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id="_NBK577492_"><span itemprop="name">How to assess people for 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 class="bkr_clear"></div></div><div id="ch6.s1"><h2 id="_ch6_s1_">1. How to assess people for RRT</h2><div id="ch6.s1.1"><h3>1.1. Review question: What assessment is needed for people progressing through later stages of CKD for whom RRT or conservative management may be appropriate?</h3></div><div id="ch6.s1.2"><h3>1.2. Introduction</h3><p>This review explores which assessments need to be carried out in people who may start renal replacement therapy. The focus is on those tests where there are variations in practice. Specifically we look at cardiac assessment, ultrasound of iliac vessels, ultrasound mapping of vascular access sites and pre-transplant psychological assessment for living donor – recipient pair or recipient only.</p><p>While there is widespread agreement that a cardiovascular assessment is required for many patients prior to transplantation, there is no consensus regarding the optimal method of assessment. Similarly there is uncertainty regarding the value of ultrasound of iliac vessels to evaluate the calibre of these blood vessels prior to transplantation. In preparation for the creation of arteriovenous fistulae (AVF), ultrasound mapping of the vascular access sites may improve outcomes. However, the utility of this compared to physical examination alone is uncertain. The purpose of the psychological assessment of transplant recipients is to assess suitability and identify concerns that may affect transplant outcome. Issues such as informed consent and motivation for donating need to be explored with the living donor. This review identifies the evidence on the clinical and cost effectiveness of the above assessments.</p></div><div id="ch6.s1.3"><h3>1.3. PICO table</h3><p>For full details see the review protocol in <a href="#ch6.appa">appendix A</a>.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch6tab1"><a href="/books/NBK577492/table/ch6.tab1/?report=objectonly" target="object" title="Table 1" class="img_link icnblk_img figpopup" rid-figpopup="figch6tab1" rid-ob="figobch6tab1"><img class="small-thumb" src="/books/NBK577492/table/ch6.tab1/?report=thumb" src-large="/books/NBK577492/table/ch6.tab1/?report=previmg" alt="Table 1. PICO characteristics of review question." /></a><div class="icnblk_cntnt"><h4 id="ch6.tab1"><a href="/books/NBK577492/table/ch6.tab1/?report=objectonly" target="object" rid-ob="figobch6tab1">Table 1</a></h4><p class="float-caption no_bottom_margin">PICO characteristics of review question. </p></div></div><p>The guideline committee prioritised the interventions listed above for consideration as components of the assessment. The committee felt they represented interventions that are currently offered variably across the country and with uncertain clinical and cost effectiveness underlying their provision.</p></div><div id="ch6.s1.4"><h3>1.4. Clinical evidence</h3><div id="ch6.s1.4.1"><h4>1.4.1. Included studies</h4><p>Three studies were included in the review;<a class="bibr" href="#ch6.ref2" rid="ch6.ref2"><sup>2</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref5" rid="ch6.ref5"><sup>5</sup></a><sup>,</sup>
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<a class="bibr" href="#ch6.ref6" rid="ch6.ref6"><sup>6</sup></a> these are summarised in <a class="figpopup" href="/books/NBK577492/table/ch6.tab2/?report=objectonly" target="object" rid-figpopup="figch6tab2" rid-ob="figobch6tab2">Table 2</a> below. Evidence from these studies is summarised in the clinical evidence summary below (<a class="figpopup" href="/books/NBK577492/table/ch6.tab3/?report=objectonly" target="object" rid-figpopup="figch6tab3" rid-ob="figobch6tab3">Table 3</a>). Psychological assessment included psychosocial assessment, evaluation and support.</p><p>All three studies were RCTs that assessed the clinical effectiveness of ultrasound mapping of vascular access sites compared to clinical examination alone. No studies, RCT or NRS, were identified that assessed the clinical effectiveness of the other interventions identified by the committee.</p><p>See also the study selection flow chart in <a href="#ch6.appc">appendix C</a>, study evidence tables in <a href="#ch6.appd">appendix D</a>, forest plots in <a href="#ch6.appe">appendix E</a> and GRADE tables in <a href="#ch6.appf">appendix F</a>.</p></div><div id="ch6.s1.4.2"><h4>1.4.2. Excluded studies</h4><p>See the excluded studies list in <a href="#ch6.appi">appendix I</a>.</p></div><div id="ch6.s1.4.3"><h4>1.4.3. Summary of clinical studies included in the evidence review</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch6tab2"><a href="/books/NBK577492/table/ch6.tab2/?report=objectonly" target="object" title="Table 2" class="img_link icnblk_img figpopup" rid-figpopup="figch6tab2" rid-ob="figobch6tab2"><img class="small-thumb" src="/books/NBK577492/table/ch6.tab2/?report=thumb" src-large="/books/NBK577492/table/ch6.tab2/?report=previmg" alt="Table 2. Summary of studies included in the evidence review." /></a><div class="icnblk_cntnt"><h4 id="ch6.tab2"><a href="/books/NBK577492/table/ch6.tab2/?report=objectonly" target="object" rid-ob="figobch6tab2">Table 2</a></h4><p class="float-caption no_bottom_margin">Summary of studies included in the evidence review. </p></div></div><p>See <a href="#ch6.appd">appendix D</a> for full evidence tables.</p></div><div id="ch6.s1.4.4"><h4>1.4.4. Quality assessment of clinical studies included in the evidence review</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch6tab3"><a href="/books/NBK577492/table/ch6.tab3/?report=objectonly" target="object" title="Table 3" class="img_link icnblk_img figpopup" rid-figpopup="figch6tab3" rid-ob="figobch6tab3"><img class="small-thumb" src="/books/NBK577492/table/ch6.tab3/?report=thumb" src-large="/books/NBK577492/table/ch6.tab3/?report=previmg" alt="Table 3. Clinical evidence summary: Ultrasound vs physical examination." /></a><div class="icnblk_cntnt"><h4 id="ch6.tab3"><a href="/books/NBK577492/table/ch6.tab3/?report=objectonly" target="object" rid-ob="figobch6tab3">Table 3</a></h4><p class="float-caption no_bottom_margin">Clinical evidence summary: Ultrasound vs physical examination. </p></div></div><p>See <a href="#ch6.appf">appendix F</a> for full GRADE tables.