><tr><td headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_1 hd_b_ch3.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_2 hd_b_ch3.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_3 hd_b_ch3.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>1</sup></td><td headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_4 hd_b_ch3.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_5 hd_b_ch3.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_6 hd_b_ch3.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_7 hd_b_ch3.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch3.appf.tab1_1_1_1_2 hd_h_ch3.appf.tab1_1_1_2_8 hd_b_ch3.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">11,664</td><td headers="hd_h_ch3.appf.tab1_1_1_1_2 hd_h_ch3.appf.tab1_1_1_2_9 hd_b_ch3.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">45,651</td><td headers="hd_h_ch3.appf.tab1_1_1_1_3 hd_h_ch3.appf.tab1_1_1_2_10 hd_b_ch3.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">HR 1.1 (1.02 to 1.18)</td><td headers="hd_h_ch3.appf.tab1_1_1_1_3 hd_h_ch3.appf.tab1_1_1_2_11 hd_b_ch3.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch3.appf.tab1_1_1_1_4 hd_b_ch3.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">VERY LOW</td><td headers="hd_h_ch3.appf.tab1_1_1_1_5 hd_b_ch3.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_1 hd_h_ch3.appf.tab1_1_1_2_2 hd_h_ch3.appf.tab1_1_1_2_3 hd_h_ch3.appf.tab1_1_1_2_4 hd_h_ch3.appf.tab1_1_1_2_5 hd_h_ch3.appf.tab1_1_1_2_6 hd_h_ch3.appf.tab1_1_1_2_7 hd_h_ch3.appf.tab1_1_1_1_2 hd_h_ch3.appf.tab1_1_1_2_8 hd_h_ch3.appf.tab1_1_1_2_9 hd_h_ch3.appf.tab1_1_1_1_3 hd_h_ch3.appf.tab1_1_1_2_10 hd_h_ch3.appf.tab1_1_1_2_11 hd_h_ch3.appf.tab1_1_1_1_4 hd_h_ch3.appf.tab1_1_1_1_5" id="hd_b_ch3.appf.tab1_1_1_3_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Death after transplant (relative risk) (follow-up 0-5 years)</th></tr><tr><td headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_1 hd_b_ch3.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_2 hd_b_ch3.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_3 hd_b_ch3.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>1</sup></td><td headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_4 hd_b_ch3.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_5 hd_b_ch3.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_6 hd_b_ch3.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_7 hd_b_ch3.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch3.appf.tab1_1_1_1_2 hd_h_ch3.appf.tab1_1_1_2_8 hd_b_ch3.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">5,621</td><td headers="hd_h_ch3.appf.tab1_1_1_1_2 hd_h_ch3.appf.tab1_1_1_2_9 hd_b_ch3.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">17,155</td><td headers="hd_h_ch3.appf.tab1_1_1_1_3 hd_h_ch3.appf.tab1_1_1_2_10 hd_b_ch3.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.95 (0.85 to 1.06)</td><td headers="hd_h_ch3.appf.tab1_1_1_1_3 hd_h_ch3.appf.tab1_1_1_2_11 hd_b_ch3.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch3.appf.tab1_1_1_1_4 hd_b_ch3.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">VERY LOW</td><td headers="hd_h_ch3.appf.tab1_1_1_1_5 hd_b_ch3.appf.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_1 hd_h_ch3.appf.tab1_1_1_2_2 hd_h_ch3.appf.tab1_1_1_2_3 hd_h_ch3.appf.tab1_1_1_2_4 hd_h_ch3.appf.tab1_1_1_2_5 hd_h_ch3.appf.tab1_1_1_2_6 hd_h_ch3.appf.tab1_1_1_2_7 hd_h_ch3.appf.tab1_1_1_1_2 hd_h_ch3.appf.tab1_1_1_2_8 hd_h_ch3.appf.tab1_1_1_2_9 hd_h_ch3.appf.tab1_1_1_1_3 hd_h_ch3.appf.tab1_1_1_2_10 hd_h_ch3.appf.tab1_1_1_2_11 hd_h_ch3.appf.tab1_1_1_1_4 hd_h_ch3.appf.tab1_1_1_1_5" id="hd_b_ch3.appf.tab1_1_1_5_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Graft failure (time to event) (follow-up 0-5 years)</th></tr><tr><td headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_1 hd_b_ch3.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_2 hd_b_ch3.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_3 hd_b_ch3.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>1</sup></td><td headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_4 hd_b_ch3.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_5 hd_b_ch3.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_6 hd_b_ch3.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_7 hd_b_ch3.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch3.appf.tab1_1_1_1_2 hd_h_ch3.appf.tab1_1_1_2_8 hd_b_ch3.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">11,664</td><td headers="hd_h_ch3.appf.tab1_1_1_1_2 hd_h_ch3.appf.tab1_1_1_2_9 hd_b_ch3.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">45,651</td><td headers="hd_h_ch3.appf.tab1_1_1_1_3 hd_h_ch3.appf.tab1_1_1_2_10 hd_b_ch3.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">HR 1.06 (1.01 to 1.12)</td><td headers="hd_h_ch3.appf.tab1_1_1_1_3 hd_h_ch3.appf.tab1_1_1_2_11 hd_b_ch3.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch3.appf.tab1_1_1_1_4 hd_b_ch3.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">VERY LOW</td><td headers="hd_h_ch3.appf.tab1_1_1_1_5 hd_b_ch3.appf.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_1 hd_h_ch3.appf.tab1_1_1_2_2 hd_h_ch3.appf.tab1_1_1_2_3 hd_h_ch3.appf.tab1_1_1_2_4 hd_h_ch3.appf.tab1_1_1_2_5 hd_h_ch3.appf.tab1_1_1_2_6 hd_h_ch3.appf.tab1_1_1_2_7 hd_h_ch3.appf.tab1_1_1_1_2 hd_h_ch3.appf.tab1_1_1_2_8 hd_h_ch3.appf.tab1_1_1_2_9 hd_h_ch3.appf.tab1_1_1_1_3 hd_h_ch3.appf.tab1_1_1_2_10 hd_h_ch3.appf.tab1_1_1_2_11 hd_h_ch3.appf.tab1_1_1_1_4 hd_h_ch3.appf.tab1_1_1_1_5" id="hd_b_ch3.appf.tab1_1_1_7_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Graft failure (relative risk) (follow-up 0-5 years)</th></tr><tr><td headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_1 hd_b_ch3.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_2 hd_b_ch3.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_3 hd_b_ch3.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>1</sup></td><td headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_4 hd_b_ch3.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_5 hd_b_ch3.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_6 hd_b_ch3.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_ch3.appf.tab1_1_1_1_1 hd_h_ch3.appf.tab1_1_1_2_7 hd_b_ch3.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch3.appf.tab1_1_1_1_2 hd_h_ch3.appf.tab1_1_1_2_8 hd_b_ch3.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">5,621</td><td headers="hd_h_ch3.appf.tab1_1_1_1_2 hd_h_ch3.appf.tab1_1_1_2_9 hd_b_ch3.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">17,155</td><td headers="hd_h_ch3.appf.tab1_1_1_1_3 hd_h_ch3.appf.tab1_1_1_2_10 hd_b_ch3.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 1.05 (0.97 to 1.13)</td><td headers="hd_h_ch3.appf.tab1_1_1_1_3 hd_h_ch3.appf.tab1_1_1_2_11 hd_b_ch3.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch3.appf.tab1_1_1_1_4 hd_b_ch3.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">VERY LOW</td><td headers="hd_h_ch3.appf.tab1_1_1_1_5 hd_b_ch3.appf.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">CRITICAL</td></tr></tbody></table></div></div><div id="ch3.appf.tab2" class="table"><h3><span class="label">Table 11</span><span class="title">Clinical evidence profile: Pre-emptive transplant for failing transplant vs Dialysis then transplant for failing transplant</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577489/table/ch3.appf.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch3.appf.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_ch3.appf.tab2_1_1_1_1" colspan="7" rowspan="1" style="text-align:center;vertical-align:middle;">Quality assessment</th><th id="hd_h_ch3.appf.tab2_1_1_1_2" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">No of patients</th><th id="hd_h_ch3.appf.tab2_1_1_1_3" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">
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<p>Effect</p>
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<p>PreT vs Non-PreT</p>
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</th><th id="hd_h_ch3.appf.tab2_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch3.appf.tab2_1_1_1_4" style="text-align:center;vertical-align:middle;">Quality</th><th id="hd_h_ch3.appf.tab2_1_1_1_5" rowspan="2" colspan="1" headers="hd_h_ch3.appf.tab2_1_1_1_5" style="text-align:center;vertical-align:middle;">Importance</th></tr><tr><th headers="hd_h_ch3.appf.tab2_1_1_1_1" id="hd_h_ch3.appf.tab2_1_1_2_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">No of studies</th><th headers="hd_h_ch3.appf.tab2_1_1_1_1" id="hd_h_ch3.appf.tab2_1_1_2_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Design</th><th headers="hd_h_ch3.appf.tab2_1_1_1_1" id="hd_h_ch3.appf.tab2_1_1_2_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Risk of bias</th><th headers="hd_h_ch3.appf.tab2_1_1_1_1" id="hd_h_ch3.appf.tab2_1_1_2_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Inconsistency</th><th headers="hd_h_ch3.appf.tab2_1_1_1_1" id="hd_h_ch3.appf.tab2_1_1_2_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Indirectness</th><th headers="hd_h_ch3.appf.tab2_1_1_1_1" id="hd_h_ch3.appf.tab2_1_1_2_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Imprecision</th><th headers="hd_h_ch3.appf.tab2_1_1_1_1" id="hd_h_ch3.appf.tab2_1_1_2_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Other considerations</th><th headers="hd_h_ch3.appf.tab2_1_1_1_2" id="hd_h_ch3.appf.tab2_1_1_2_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Pre-emptive transplant for failing transplant</th><th headers="hd_h_ch3.appf.tab2_1_1_1_2" id="hd_h_ch3.appf.tab2_1_1_2_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Dialysis then transplant for failing transplant</th><th headers="hd_h_ch3.appf.tab2_1_1_1_3" id="hd_h_ch3.appf.tab2_1_1_2_10" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Relative (95% CI)</th><th headers="hd_h_ch3.appf.tab2_1_1_1_3" id="hd_h_ch3.appf.tab2_1_1_2_11" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Absolute</th></tr></thead><tbody><tr><th headers="hd_h_ch3.appf.tab2_1_1_1_1 hd_h_ch3.appf.tab2_1_1_2_1 hd_h_ch3.appf.tab2_1_1_2_2 hd_h_ch3.appf.tab2_1_1_2_3 hd_h_ch3.appf.tab2_1_1_2_4 hd_h_ch3.appf.tab2_1_1_2_5 hd_h_ch3.appf.tab2_1_1_2_6 hd_h_ch3.appf.tab2_1_1_2_7 hd_h_ch3.appf.tab2_1_1_1_2 hd_h_ch3.appf.tab2_1_1_2_8 hd_h_ch3.appf.tab2_1_1_2_9 hd_h_ch3.appf.tab2_1_1_1_3 hd_h_ch3.appf.tab2_1_1_2_10 hd_h_ch3.appf.tab2_1_1_2_11 hd_h_ch3.appf.tab2_1_1_1_4 hd_h_ch3.appf.tab2_1_1_1_5" id="hd_b_ch3.appf.tab2_1_1_1_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Mortality (time to event) post-retransplant (follow-up 0-10 years)</th></tr><tr><td headers="hd_h_ch3.appf.tab2_1_1_1_1 hd_h_ch3.appf.tab2_1_1_2_1 hd_b_ch3.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch3.appf.tab2_1_1_1_1 hd_h_ch3.appf.tab2_1_1_2_2 hd_b_ch3.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch3.appf.tab2_1_1_1_1 hd_h_ch3.appf.tab2_1_1_2_3 hd_b_ch3.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>1</sup></td><td headers="hd_h_ch3.appf.tab2_1_1_1_1 hd_h_ch3.appf.tab2_1_1_2_4 hd_b_ch3.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch3.appf.tab2_1_1_1_1 hd_h_ch3.appf.tab2_1_1_2_5 hd_b_ch3.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch3.appf.tab2_1_1_1_1 hd_h_ch3.appf.tab2_1_1_2_6 hd_b_ch3.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious imprecision</td><td headers="hd_h_ch3.appf.tab2_1_1_1_1 hd_h_ch3.appf.tab2_1_1_2_7 hd_b_ch3.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch3.appf.tab2_1_1_1_2 hd_h_ch3.appf.tab2_1_1_2_8 hd_b_ch3.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">1,609</td><td headers="hd_h_ch3.appf.tab2_1_1_1_2 hd_h_ch3.appf.tab2_1_1_2_9 hd_b_ch3.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">10,105</td><td headers="hd_h_ch3.appf.tab2_1_1_1_3 hd_h_ch3.appf.tab2_1_1_2_10 hd_b_ch3.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">HR 1.02 (0.9 to 1.15)</td><td headers="hd_h_ch3.appf.tab2_1_1_1_3 hd_h_ch3.appf.tab2_1_1_2_11 hd_b_ch3.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch3.appf.tab2_1_1_1_4 hd_b_ch3.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">VERY LOW</td><td headers="hd_h_ch3.appf.tab2_1_1_1_5 hd_b_ch3.appf.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">CRITICAL</td></tr><tr><th headers="hd_h_ch3.appf.tab2_1_1_1_1 hd_h_ch3.appf.tab2_1_1_2_1 hd_h_ch3.appf.tab2_1_1_2_2 hd_h_ch3.appf.tab2_1_1_2_3 hd_h_ch3.appf.tab2_1_1_2_4 hd_h_ch3.appf.tab2_1_1_2_5 hd_h_ch3.appf.tab2_1_1_2_6 hd_h_ch3.appf.tab2_1_1_2_7 hd_h_ch3.appf.tab2_1_1_1_2 hd_h_ch3.appf.tab2_1_1_2_8 hd_h_ch3.appf.tab2_1_1_2_9 hd_h_ch3.appf.tab2_1_1_1_3 hd_h_ch3.appf.tab2_1_1_2_10 hd_h_ch3.appf.tab2_1_1_2_11 hd_h_ch3.appf.tab2_1_1_1_4 hd_h_ch3.appf.tab2_1_1_1_5" id="hd_b_ch3.appf.tab2_1_1_3_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">Graft failure (time to event) - retransplant (follow-up 0-10 years)</th></tr><tr><td headers="hd_h_ch3.appf.tab2_1_1_1_1 hd_h_ch3.appf.tab2_1_1_2_1 hd_b_ch3.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1</td><td headers="hd_h_ch3.appf.tab2_1_1_1_1 hd_h_ch3.appf.tab2_1_1_2_2 hd_b_ch3.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">observational studies</td><td headers="hd_h_ch3.appf.tab2_1_1_1_1 hd_h_ch3.appf.tab2_1_1_2_3 hd_b_ch3.