</p></div></div><div id="ch6.s1.5"><h3>1.5. Economic evidence</h3><div id="ch6.s1.5.1"><h4>1.5.1. Included studies</h4><p>No relevant health economic studies were included.</p></div><div id="ch6.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="#ch6.appg">appendix G</a>.</p></div><div id="ch6.s1.5.3"><h4>1.5.3. Unit costs</h4><p>Relevant current UK unit costs were provided to aid consideration of cost effectiveness. Clinical evidence was identified relating to ultrasound mapping of veins prior to creation of vascular access for haemodialysis. Below is the cost of a vascular ultrasound scan occurring in an outpatient setting. Diagnostic imaging is reported separately in the NHS reference costs in this setting. The clinical evidence suggested a possible reduction in access failure. Access failure may result in an additional access-related procedure and so NHS reference costs for these are included in <a class="figpopup" href="/books/NBK577492/table/ch6.tab5/?report=objectonly" target="object" rid-figpopup="figch6tab5" rid-ob="figobch6tab5">Table 5</a>.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch6tab4"><a href="/books/NBK577492/table/ch6.tab4/?report=objectonly" target="object" title="Table 4" class="img_link icnblk_img figpopup" rid-figpopup="figch6tab4" rid-ob="figobch6tab4"><img class="small-thumb" src="/books/NBK577492/table/ch6.tab4/?report=thumb" src-large="/books/NBK577492/table/ch6.tab4/?report=previmg" alt="Table 4. UK NHS reference costs 2015/16 for ultrasound occurring in an outpatient setting." /></a><div class="icnblk_cntnt"><h4 id="ch6.tab4"><a href="/books/NBK577492/table/ch6.tab4/?report=objectonly" target="object" rid-ob="figobch6tab4">Table 4</a></h4><p class="float-caption no_bottom_margin">UK NHS reference costs 2015/16 for ultrasound occurring in an outpatient setting. </p></div></div><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch6tab5"><a href="/books/NBK577492/table/ch6.tab5/?report=objectonly" target="object" title="Table 5" class="img_link icnblk_img figpopup" rid-figpopup="figch6tab5" rid-ob="figobch6tab5"><img class="small-thumb" src="/books/NBK577492/table/ch6.tab5/?report=thumb" src-large="/books/NBK577492/table/ch6.tab5/?report=previmg" alt="Table 5. UK NHS reference costs 2015/16 for dialysis access-related inpatient and outpatient procedures." /></a><div class="icnblk_cntnt"><h4 id="ch6.tab5"><a href="/books/NBK577492/table/ch6.tab5/?report=objectonly" target="object" rid-ob="figobch6tab5">Table 5</a></h4><p class="float-caption no_bottom_margin">UK NHS reference costs 2015/16 for dialysis access-related inpatient and outpatient procedures. </p></div></div></div><div id="ch6.s1.5.4"><h4>1.5.4. Cost calculation</h4><p>Clinical evidence was identified relating to routine ultrasound mapping of veins prior to creation of AVF for haemodialysis. Rates of ultrasound use will be higher with a routine ultrasound strategy, and so ultrasound costs will be higher; the exact difference between strategies will depend on whether the comparator is no ultrasound or selective ultrasound which varied between included clinical studies. However, the evidence suggests that the rates of AVF failure (which will require an additional procedure) are lower and this will offset the additional ultrasound costs. Below we calculate the cost of AVF failure required to completely offset the additional ultrasound costs. This is also summarised in <a class="figpopup" href="/books/NBK577492/table/ch6.tab6/?report=objectonly" target="object" rid-figpopup="figch6tab6" rid-ob="figobch6tab6">Table 6</a> below.</p><p>Where the comparison is routine ultrasound versus no ultrasound (as in Nursal 2006<a class="bibr" href="#ch6.ref5" rid="ch6.ref5"><sup>5</sup></a> and Ferring 2010<a class="bibr" href="#ch6.ref2" rid="ch6.ref2"><sup>2</sup></a>) the average per person cost difference will be the cost of an ultrasound; that is £58 (see unit cost section above). Where the comparison is routine ultrasound versus selective ultrasound the rate of ultrasound in the selective arm needs to be taken into account. In Smith 2014<a class="bibr" href="#ch6.ref6" rid="ch6.ref6"><sup>6</sup></a> from the clinical review, 34% of people had an ultrasound in the selective arm resulting in an average ultrasound cost per person of £20 (£58 x 34%) and the difference with a routine ultrasound strategy is reduced to £38 (£58 - £20).</p><p>Downstream, the clinical evidence suggested a lower rate of AVF failure with routine ultrasound. AVF failure would result in resource use such as an additional vascular access procedure and so this would at least partially offset the higher cost with routine ultrasound. Using the absolute failure rates reported in the clinical evidence profile in section 1.44 of an absolute reduction of 97 per 1000, to offset the additional cost of ultrasound AVF failure would need to associated with a cost at least £593 (when the comparator is no ultrasound) or £391 (when the comparator is selective ultrasound with a 34% use rate).</p><p>The definition of AVF failure varied between the included clinical studies. In Ferring 2010<a class="bibr" href="#ch6.ref2" rid="ch6.ref2"><sup>2</sup></a> AVF failure was defined as “AVFs were unusable for dialysis, requiring a salvage intervention, new access formation or insertion of a HD catheter” while in Smith 2014<a class="bibr" href="#ch6.ref6" rid="ch6.ref6"><sup>6</sup></a> it was just thrombosis. The NHS references costs related to dialysis access are reported in <a class="figpopup" href="/books/NBK577492/table/ch6.tab5/?report=objectonly" target="object" rid-figpopup="figch6tab5" rid-ob="figobch6tab5">Table 5</a> in the previous section. The average cost for admission for these procedures is greater than that required to offset the additional cost of ultrasound - ‘Open Arteriovenous Fistula, Graft or Shunt Procedures’ is £2012 and ‘Insertion of HD catheter’ is £1149 in adults and £2367 in children.</p><p>Even if a higher cost of ultrasound is used (£70, the upper quartile from the NHS reference costs), the cost of AVF required to offset the additional ultrasound costs is below these average admission costs.