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">very serious<sup>1</sup></td><td headers="hd_h_ch3.appf.tab2_1_1_1_1 hd_h_ch3.appf.tab2_1_1_2_4 hd_b_ch3.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious inconsistency</td><td headers="hd_h_ch3.appf.tab2_1_1_1_1 hd_h_ch3.appf.tab2_1_1_2_5 hd_b_ch3.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious indirectness</td><td headers="hd_h_ch3.appf.tab2_1_1_1_1 hd_h_ch3.appf.tab2_1_1_2_6 hd_b_ch3.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>2</sup></td><td headers="hd_h_ch3.appf.tab2_1_1_1_1 hd_h_ch3.appf.tab2_1_1_2_7 hd_b_ch3.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch3.appf.tab2_1_1_1_2 hd_h_ch3.appf.tab2_1_1_2_8 hd_b_ch3.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">1,609</td><td headers="hd_h_ch3.appf.tab2_1_1_1_2 hd_h_ch3.appf.tab2_1_1_2_9 hd_b_ch3.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">10,105</td><td headers="hd_h_ch3.appf.tab2_1_1_1_3 hd_h_ch3.appf.tab2_1_1_2_10 hd_b_ch3.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">HR 1.36 (1.21 to 1.53)</td><td headers="hd_h_ch3.appf.tab2_1_1_1_3 hd_h_ch3.appf.tab2_1_1_2_11 hd_b_ch3.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">-</td><td headers="hd_h_ch3.appf.tab2_1_1_1_4 hd_b_ch3.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">VERY LOW</td><td headers="hd_h_ch3.appf.tab2_1_1_1_5 hd_b_ch3.appf.tab2_1_1_3_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">CRITICAL</td></tr></tbody></table></div></div></div><div id="ch3.appg"><h3>Appendix G. Health economic evidence selection</h3><div id="ch3.appg.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%208.%20Flow%20chart%20of%20economic%20study%20selection%20for%20the%20guideline.&p=BOOKS&id=577489_ch3appgf1.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK577489/bin/ch3appgf1.jpg" alt="Figure 8. Flow chart of economic study selection for the guideline." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 8</span><span class="title">Flow chart of economic study selection for the guideline</span></h3><div class="caption"><p>A = starting RRT</p><p>B = modality of RRT, subgroups and CM</p><p>C = sequencing</p><p>D = planning for RRT</p><p>E = When to assess</p><p>F = what to assess</p><p>G = Indicators for switching or stopping RRT</p><p>I = diet and fluids</p><p>J = frequency of review</p><p>L = decision support interventions</p><p>M = coordinating care</p><p>Note: Reviews H and K do not have an economic component</p><p>* Non-relevant population, intervention, comparison, design or setting; non-English language</p></div></div></div><div id="ch3.apph"><h3>Appendix H. Health economic evidence tables</h3><p id="ch3.apph.et1"><a href="/books/NBK577489/bin/ch3-apph-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (228K)</span></p></div><div id="ch3.appi"><h3>Appendix I. Excluded studies</h3><div id="ch3.appi.s1"><h4>I.1. Excluded clinical studies</h4><div id="ch3.appi.tab1" class="table"><h3><span class="label">Table 12</span><span class="title">Studies excluded from the clinical review</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577489/table/ch3.appi.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch3.appi.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Study</th><th id="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Exclusion reason</th></tr></thead><tbody><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Albrechtsen 1987<a class="bk_pop" href="#ch3.ref1"><sup>1</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Wrong comparison</td></tr><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Ardalan 2011<a class="bk_pop" href="#ch3.ref2"><sup>2</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">NRS without adequate adjustment</td></tr><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Binaut 1997<a class="bk_pop" href="#ch3.ref3"><sup>3</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">NRS without adequate adjustment</td></tr><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Bray 2006<a class="bk_pop" href="#ch3.ref4"><sup>4</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Wrong intervention</td></tr><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Cecka 1995<a class="bk_pop" href="#ch3.ref5"><sup>5</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">NRS without adequate adjustment</td></tr><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Chertow 1996<a class="bk_pop" href="#ch3.ref6"><sup>6</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Wrong comparison</td></tr><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Cosio 1998<a class="bk_pop" href="#ch3.ref8"><sup>8</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Inappropriate comparison</td></tr><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">De Jonge 2006<a class="bk_pop" href="#ch3.ref9"><sup>9</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">NRS without adequate adjustment</td></tr><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Donnelly 1985<a class="bk_pop" href="#ch3.ref10"><sup>10</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">NRS without adequate adjustment</td></tr><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Doxiadis 1998<a class="bk_pop" href="#ch3.ref11"><sup>11</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Incorrect interventions</td></tr><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Freier 1976<a class="bk_pop" href="#ch3.ref12"><sup>12</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">NRS without adequate adjustment</td></tr><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Griveas 2005<a class="bk_pop" href="#ch3.ref14"><sup>14</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">NRS without adequate adjustment</td></tr><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Iles-Smith 1999<a class="bk_pop" href="#ch3.ref15"><sup>15</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Wrong comparison</td></tr><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Jimenez 2008<a class="bk_pop" href="#ch3.ref16"><sup>16</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">NRS without adequate adjustment</td></tr><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Johnston 2013<a class="bk_pop" href="#ch3.ref17"><sup>17</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">NRS without adequate adjustment</td></tr><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Koc 2012<a class="bk_pop" href="#ch3.ref18"><sup>18</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">NRS without adequate adjustment</td></tr><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Kostro 2016<a class="bk_pop" href="#ch3.ref19"><sup>19</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">NRS without adequate adjustment</td></tr><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Lorent 2016<a class="bk_pop" href="#ch3.ref20"><sup>20</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">NRS without adequate adjustment</td></tr><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Nadeau-Fredette 2015<a class="bk_pop" href="#ch3.ref21"><sup>21</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Wrong comparison</td></tr><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Odor-Morales 1987<a class="bk_pop" href="#ch3.ref23"><sup>23</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">NRS without adequate adjustment</td></tr><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Opelz 1992<a class="bk_pop" href="#ch3.ref24"><sup>24</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Incorrect interventions</td></tr><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Persijn 1984<a class="bk_pop" href="#ch3.ref26"><sup>26</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Wrong intervention</td></tr><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Resende 2009<a class="bk_pop" href="#ch3.ref27"><sup>27</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">NRS without adequate adjustment</td></tr><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Rigo 2011<a class="bk_pop" href="#ch3.ref28"><sup>28</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">NRS without adequate adjustment</td></tr><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Schold 2006<a class="bk_pop" href="#ch3.ref29"><sup>29</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Inappropriate comparison</td></tr><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Traynor 2011<a class="bk_pop" href="#ch3.ref32"><sup>32</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">NRS without adequate adjustment</td></tr><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Van den Berg-Loonen 2008<a class="bk_pop" href="#ch3.ref33"><sup>33</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Wrong comparison</td></tr><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">West 1992<a class="bk_pop" href="#ch3.ref34"><sup>34</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Inappropriate comparison</td></tr><tr><td headers="hd_h_ch3.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Zhou 1991<a class="bk_pop" href="#ch3.ref35"><sup>35</sup></a></td><td headers="hd_h_ch3.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Descriptive study</td></tr></tbody></table></div></div></div><div id="ch3.appi.s2"><h4>I.2. Excluded health economic studies</h4><p>Studies that meet the review protocol population and interventions and economic study design criteria but have not been included in the review based on applicability and/or methodological quality are summarised below with reasons for exclusion.</p><div id="ch3.appi.tab2" class="table"><h3><span class="label">Table 13</span><span class="title">Studies excluded from the health economic review</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577489/table/ch3.appi.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch3.appi.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_ch3.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Reference</th><th id="hd_h_ch3.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Reason for exclusion</th></tr></thead><tbody><tr><td headers="hd_h_ch3.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None.</td><td headers="hd_h_ch3.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></div></div><div id="ch3.appj"><h3>Appendix J. Research recommendations</h3><div id="ch3.appj.s1"><h4>J.1. HD/HDF before PD vs PD before HD/HDF</h4><p>
|
||
<b>Research question: What is the clinical and cost effectiveness of haemodialysis/haemodiafiltration before PD versus PD before haemodialysis/haemodiafiltration?</b>
|
||
</p><p>
|
||
<b>Why this is important:</b>
|
||
</p><p>In general this guideline concluded that the decision to use HD/HDF or PD was one guided by patient choice. However some people believe that the order of treatments may have an effect on overall efficacy, no high quality evidence was found in this area. If evidence was available this would allow people to make a more informed choice between HD/HDF and PD at the first point in the treatment pathway.</p><div id="ch3.appj.tab1" class="table"><h3><span class="title">Criteria for selecting high-priority research recommendations</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577489/table/ch3.appj.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch3.appj.tab1_lrgtbl__"><table><tbody><tr><th id="hd_b_ch3.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">PICO question</th><td headers="hd_b_ch3.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>Population: people in the later stages of CKD who are not receiving a pre-emptive transplant</p>
|
||
<p>Intervention(s): HD/HDF (at least 90 days) before PD</p>
|
||
<p>Comparison: PD (at least 90 days) before HD/HDF</p>
|
||
<p>Outcome(s): quality of life, mortality, time to failure of RRT modality, resource use/hospitalisation, symptom scores/functional measures, experience of care, adverse events (infections, access issues)</p>
|
||
</td></tr><tr><th id="hd_b_ch3.appj.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Importance to patients or the population</th><td headers="hd_b_ch3.appj.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Improved evidence in this area could allow people to make a more informed choice with the long term consequences of choosing to start on either HD/HDF or PD</td></tr><tr><th id="hd_b_ch3.appj.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Relevance to NICE guidance</th><td headers="hd_b_ch3.appj.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">If one particularly strategy was found to be more clinically and cost effective than the other, this could feed into recommendations on which strategy may be optimal</td></tr><tr><th id="hd_b_ch3.appj.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Relevance to the NHS</th><td headers="hd_b_ch3.appj.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">If one strategy was more cost effective than the other, and supported by sufficient clinical benefit or lack of harm, recommendations promoting this strategy could be cost saving</td></tr><tr><th id="hd_b_ch3.appj.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">National priorities</th><td headers="hd_b_ch3.appj.