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figch6tab6"><a href="/books/NBK577492/table/ch6.tab6/?report=objectonly" target="object" title="Table 6" class="img_link icnblk_img figpopup" rid-figpopup="figch6tab6" rid-ob="figobch6tab6"><img class="small-thumb" src="/books/NBK577492/table/ch6.tab6/?report=thumb" src-large="/books/NBK577492/table/ch6.tab6/?report=previmg" alt="Table 6. Routine ultrasound mapping of veins prior to creation of vascular access for haemodialysis: threshold cost calculation." /></a><div class="icnblk_cntnt"><h4 id="ch6.tab6"><a href="/books/NBK577492/table/ch6.tab6/?report=objectonly" target="object" rid-ob="figobch6tab6">Table 6</a></h4><p class="float-caption no_bottom_margin">Routine ultrasound mapping of veins prior to creation of vascular access for haemodialysis: threshold cost calculation. </p></div></div></div></div><div id="ch6.s1.6"><h3>1.6. Resource impact</h3><p>The recommendations made based on this review (see section 1.9) are not expected to have a substantial impact on resources.</p></div><div id="ch6.s1.7"><h3>1.7. Evidence statements</h3><div id="ch6.s1.7.1"><h4>1.7.1. Clinical evidence statements</h4><ul id="ch6.l5"><li id="ch6.lt20" class="half_rhythm"><div>Moderate quality evidence from 3 studies of 333 participants showed a clinically important benefit of routine ultrasound scanning in terms of AVF success rate.</div></li></ul></div><div id="ch6.s1.7.2"><h4>1.7.2. Health economic evidence statements</h4><ul id="ch6.l6"><li id="ch6.lt21" class="half_rhythm"><div>No relevant economic evaluations were included.</div></li></ul></div></div><div id="ch6.s1.8"><h3>1.8. Interpreting the evidence</h3><div id="ch6.s1.8.1"><h4>1.8.1.1. The outcomes that matter most</h4><div id="ch6.s1.8.1.1"><h5>Routine ultrasound mapping of veins prior to creation of vascular access</h5><p>Critical outcomes were mortality and quality of life. Time to failure of RRT was defined as time until that modality of RRT was no longer working or suitable, and a modality switch occurred. Since death in a person receiving RRT could also be considered “failure”, some papers presented “death censored failure”, but we have favoured presenting both death and failure separately.</p><p>Other important outcomes were numbers of hospitalisation, measures of mental wellbeing and cognitive impairment, malignancy and adverse events, in the case of ultrasound scanning vascular access issues (including AVF failure) was a particularly important adverse event. We were also interested in outcomes representing people’s experience of care.</p></div><div id="ch6.s1.8.1.2"><h5>Cardiac assessment</h5><p>No evidence was identified.</p></div><div id="ch6.s1.8.1.3"><h5>US of iliac vessels</h5><p>No evidence was identified.</p></div><div id="ch6.s1.8.1.4"><h5>Psychological assessment for live donor pair or recipient</h5><p>No evidence was identified</p></div></div><div id="ch6.s1.8.2"><h4>1.8.1.2. The quality of the evidence</h4><div id="ch6.s1.8.2.1"><h5>Routine ultrasound mapping of veins prior to creation of vascular access</h5><p>There was moderate quality evidence in adults, for a benefit of routine ultrasound scanning on the outcome of AVF failure. There were no other outcomes available for this comparison in any age group. There was no other evidence available for any of the other comparisons.</p></div><div id="ch6.s1.8.2.2"><h5>Cardiac assessment</h5><p>No evidence was identified.</p></div><div id="ch6.s1.8.2.3"><h5>US of iliac vessels</h5><p>No evidence was identified.</p></div><div id="ch6.s1.8.2.4"><h5>Psychological assessment for live donor pair or recipient</h5><p>No evidence was identified.</p></div></div><div id="ch6.s1.8.3"><h4>1.8.1.3. Benefits and harms</h4><div id="ch6.s1.8.3.1"><h5>Routine ultrasound mapping of veins prior to creation of vascular access</h5><p>The point estimate for the absolute effect fell just short of the agreed upon absolute MID for dichotomous outcomes but given the magnitude of the relative and absolute effects, the impact of AVF failures and the consensus based nature of the absolute MID points, the committee agreed that the evidence represented a clinically important benefit of routine ultrasound scanning in terms of reducing AVF failure.</p><p>The committee noted that there were unlikely to be any specific harms of routine ultrasound scanning, the harms of offering the intervention therefore were only related to any possible delays in fistula formation if scanning was not immediately available. The committee agreed that the benefit in terms of failure rate outweighed concerns about delays in formation.</p></div><div id="ch6.s1.8.3.2"><h5>Cardiac assessment</h5><p>The committee noted that there may be benefits of cardiac assessment in preparation for transplant in terms of preventing people with excessively high cardiovascular risk from being inappropriately exposed to the risks of surgery, allowing people to optimise their cardiovascular risk profile before surgery and promoting the most appropriate use of potential kidney transplants. However there are considerable harms involved in terms of potentially delaying the patient pathway towards transplantation (especially when the benefits of pre-emptive transplantation are considered) and the harms of each individual cardiac assessment themselves. Given the magnitude and uncertainty of these benefits and harms, as well as the current variability of service provision, this was considered an important area for a research recommendation.</p><p>The committee noted that it is current practice to undertake cardiac assessment in children and young people (up to 18 years) to identify congenital anomalies and confirm adequate function to withstand high fluid loads during transplantation</p></div><div id="ch6.s1.8.3.3"><h5>US of iliac vessels</h5><p>No evidence was identified.</p></div><div id="ch6.s1.8.3.4"><h5>Psychological assessment for live donor – recipient pair or recipient</h5><p>No evidence was identified.</p></div></div><div id="ch6.s1.8.4"><h4>1.8.2. Cost effectiveness and resource use</h4><div id="ch6.s1.8.4.1"><h5>Routine ultrasound mapping of veins prior to creation of vascular access</h5><p>No relevant published studies were identified.</p><p>Clinical evidence of benefit was identified for routine ultrasound mapping of veins prior to creation of an AVF for haemodialysis. Rates of ultrasound use will be higher with the routine ultrasound strategy, and so ultrasound costs will be higher; the exact difference between strategies will depend on whether the comparator is no ultrasound or selective ultrasound which varied between included clinical studies. However, the rates of AVF failure (which will require an additional procedure) were found to be higher in the clinical review and this will offset the additional ultrasound costs.