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not applicable</td></tr><tr><th id="hd_b_ch3.appj.tab1_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Current evidence base</th><td headers="hd_b_ch3.appj.tab1_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">There were no RCTs or non-randomised studies available in this area</td></tr><tr><th id="hd_b_ch3.appj.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Equality</th><td headers="hd_b_ch3.appj.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not applicable</td></tr><tr><th id="hd_b_ch3.appj.tab1_1_1_8_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design</th><td headers="hd_b_ch3.appj.tab1_1_1_8_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ideally this would be an RCT but given the likely long timeframe required for follow-up, non-randomised cohort studies with adequate adjustment for key confounders (including age, ethnicity, co-existing conditions and some estimate of baseline health (e.g. quality of life)) may be more feasible and appropriate</td></tr><tr><th id="hd_b_ch3.appj.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Feasibility</th><td headers="hd_b_ch3.appj.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">As above</td></tr><tr><th id="hd_b_ch3.appj.tab1_1_1_10_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Other comments</th><td headers="hd_b_ch3.appj.tab1_1_1_10_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not applicable</td></tr><tr><th id="hd_b_ch3.appj.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Importance</th><td headers="hd_b_ch3.appj.tab1_1_1_11_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<ul id="ch3.l26"><li id="ch3.lt93" class="half_rhythm"><div>Medium: the research is relevant to the recommendations in the guideline, but the research recommendations are not key to future updates.</div></li></ul>
|
||
</td></tr></tbody></table></div></div></div></div></div><div class="bk_prnt_sctn"><h2>Tables</h2><div class="whole_rhythm bk_prnt_obj bk_first_prnt_obj"><div id="ch3.tab1" class="table"><h3><span class="label">Table 1</span><span class="title">PICO characteristics of review question</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577489/table/ch3.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch3.tab1_lrgtbl__"><table><tbody><tr><th id="hd_b_ch3.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><td headers="hd_b_ch3.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>People requiring RRT for CKD, who have received more than one modality of RRT sequentially, either because the earlier modality was considered to have failed, or because they received one modality while waiting for another (e.g. receiving dialysis prior to receiving a kidney transplant). Studies will be included where the majority meet one of these criteria. Studies will be downgraded for indirectness if >25% are RRT naïve. Definition of modality failure to be determined by studies.</p>
|
||
<p>Stratified by:
|
||
<ul id="ch3.l1"><li id="ch3.lt1" class="half_rhythm"><div>Previously modality</div></li><li id="ch3.lt2" class="half_rhythm"><div>Age (<2, 2 to <18, 18 to <70, ≥70)</div></li><li id="ch3.lt3" class="half_rhythm"><div>DM vs no DM</div></li><li id="ch3.lt4" class="half_rhythm"><div>BAME vs non-BAME</div></li><li id="ch3.lt5" class="half_rhythm"><div>Unplanned starters vs planned starters</div></li></ul></p>
|
||
</td></tr><tr><th id="hd_b_ch3.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interventions and Comparisons</th><td headers="hd_b_ch3.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Modalities
|
||
<ul id="ch3.l2"><li id="ch3.lt6" class="half_rhythm"><div>Haemodialysis (HD) – including home or in centre, 3 days a week or more frequently, haemodialysis or haemodiafiltration</div></li><li id="ch3.lt7" class="half_rhythm"><div>Peritoneal dialysis (PD) – including CAPD, assisted PD or APD/CCPD</div></li><li id="ch3.lt8" class="half_rhythm"><div>Transplant – including live donor or deceased, pre-emptive or reactive</div></li><li id="ch3.lt9" class="half_rhythm"><div>Conservative management</div></li></ul>
|
||
Any modality or sub-modality vs any other, including where the comparison is between the first modality in a sequence (e.g. HD vs PD before transplantation), the second modality in a sequence (e.g. HD vs PD after transplantation) or between two sequences (e.g. HD then PD vs PD then HD)</td></tr><tr><th id="hd_b_ch3.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><td headers="hd_b_ch3.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Critical
|
||
<ul id="ch3.l3"><li id="ch3.lt10" class="half_rhythm"><div>Patient, family/carer health-related quality of life (continuous)</div></li><li id="ch3.lt11" class="half_rhythm"><div>Mortality (dichotomous and time to event)</div></li><li id="ch3.lt12" class="half_rhythm"><div>Time to failure of RRT form (time to event)</div></li></ul>
|
||
Important
|
||
<ul id="ch3.l4"><li id="ch3.lt13" class="half_rhythm"><div>Hospitalisation (rates or continuous)</div></li><li id="ch3.lt14" class="half_rhythm"><div>Preferred place of death (dichotomous)</div></li><li id="ch3.lt15" class="half_rhythm"><div>Symptom scores and functional measures (continuous)</div></li><li id="ch3.lt16" class="half_rhythm"><div>Psychological distress and mental wellbeing (continuous)</div></li><li id="ch3.lt17" class="half_rhythm"><div>Cognitive impairment (dichotomous)</div></li><li id="ch3.lt18" class="half_rhythm"><div>Patient, family and carer experience of care (continuous)</div></li><li id="ch3.lt19" class="half_rhythm"><div>Growth (continuous)</div></li><li id="ch3.lt20" class="half_rhythm"><div>Malignancy (dichotomous)</div></li><li id="ch3.lt21" class="half_rhythm"><div>Adverse events
|
||
<ul id="ch3.l5" class="circle"><li id="ch3.lt22" class="half_rhythm"><div>Infections (dichotomous)</div></li><li id="ch3.lt23" class="half_rhythm"><div>Vascular access issues (dichotomous)</div></li><li id="ch3.lt24" class="half_rhythm"><div>Dialysis access issues (dichotomous)</div></li><li id="ch3.lt25" class="half_rhythm"><div>Acute transplant rejection episodes (dichotomous)</div></li></ul></div></li></ul></td></tr><tr><th id="hd_b_ch3.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design</th><td headers="hd_b_ch3.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RCTs will be prioritised. If insufficient evidence is found for any specified comparisons non-randomised studies will be considered but only if outcomes are adjusted for the following key confounders:
|
||
<ul id="ch3.l6"><li id="ch3.lt26" class="half_rhythm"><div>Age</div></li><li id="ch3.lt27" class="half_rhythm"><div>Health at baseline</div></li><li id="ch3.lt28" class="half_rhythm"><div>Co-morbidities</div></li><li id="ch3.lt29" class="half_rhythm"><div>Ethnicity</div></li></ul></td></tr></tbody></table></div></div></div><div class="whole_rhythm bk_prnt_obj"><div id="ch3.tab2" class="table"><h3><span class="label">Table 2</span><span class="title">Summary of studies included in the evidence review</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577489/table/ch3.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch3.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_ch3.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Study</th><th id="hd_h_ch3.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Intervention and comparison</th><th id="hd_h_ch3.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Population</th><th id="hd_h_ch3.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_ch3.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Comments</th></tr></thead><tbody><tr><td headers="hd_h_ch3.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>CTS trial</p>
|
||
<p>Schwenger 2011<a class="bk_pop" href="#ch3.ref30"><sup>30</sup></a></p>
|
||
</td><td headers="hd_h_ch3.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p><ul id="ch3.l7"><li id="ch3.lt30" class="half_rhythm"><div>Dialysis prior to transplant</div></li></ul>
|
||
HD then transplant (n=45,651)</p>
|
||
<p>PD then transplant (n=11,664)</p>
|
||
</td><td headers="hd_h_ch3.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>Recipient of a first kidney transplant, deceased-donor</p>
|
||
<p>Aged 18 or over.</p>
|
||
<p>Mean age 50y</p>
|
||
<p>Gender (M:F) 65:35</p>
|
||
<p>92% Caucasian</p>
|
||
</td><td headers="hd_h_ch3.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>Mortality (post-transplant)</p>
|
||
<p>Failure RRT modality (transplant)</p>
|
||
</td><td headers="hd_h_ch3.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>Collaborative Transplant Study trial is multicentre registry with participating centres in Europe, N. America, Australia and New Zealand (85% from Europe)</p>
|
||
<p>Data 1998-2007</p>
|
||
<p>Duration: 5 years post-<b>transplant</b> (outcome censored at five years for model)</p>
|
||
</td></tr><tr><td headers="hd_h_ch3.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Snyder 2002<a class="bk_pop" href="#ch3.ref31"><sup>31</sup></a></td><td headers="hd_h_ch3.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
|
||
<ul id="ch3.l8"><li id="ch3.lt31" class="half_rhythm"><div>Dialysis prior to transplant</div></li></ul>
|
||
|
||
<p>HD then transplant (n=17,155)</p>
|
||
<p>PD then transplant (n=5,621)</p>
|
||
</td><td headers="hd_h_ch3.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>Recipient of dialysis and subsequent first kidney transplant</p>
|
||
<p>Aged 18 or over, median age ~44y</p>
|
||
<p>Gender (M:F) 53:47</p>
|
||
<p>~50% Caucasian, ~30% African American</p>
|
||
</td><td headers="hd_h_ch3.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>Mortality (post-transplant)</p>
|
||
<p>Failure RRT modality (transplant)</p>
|
||
</td><td headers="hd_h_ch3.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>Database connected to U.S. Medicare</p>
|
||
<p>Data 1995-2000</p>
|
||
<p>Duration: Up to 5 years post-<b>dialysis</b> (transplant could take place from 90 days after dialysis)</p>
|
||
</td></tr><tr><td headers="hd_h_ch3.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>USRDS (retransplant)</p>
|
||
<p>Goldfarb-rumyantzev 2006<a class="bk_pop" href="#ch3.ref13"><sup>13</sup></a></p>
|
||
</td><td headers="hd_h_ch3.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p><ul id="ch3.l9"><li id="ch3.lt32" class="half_rhythm"><div>Post-transplant failure</div></li></ul>
|
||
Pre-emptive re-transplant (<7d between reported failure of transplant kidney and retransplant) (n=1,609)</p>
|
||
<p>Non-pre-emptive re-transplant (n=10,105)</p>
|
||
</td><td headers="hd_h_ch3.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>People who received retransplants (both kidney and kidney-pancreas) regardless of number of previous transplants</p>
|
||
<p>Any age, mean ~39y</p>
|
||
<p>Gender (M:F) 59:41</p>
|
||
<p>~78% White, 18% African American</p>
|
||
</td><td headers="hd_h_ch3.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>Mortality (post-retransplant)</p>
|
||
<p>Failure RRT modality (retransplant)</p>
|
||
</td><td headers="hd_h_ch3.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>United States Renal Data Service (USRDS) and United Network for Organ Sharing (UNOS) used throughout USA</p>
|
||
<p>Data 1990-1999</p>
|
||
<p>Duration: Up to 10 years post-transplant</p>
|
||
</td></tr></tbody></table></div></div></div><div class="whole_rhythm bk_prnt_obj"><div id="ch3.tab3" class="table"><h3><span class="label">Table 3</span><span class="title">Clinical evidence summary: Peritoneal dialysis (PD) prior to transplant vs Haemodialysis (HD) prior to a transplant</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577489/table/ch3.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch3.tab3_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch3.tab3_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_ch3.tab3_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_ch3.tab3_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_ch3.tab3_1_1_1_2" style="text-align:left;vertical-align:bottom;">No of Participants (studies) Follow up</th><th id="hd_h_ch3.tab3_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_ch3.tab3_1_1_1_3" style="text-align:left;vertical-align:bottom;">Quality of the evidence (GRADE)</th><th id="hd_h_ch3.tab3_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch3.tab3_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_ch3.tab3_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th></tr><tr><th headers="hd_h_ch3.tab3_1_1_1_5" id="hd_h_ch3.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with Haemodialysis (HD) prior to a transplant</th><th headers="hd_h_ch3.tab3_1_1_1_5" id="hd_h_ch3.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with Peritoneal dialysis (PD) prior to transplant (95% CI)</th></tr></thead><tbody><tr><td headers="hd_h_ch3.tab3_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Death after transplant (time to event)</td><td headers="hd_h_ch3.tab3_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>57315</p>
|
||
<p>(1 study)</p>
|
||
<p>5 years</p>
|
||
</td><td headers="hd_h_ch3.tab3_1_1_1_3" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>VERY LOW<sup><a class="bk_pop" href="#ch3.tab3_1">a</a></sup></p>