</p><p>A threshold analysis based on the evidence included in the clinical review found that in order to offset the additional costs of a routine ultrasound strategy the cost of AVF failure would need to be at least £593 when the comparator was no ultrasound or £391 when the comparator was selective ultrasound. The committee considered the current UK average costs for procedures that would be required in the case of AVF failure (for example, a salvage procedure, new AVF creation procedure or insertion of an HD catheter), and concluded that as these were well in excess of the threshold value required to offset the cost of routine ultrasound it was reasonable to conclude that this was likely to be cost saving. The average cost for admission for ‘Open Arteriovenous Fistula, Graft or Shunt Procedures’ is £2012 and ‘Insertion of HD catheter’ is £1149 in adults and £2367 in children.</p><p>Given the clinical benefit to the patient of avoiding procedures and the likely cost savings the committee concluded that routine ultrasound mapping prior to creation of AVF was likely to be cost effective and so this supported a recommendation for its use.</p><p>The committee believe that currently practice is variable regarding whether a selective or routine strategy is employed but agreed that a recommendation for routine ultrasound scanning would not involve a large change in practice. The recommendation is not expected to result in a substantial resource impact to the NHS in England.</p></div><div id="ch6.s1.8.4.2"><h5>Cardiac assessment</h5><p>No relevant published studies were identified. Undertaking cardiac assessment will involve resource use and this will vary depending on what assessments are undertaken, although plausibly there may be downstream cost or health benefits that offset this. However, given the lack of clinical evidence the committee was unable to make a judgement regarding cost effectiveness.</p></div><div id="ch6.s1.8.4.3"><h5>US of iliac vessels</h5><p>No relevant published studies were identified. Undertaking ultrasound of iliac vessels will involve resource use, although there may be cost or health benefits that offset this. Given the lack of clinical evidence the committee was unable to make a judgement regarding cost effectiveness.</p></div><div id="ch6.s1.8.4.4"><h5>Psychological assessment for live donor – recipient pair or recipient</h5><p>No relevant published studies were identified. Undertaking psychological assessment for live donor pairs or recipients will involve resource use and may delay treatment. The committee agreed that there were likely benefits to patients but also potential harms due to delays in treatment. Given this and the lack of clinical or cost effectiveness evidence the committee agreed that a recommendation for assessment in specific high risk groups was appropriate. Psychological assessment in high risk people was considered current practice in many areas. The recommendation was considered likely to better target psychological assessment in other areas. The recommendation was not considered likely to have a substantial resource impact overall.</p></div></div><div id="ch6.s1.8.5"><h4>1.8.3. Other factors the committee took into account</h4><p>The committee also recognised that an assessment should involve preparing people for renal replacement therapy for example procedures to create vascular access. Preparing a person psychologically is important for reducing non-adherence and improving outcomes. The committee also highlighted the importance of discussing a person’s individual preferences and understanding how decisions on renal replacement therapy or conservative management are likely to impact on a person’s everyday life.</p><div id="ch6.s1.8.5.1"><h5>Routine ultrasound mapping of veins prior to creation of vascular access</h5><p>The committee discussed how ultrasound scanning may take place. Current clinical practice is variable but typically involves at minimum a selective ultrasound scanning program, for those in whom a physical examination alone is insufficient or impractical (CT or angiography may also be required). In some centres this scanning is done by the consultant who will be responsible for subsequent AVF creation, whereas in others people are referred to ultrasound departments. The studies including in the review involved duplex ultrasound scanning.</p><p>The committee discussed whether there would be any implementation issues for a routine ultrasound strategy and concluded that there should not be any significant issues as ultrasound is already widely used within hospitals.</p></div><div id="ch6.s1.8.5.2"><h5>Psychological assessment for live donor pair or recipient</h5><p>The committee noted that as part of the initial assessment for RRT other members of the MDT and psychosocial team may assess for psychosocial issues and provide support as appropriate. Further assessment by a clinical psychologist or psychiatrist is only for those people who are considering transplant and where complex risk factors have been previously identified in order plan appropriate support/psychological intervention. These issues are usually complex, and assessment should be carried out a specially trained mental health professional</p><p>The committee discussed that the purpose of this assessment of the transplant recipient is to identify any potential risk factors for example substance abuse, non-adherence to treatment or a previous or current mental health condition that may result in post-operative non-adherence or morbidity, and to advise on or provide support and intervention as appropriate. The psychological assessment of young people and children covers psycho-social factors, quality of life, knowledge of the condition, worries and concerns and readiness for transplant. How the person processes information and any barriers to learning are also assessed.</p><p>The committee noted that living donors have to undergo a Human Tissue Authority Independent Assessment. This explores capacity, checks the person is not being pressured and will not receive any payment. The committee discussed whether donors should undergo additional psychological assessment but agreed that this should be based on individual circumstances.