|
||
<p>due to risk of bias</p>
|
||
</td><td headers="hd_h_ch3.tab3_1_1_1_4" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>HR 1.1</p>
|
||
<p>(1.02 to 1.18)</p>
|
||
</td><td headers="hd_h_ch3.tab3_1_1_1_5 hd_h_ch3.tab3_1_1_2_1 hd_h_ch3.tab3_1_1_2_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">No adjusted control rate available</td></tr><tr><td headers="hd_h_ch3.tab3_1_1_1_5 hd_h_ch3.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch3.tab3_1_1_1_5 hd_h_ch3.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_ch3.tab3_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Death after transplant (relative risk)</td><td headers="hd_h_ch3.tab3_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>22776</p>
|
||
<p>(1 study)</p>
|
||
<p>0-5 years</p>
|
||
</td><td headers="hd_h_ch3.tab3_1_1_1_3" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>VERY LOW<sup><a class="bk_pop" href="#ch3.tab3_1">a</a></sup></p>
|
||
<p>due to risk of bias</p>
|
||
</td><td headers="hd_h_ch3.tab3_1_1_1_4" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>RR 0.95</p>
|
||
<p>(0.85 to 1.06)</p>
|
||
</td><td headers="hd_h_ch3.tab3_1_1_1_5 hd_h_ch3.tab3_1_1_2_1 hd_h_ch3.tab3_1_1_2_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">No adjusted control rate available</td></tr><tr><td headers="hd_h_ch3.tab3_1_1_1_5 hd_h_ch3.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch3.tab3_1_1_1_5 hd_h_ch3.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_ch3.tab3_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Graft failure (time to event)</td><td headers="hd_h_ch3.tab3_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>57315</p>
|
||
<p>(1 study)</p>
|
||
<p>5 years</p>
|
||
</td><td headers="hd_h_ch3.tab3_1_1_1_3" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>VERY LOW<sup><a class="bk_pop" href="#ch3.tab3_1">a</a></sup></p>
|
||
<p>due to risk of bias</p>
|
||
</td><td headers="hd_h_ch3.tab3_1_1_1_4" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>HR 1.06</p>
|
||
<p>(1.01 to 1.12)</p>
|
||
</td><td headers="hd_h_ch3.tab3_1_1_1_5 hd_h_ch3.tab3_1_1_2_1 hd_h_ch3.tab3_1_1_2_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">No adjusted control rate available</td></tr><tr><td headers="hd_h_ch3.tab3_1_1_1_5 hd_h_ch3.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch3.tab3_1_1_1_5 hd_h_ch3.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_ch3.tab3_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Graft failure (relative risk)</td><td headers="hd_h_ch3.tab3_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>22776</p>
|
||
<p>(1 study)</p>
|
||
<p>0-5 years</p>
|
||
</td><td headers="hd_h_ch3.tab3_1_1_1_3" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>VERY LOW<sup><a class="bk_pop" href="#ch3.tab3_1">a</a></sup></p>
|
||
<p>due to risk of bias</p>
|
||
</td><td headers="hd_h_ch3.tab3_1_1_1_4" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>RR 1.05</p>
|
||
<p>(0.97 to 1.13)</p>
|
||
</td><td headers="hd_h_ch3.tab3_1_1_1_5 hd_h_ch3.tab3_1_1_2_1 hd_h_ch3.tab3_1_1_2_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">No adjusted control rate available</td></tr><tr><td headers="hd_h_ch3.tab3_1_1_1_5 hd_h_ch3.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch3.tab3_1_1_1_5 hd_h_ch3.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div><div><div><dl class="temp-labeled-list small"><dt>a</dt><dd><div id="ch3.tab3_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd></dl></div></div></div></div><div class="whole_rhythm bk_prnt_obj"><div id="ch3.tab4" class="table"><h3><span class="label">Table 4</span><span class="title">Pre-emptive transplant for failing transplant vs Dialysis then transplant for failing transplant</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577489/table/ch3.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch3.tab4_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch3.tab4_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_ch3.tab4_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_ch3.tab4_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_ch3.tab4_1_1_1_2" style="text-align:left;vertical-align:bottom;">No of Participants (studies) Follow up</th><th id="hd_h_ch3.tab4_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_ch3.tab4_1_1_1_3" style="text-align:left;vertical-align:bottom;">Quality of the evidence (GRADE)</th><th id="hd_h_ch3.tab4_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch3.tab4_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_ch3.tab4_1_1_1_5" colspan="2" rowspan="1" style="text-align:left;vertical-align:bottom;">Anticipated absolute effects</th></tr><tr><th headers="hd_h_ch3.tab4_1_1_1_5" id="hd_h_ch3.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk with Non-pre-emptive</th><th headers="hd_h_ch3.tab4_1_1_1_5" id="hd_h_ch3.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Risk difference with Pre-emptive transplant for failing transplant (95% CI)</th></tr></thead><tbody><tr><td headers="hd_h_ch3.tab4_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Mortality (time to event) post-retransplant</td><td headers="hd_h_ch3.tab4_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>11714</p>
|
||
<p>(1 study)</p>
|
||
<p>0-10 years</p>
|
||
</td><td headers="hd_h_ch3.tab4_1_1_1_3" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>VERY LOW<sup><a class="bk_pop" href="#ch3.tab4_1">a</a></sup></p>
|
||
<p>due to risk of bias</p>
|
||
</td><td headers="hd_h_ch3.tab4_1_1_1_4" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>HR 1.02</p>
|
||
<p>(0.9 to 1.15)</p>
|
||
</td><td headers="hd_h_ch3.tab4_1_1_1_5 hd_h_ch3.tab4_1_1_2_1 hd_h_ch3.tab4_1_1_2_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">No adjusted control rate available</td></tr><tr><td headers="hd_h_ch3.tab4_1_1_1_5 hd_h_ch3.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch3.tab4_1_1_1_5 hd_h_ch3.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_ch3.tab4_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">Graft failure (time to event) - retransplant</td><td headers="hd_h_ch3.tab4_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>11714</p>
|
||
<p>(1 study)</p>
|
||
<p>0-10 years</p>
|
||
</td><td headers="hd_h_ch3.tab4_1_1_1_3" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>VERY LOW<sup><a class="bk_pop" href="#ch3.tab4_1">a</a></sup><sup>,</sup><sup><a class="bk_pop" href="#ch3.tab4_2">b</a></sup></p>
|
||
<p>due to risk of bias, imprecision</p>
|
||
</td><td headers="hd_h_ch3.tab4_1_1_1_4" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>HR 1.36</p>
|
||
<p>(1.21 to 1.53)</p>
|
||
</td><td headers="hd_h_ch3.tab4_1_1_1_5 hd_h_ch3.tab4_1_1_2_1 hd_h_ch3.tab4_1_1_2_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">No adjusted control rate available</td></tr><tr><td headers="hd_h_ch3.tab4_1_1_1_5 hd_h_ch3.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td><td headers="hd_h_ch3.tab4_1_1_1_5 hd_h_ch3.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div><div><div><dl class="temp-labeled-list small"><dt>a</dt><dd><div id="ch3.tab4_1"><p class="no_margin">Downgraded by 1 increment if the majority of the evidence was at high risk of bias, and downgraded by 2 increments if the majority of the evidence was at very high risk of bias</p></div></dd><dt>b</dt><dd><div id="ch3.tab4_2"><p class="no_margin">Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs</p></div></dd></dl></div></div></div></div><div class="whole_rhythm bk_prnt_obj"><div id="ch3.tab5" class="table"><h3><span class="label">Table 5</span><span class="title">Health economic evidence profile: sequencing of RRT</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577489/table/ch3.tab5/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch3.tab5_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch3.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Study</th><th id="hd_h_ch3.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Applicability</th><th id="hd_h_ch3.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Limitations</th><th id="hd_h_ch3.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Other comments</th><th id="hd_h_ch3.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Incremental cost</th><th id="hd_h_ch3.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Incremental effects</th><th id="hd_h_ch3.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Cost effectiveness</th><th id="hd_h_ch3.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Uncertainty</th></tr></thead><tbody><tr><td headers="hd_h_ch3.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>Chui 2013<a class="bk_pop" href="#ch3.ref7"><sup>7</sup></a></p>
|
||
<p>(Canada)</p>
|
||
</td><td headers="hd_h_ch3.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Partially applicable<sup><a class="bk_pop" href="#ch3.tab5_1">(a)</a></sup></td><td headers="hd_h_ch3.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Potentially serious limitations<sup><a class="bk_pop" href="#ch3.tab5_2">(b)</a></sup></td><td headers="hd_h_ch3.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<ul id="ch3.l10"><li id="ch3.lt33" class="half_rhythm"><div>Cohort analysis with all cost models adjusted for age, sex, body mass index, race, comorbid conditions, cause of ESRD, and pre-dialysis care.</div></li><li id="ch3.lt34" class="half_rhythm"><div>Comparative costing</div></li><li id="ch3.lt35" class="half_rhythm"><div>Population: Adult patients who initiated long-term dialysis (PD or in-centre HD) for ESRD</div></li><li id="ch3.lt36" class="half_rhythm"><div>Comparators:
|
||
<ul id="ch3.l11" class="circle"><li id="ch3.lt37" class="half_rhythm"><div>HD</div></li><li id="ch3.lt38" class="half_rhythm"><div>PD</div></li><li id="ch3.lt39" class="half_rhythm"><div>HD then switched to PD in first year</div></li><li id="ch3.lt40" class="half_rhythm"><div>PD then switched to HD in first year</div></li></ul></div></li><li id="ch3.lt41" class="half_rhythm"><div>Follow-up: 1 and 3 years</div></li></ul>
|
||
</td><td headers="hd_h_ch3.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>
|
||
<b>Vs HD 1 year</b>
|
||
</p>
|
||
<p>PD: −£31,097</p>
|
||
<p>HD>PD: −£14,478</p>
|
||
<p>PD>HD: −£6,493</p>
|
||
<p>
|
||
<b>Vs HD 3 years</b>
|
||
</p>
|
||
<p>PD: −£66,404</p>
|
||
<p>HD>PD: −£34,820</p>
|
||
<p>PD>HD: −£1,522</p>
|
||
</td><td headers="hd_h_ch3.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">n/a</td><td headers="hd_h_ch3.tab5_1_1_1_7" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">n/a</td><td headers="hd_h_ch3.tab5_1_1_1_8" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
||
<p>
|
||
<b>95% CI - 1 year incremental cost vs HD:</b>
|
||
</p>
|
||
<p>PD: −£34,064 to −£28,130</p>
|
||
<p>HD > PD: −£18,692 to −£10,264</p>
|
||
<p>PD >HD: −£12,845 to −£140</p>
|
||
<p>
|
||
<b>95% CI - 3 years incremental cost vs HD:</b>
|
||
</p>
|
||
<p>PD: −£45,117 to −£24,523</p>
|
||
<p>HD > PD: −£74,672 to −£58,136</p>
|
||
<p>PD >HD: −£16,008 to £12,964</p>
|
||
</td></tr></tbody></table></div><div><div><dl class="temp-labeled-list small"><dt></dt><dd><div><p class="no_margin">Abbreviations: CI = confidence interval; HD = haemodialysis; ICER: incremental cost-effectiveness ratio; PD = peritoneal dialysis; QALY: quality-adjusted life years; RCT: randomised controlled trial</p></div></dd><dt>(a)</dt><dd><div id="ch3.tab5_1"><p class="no_margin">2010 Canadian costs based on resource use from 1999-2006 may not reflect current NHS context. Discounting not applied. Health outcomes not incorporated.</p></div></dd><dt>(b)</dt><dd><div id="ch3.tab5_2"><p class="no_margin">Within-trial analysis (cohort) so does not reflect the full body of evidence in this area (note: no parallel clinical study, costs only). It is unclear whether any transport costs are included.</p></div></dd><dt>(c)</dt><dd><div id="ch3.tab5_3"><p class="no_margin">Cost components incorporated: dialysis costs, inpatient costs, medication costs, and physician fees.</p></div></dd></dl></div></div></div></div></div><div><p>Final</p></div><div><p>Intervention evidence review</p><p>These evidence reviews were developed by the National Guideline Centre</p></div><div><p><b>Disclaimer</b>: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.</p><p>Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.</p><p>NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the <a href="http://wales.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Welsh Government</a>, <a href="http://www.scotland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Scottish Government</a>, and <a href="http://www.northernireland.gov.uk/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Northern Ireland Executive</a>. All NICE guidance is subject to regular review and may be updated or withdrawn.</p></div></div></div>
|
||
<div class="post-content"><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © NICE 2018.</div><div class="small"><span class="label">Bookshelf ID: NBK577489</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/35133740" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">35133740</a></span></div></div></div>
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