</p><p>The committee noted the importance of adhering to the Mental Capacity Act (2005).</p><p>The guideline committee was aware of NICE’s guideline on information and education in CG182 Chronic Kidney Disease in adults: assessment and management.</p></div></div></div></div><div id="ch6.rl.r1"><h2 id="_ch6_rl_r1_">References</h2><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1.</dt><dd><div class="bk_ref" id="ch6.ref1">Department of Health. NHS reference costs 2015-16. Available from: <a href="https://www.gov.uk/government/publications/nhs-reference-costs-2015-to-2016" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.gov.uk/government<wbr style="display:inline-block"></wbr>​/publications<wbr style="display:inline-block"></wbr>​/nhs-reference-costs-2015-to-2016</a> Last accessed: 17/01/2018.</div></dd></dl><dl class="bkr_refwrap"><dt>2.</dt><dd><div class="bk_ref" id="ch6.ref2">Ferring
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M, Claridge
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M, Smith
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SA, Wilmink
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T. Routine preoperative vascular ultrasound improves patency and use of arteriovenous fistulas for hemodialysis: a randomized trial. Clinical Journal of the American Society of Nephrology. 2010; 5(12):2236–44 [<a href="/pmc/articles/PMC2994085/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2994085</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/20829420" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20829420</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>3.</dt><dd><div class="bk_ref" id="ch6.ref3">Mihmanli
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I, Besirli
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K, Kurugoglu
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S, Atakir
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K, Haider
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S, Ogut
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et al. Cephalic vein and hemodialysis fistula: surgeon’s observation versus color Doppler ultrasonographic findings. Journal of Ultrasound in Medicine. 2001; 20(3):217–22 [<a href="https://pubmed.ncbi.nlm.nih.gov/11270525" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11270525</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>4.</dt><dd><div class="bk_ref" id="ch6.ref4">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></dl><dl class="bkr_refwrap"><dt>5.</dt><dd><div class="bk_ref" id="ch6.ref5">Nursal
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TZ, Oguzkurt
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L, Tercan
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F, Torer
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N, Noyan
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T, Karakayali
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H
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et al. Is routine preoperative ultrasonographic mapping for arteriovenous fistula creation necessary in patients with favorable physical examination findings? Results of a randomized controlled trial. World Journal of Surgery. 2006; 30(6):1100–7 [<a href="https://pubmed.ncbi.nlm.nih.gov/16736343" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16736343</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>6.</dt><dd><div class="bk_ref" id="ch6.ref6">Smith
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GE, Barnes
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R, Chetter
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IC. Randomized clinical trial of selective versus routine preoperative duplex ultrasound imaging before arteriovenous fistula surgery. British Journal of Surgery. 2014; 101(5):469–74 [<a href="https://pubmed.ncbi.nlm.nih.gov/24756913" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24756913</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>7.</dt><dd><div class="bk_ref" id="ch6.ref7">Zhang
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Z, Wang
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XM. Hemodynamic evaluation of native arteriovenous fistulas for chronic hemodialysis with color Doppler ultrasound. Chinese Journal of medical imaging technology. 2006; 22(5):718–21</div></dd></dl></dl></div><div id="appendixes.appgroup6"><h2 id="_appendixes_appgroup6_">Appendices</h2><div id="ch6.appa"><h3>Appendix A. Review protocols</h3><p id="ch6.appa.tab1"><a href="/books/NBK577492/table/ch6.appa.tab1/?report=objectonly" target="object" rid-ob="figobch6appatab1" class="figpopup">Table 7. Review protocol: how to assess people for RRT</a></p><p id="ch6.appa.tab2"><a href="/books/NBK577492/table/ch6.appa.tab2/?report=objectonly" target="object" rid-ob="figobch6appatab2" class="figpopup">Table 8. Health economic review protocol</a></p></div><div id="ch6.appb"><h3>Appendix B. Literature search strategies</h3><div id="ch6.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><p id="ch6.appb.tab1"><a href="/books/NBK577492/table/ch6.appb.tab1/?report=objectonly" target="object" rid-ob="figobch6appbtab1" class="figpopup">Table 9. Database date parameters and filters used</a></p><ol id="ch6.l21"><li id="ch6.lt73" 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><p id="ch6.appb.tab2"><a href="/books/NBK577492/table/ch6.appb.tab2/?report=objectonly" target="object" rid-ob="figobch6appbtab2" class="figpopup">Medline (Ovid) search terms</a></p><p id="ch6.appb.tab3"><a href="/books/NBK577492/table/ch6.appb.tab3/?report=objectonly" target="object" rid-ob="figobch6appbtab3" class="figpopup">Embase (Ovid) search terms</a></p><p id="ch6.appb.tab4"><a href="/books/NBK577492/table/ch6.appb.tab4/?report=objectonly" target="object" rid-ob="figobch6appbtab4" class="figpopup">Cochrane Library (Wiley) search terms</a></p></div><div id="ch6.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><p id="ch6.appb.tab5"><a href="/books/NBK577492/table/ch6.appb.tab5/?report=objectonly" target="object" rid-ob="figobch6appbtab5" class="figpopup">Table 10. Database date parameters and filters used</a></p><p id="ch6.appb.tab6"><a href="/books/NBK577492/table/ch6.appb.tab6/?report=objectonly" target="object" rid-ob="figobch6appbtab6" class="figpopup">Medline (Ovid) search terms</a></p><p id="ch6.appb.tab7"><a href="/books/NBK577492/table/ch6.appb.tab7/?report=objectonly" target="object" rid-ob="figobch6appbtab7" class="figpopup">Embase (Ovid) search terms</a></p><p id="ch6.appb.tab8"><a href="/books/NBK577492/table/ch6.appb.tab8/?report=objectonly" target="object" rid-ob="figobch6appbtab8" class="figpopup">NHS EED and HTA (CRD) search terms</a></p></div></div><div id="ch6.appc"><h3>Appendix C. Clinical evidence selection</h3><div id="ch6.appc.fig1" class="figure"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Image%20ch6appcf1&p=BOOKS&id=577492_ch6appcf1.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/NBK577492/bin/ch6appcf1.jpg" alt="Image ch6appcf1" class="tileshop" title="Click on image to zoom" /></a></div></div></div><div id="ch6.appd"><h3>Appendix D. Clinical evidence tables</h3><p id="ch6.appd.et1"><a href="/books/NBK577492/bin/ch6-appd-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Download PDF</a><span class="small"> (264K)</span></p></div><div id="ch6.appe"><h3>Appendix E. Forest plots</h3><div id="ch6.appe.s1"><h4>E.1. Ultrasound versus physical examination</h4><p id="ch6.appe.fig1"><a href="/books/NBK577492/figure/ch6.appe.fig1/?report=objectonly" target="object" rid-ob="figobch6appefig1" class="figpopup">Figure 1. AVF failure</a></p></div></div><div id="ch6.appf"><h3>Appendix F. GRADE tables</h3><p id="ch6.appf.tab1"><a href="/books/NBK577492/table/ch6.appf.tab1/?report=objectonly" target="object" rid-ob="figobch6appftab1" class="figpopup">Table 11. Clinical evidence profile: US vs PE</a></p></div><div id="ch6.appg"><h3>Appendix G. Health economic evidence selection</h3><p id="ch6.appg.fig1"><a href="/books/NBK577492/figure/ch6.appg.fig1/?report=objectonly" target="object" rid-ob="figobch6appgfig1" class="figpopup">Figure 57. Flow chart of economic study selection for the guideline</a></p></div><div id="ch6.apph"><h3>Appendix H. Health economic evidence tables</h3><p>None.</p></div><div id="ch6.appi"><h3>Appendix I. Excluded studies</h3><div id="ch6.appi.s1"><h4>I.1. Excluded clinical studies</h4><p id="ch6.appi.tab1"><a href="/books/NBK577492/table/ch6.appi.tab1/?report=objectonly" target="object" rid-ob="figobch6appitab1" class="figpopup">Table 12. Studies excluded from the clinical review</a></p></div><div id="ch6.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><p id="ch6.appi.tab2"><a href="/books/NBK577492/table/ch6.appi.tab2/?report=objectonly" target="object" rid-ob="figobch6appitab2" class="figpopup">Table 13. Studies excluded from the health economic review</a></p></div></div><div id="ch6.appj"><h3>Appendix J. Research recommendations</h3><div id="ch6.appj.s1"><h4>J.1. Cardiac assessment before transplantation</h4><p>
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<b>Research question: What is the clinical and cost effectiveness of cardiac assessment before transplantation?</b>
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</p><p>
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<b>Why this is important:</b>
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</p><p>There was no evidence for cardiac assessment identified in this review so the committee could not form a recommendation regarding its effectiveness. It is important to form recommendations in this area so that assessment of people prior to transplantation is done in the most clinical and cost effective manner.</p><p id="ch6.appj.tab1"><a href="/books/NBK577492/table/ch6.appj.tab1/?report=objectonly" target="object" rid-ob="figobch6appjtab1" class="figpopup">Criteria for selecting high-priority research recommendations</a></p></div></div></div></div><div class="fm-sec"><div><p>Final</p></div><div><p>Guideline number NG107</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 class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © NICE 2018.</div><div class="small"><span class="label">Bookshelf ID: NBK577492</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/35133748" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">35133748</a></span></div></div><div class="small-screen-prev"></div><div class="small-screen-next"></div></article><article data-type="table-wrap" id="figobch6tab1"><div id="ch6.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/NBK577492/table/ch6.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.tab1_lrgtbl__"><table><tbody><tr><th id="hd_b_ch6.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><td headers="hd_b_ch6.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Children young people and adults with CKD stage 3 to 5 considering RRT or conservative management of established renal failure</td></tr><tr><th id="hd_b_ch6.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Interventions</th><td headers="hd_b_ch6.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Cardiac assessment (including at least a cardiac stress test or echocardiogram)</p>
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<p>Ultrasound of iliac vessels</p>
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<p>Ultrasound mapping of vascular access sites</p>
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<p>Psychological assessment for live donor – recipient pair or recipient</p>
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</td></tr><tr><th id="hd_b_ch6.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparisons</th><td headers="hd_b_ch6.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Any of the above strategies (alone or in combination) compared with any other or usual care/sham</td></tr><tr><th id="hd_b_ch6.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><td headers="hd_b_ch6.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Critical
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<ul id="ch6.l1"><li id="ch6.lt1" class="half_rhythm"><div>Patient, family/carer health-related QoL (continuous)</div></li><li id="ch6.lt2" class="half_rhythm"><div>Symptom scores and functional measures (continuous)</div></li><li id="ch6.lt3" class="half_rhythm"><div>Mortality (dichotomous and time to event)</div></li><li id="ch6.lt4" class="half_rhythm"><div>Hospitalisation (rates or continuous)</div></li><li id="ch6.lt5" class="half_rhythm"><div>Time to failure of RRT form (time to event)</div></li></ul></p>
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<p>Important
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<ul id="ch6.l2"><li id="ch6.lt6" class="half_rhythm"><div>Psychological distress and mental wellbeing (continuous)</div></li><li id="ch6.lt7" class="half_rhythm"><div>Cognitive impairment (dichotomous)</div></li><li id="ch6.lt8" class="half_rhythm"><div>Patient, family/carer experience of care (continuous)</div></li><li id="ch6.lt9" class="half_rhythm"><div>Growth (continuous)</div></li><li id="ch6.lt10" class="half_rhythm"><div>Malignancy (dichotomous)</div></li><li id="ch6.lt11" class="half_rhythm"><div>Adverse events
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<ul id="ch6.l3" class="circle"><li id="ch6.lt12" class="half_rhythm"><div>Infections (dichotomous)</div></li><li id="ch6.lt13" class="half_rhythm"><div>Vascular access issues (dichotomous)</div></li><li id="ch6.lt14" class="half_rhythm"><div>Dialysis access issues (dichotomous)</div></li><li id="ch6.lt15" class="half_rhythm"><div>Acute transplant rejection episodes (dichotomous)</div></li></ul></div></li></ul></p></td></tr><tr><th id="hd_b_ch6.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design</th><td headers="hd_b_ch6.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RCTs will be prioritised. If insufficient evidence is found, non-randomised studies will be considered but only if outcomes are adjusted for the following key confounders
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<ul id="ch6.l4"><li id="ch6.lt16" class="half_rhythm"><div>Age</div></li><li id="ch6.lt17" class="half_rhythm"><div>Health at baseline</div></li><li id="ch6.lt18" class="half_rhythm"><div>Co-morbidities</div></li><li id="ch6.lt19" class="half_rhythm"><div>Ethnicity</div></li></ul></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch6tab2"><div id="ch6.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/NBK577492/table/ch6.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Study</th><th id="hd_h_ch6.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Intervention and comparison</th><th id="hd_h_ch6.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Population</th><th id="hd_h_ch6.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_ch6.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_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Ferring 2010<a class="bibr" href="#ch6.ref2" rid="ch6.ref2"><sup>2</sup></a></td><td headers="hd_h_ch6.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Ultrasound mapping + physical examination (n = 112)</p>
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<p>Physical examination only (n = 106)</p>
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</td><td headers="hd_h_ch6.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>UK</p>
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<p>Median age 68</p>
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<p>People with end stage kidney disease referred for permanent access formation</p>
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</td><td headers="hd_h_ch6.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Primary AVF failure (at 1 month)</td><td headers="hd_h_ch6.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Both groups received ultrasound but control group did not have their surgeon informed of ultrasound results</td></tr><tr><td headers="hd_h_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Nursal 2006<a class="bibr" href="#ch6.ref5" rid="ch6.ref5"><sup>5</sup></a></td><td headers="hd_h_ch6.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Ultrasound mapping + physical examination (n = 35)</p>
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<p>Physical examination only (n = 35)</p>
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</td><td headers="hd_h_ch6.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Turkey</p>
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<p>Mean age 57 (SD 14)</p>
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<p>People with end stage kidney disease referred for permanent access formation</p>
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</td><td headers="hd_h_ch6.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Lack of AVF patency (at end of follow-up)</td><td headers="hd_h_ch6.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Excluded people in whom a suitable site could not be found by physical examination alone</td></tr><tr><td headers="hd_h_ch6.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Smith 2014<a class="bibr" href="#ch6.ref6" rid="ch6.ref6"><sup>6</sup></a></td><td headers="hd_h_ch6.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Ultrasound mapping + physical examination (n = 47)</p>
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<p>Physical examination + selective ultrasound mapping (n = 47)</p>
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</td><td headers="hd_h_ch6.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>UK</p>
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<p>Mean age 65 (range 23 to 85)</p>
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<p>People referred to vascular department to assess for AVF formation</p>
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</td><td headers="hd_h_ch6.tab2_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Primary AVF failure (thrombosis within 30 days of formation)</td><td headers="hd_h_ch6.tab2_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Control arm received ultrasound mapping if physical examination deemed unsatisfactory</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch6tab3"><div id="ch6.tab3" class="table"><h3><span class="label">Table 3</span><span class="title">Clinical evidence summary: Ultrasound vs physical examination</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577492/table/ch6.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.tab3_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch6.tab3_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_ch6.tab3_1_1_1_1" style="text-align:left;vertical-align:bottom;">Outcomes</th><th id="hd_h_ch6.tab3_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_ch6.tab3_1_1_1_2" style="text-align:left;vertical-align:bottom;">No of Participants (studies) Follow up</th><th id="hd_h_ch6.tab3_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_ch6.tab3_1_1_1_3" style="text-align:left;vertical-align:bottom;">Quality of the evidence (GRADE)</th><th id="hd_h_ch6.tab3_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch6.tab3_1_1_1_4" style="text-align:left;vertical-align:bottom;">Relative effect (95% CI)</th><th id="hd_h_ch6.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_ch6.tab3_1_1_1_5" id="hd_h_ch6.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk with Physical examination</th><th headers="hd_h_ch6.tab3_1_1_1_5" id="hd_h_ch6.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Risk difference with Ultrasound (95% CI)</th></tr></thead><tbody><tr><td headers="hd_h_ch6.tab3_1_1_1_1" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">AVF failure</td><td headers="hd_h_ch6.tab3_1_1_1_2" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
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<p>333</p>
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<p>(3 studies)</p>
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<p>1 to 6 months</p>
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</td><td headers="hd_h_ch6.tab3_1_1_1_3" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
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<p>MODERATE<sup>1</sup></p>
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<p>due to imprecision</p>
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</td><td headers="hd_h_ch6.tab3_1_1_1_4" rowspan="2" colspan="1" style="text-align:left;vertical-align:top;">
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<p>RR 0.73</p>
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<p>(0.53 to 1.01)</p>
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</td><td headers="hd_h_ch6.tab3_1_1_1_5 hd_h_ch6.tab3_1_1_2_1 hd_h_ch6.tab3_1_1_2_2" colspan="2" rowspan="1" style="text-align:left;vertical-align:top;">Moderate</td></tr><tr><td headers="hd_h_ch6.tab3_1_1_1_5 hd_h_ch6.tab3_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">358 per 1000</td><td headers="hd_h_ch6.tab3_1_1_1_5 hd_h_ch6.tab3_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>97 fewer per 1000</p>
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<p>(from 168 fewer to 4 more)</p>
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</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch6.tab3_1"><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></dl></div></div></div></article><article data-type="table-wrap" id="figobch6tab4"><div id="ch6.tab4" class="table"><h3><span class="label">Table 4</span><span class="title">UK NHS reference costs 2015/16 for ultrasound occurring in an outpatient setting</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577492/table/ch6.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.tab4_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch6.tab4_1_1_1_1" rowspan="2" colspan="1" headers="hd_h_ch6.tab4_1_1_1_1" style="text-align:left;vertical-align:bottom;">Currency Code</th><th id="hd_h_ch6.tab4_1_1_1_2" rowspan="2" colspan="1" headers="hd_h_ch6.tab4_1_1_1_2" style="text-align:left;vertical-align:bottom;">Currency Description</th><th id="hd_h_ch6.tab4_1_1_1_3" rowspan="2" colspan="1" headers="hd_h_ch6.tab4_1_1_1_3" style="text-align:left;vertical-align:bottom;">No. of examinations</th><th id="hd_h_ch6.tab4_1_1_1_4" colspan="3" rowspan="1" style="text-align:left;vertical-align:bottom;">Unit Cost</th></tr><tr><th headers="hd_h_ch6.tab4_1_1_1_4" id="hd_h_ch6.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">National Average</th><th headers="hd_h_ch6.tab4_1_1_1_4" id="hd_h_ch6.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Lower Quartile</th><th headers="hd_h_ch6.tab4_1_1_1_4" id="hd_h_ch6.tab4_1_1_2_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Upper Quartile</th></tr></thead><tbody><tr><td headers="hd_h_ch6.tab4_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RD47Z</td><td headers="hd_h_ch6.tab4_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Vascular Ultrasound Scan</td><td headers="hd_h_ch6.tab4_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">126,486</td><td headers="hd_h_ch6.tab4_1_1_1_4 hd_h_ch6.tab4_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£58</td><td headers="hd_h_ch6.tab4_1_1_1_4 hd_h_ch6.tab4_1_1_2_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£39</td><td headers="hd_h_ch6.tab4_1_1_1_4 hd_h_ch6.tab4_1_1_2_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£70</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">Source: NHS reference costs 2015/16<a class="bibr" href="#ch6.ref1" rid="ch6.ref1"><sup>1</sup></a></p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch6tab5"><div id="ch6.tab5" class="table"><h3><span class="label">Table 5</span><span class="title">UK NHS reference costs 2015/16 for dialysis access-related inpatient and outpatient procedures</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577492/table/ch6.tab5/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.tab5_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch6.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Currency description</th><th id="hd_h_ch6.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Currency code</th><th id="hd_h_ch6.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Admission</th><th id="hd_h_ch6.tab5_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Number of FCEs</th><th id="hd_h_ch6.tab5_1_1_1_5" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">National average unit cost</th><th id="hd_h_ch6.tab5_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Weighted average</th></tr></thead><tbody><tr><th headers="hd_h_ch6.tab5_1_1_1_1 hd_h_ch6.tab5_1_1_1_2 hd_h_ch6.tab5_1_1_1_3 hd_h_ch6.tab5_1_1_1_4 hd_h_ch6.tab5_1_1_1_5 hd_h_ch6.tab5_1_1_1_6" id="hd_b_ch6.tab5_1_1_1_1" colspan="6" rowspan="1" style="text-align:left;vertical-align:top;">HD access: tunnelled line</th></tr><tr><th headers="hd_h_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_1_1 hd_h_ch6.tab5_1_1_1_2 hd_h_ch6.tab5_1_1_1_3 hd_h_ch6.tab5_1_1_1_4 hd_h_ch6.tab5_1_1_1_5 hd_h_ch6.tab5_1_1_1_6" id="hd_b_ch6.tab5_1_1_2_1" colspan="6" rowspan="1" style="text-align:left;vertical-align:top;">Adults</th></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="6" colspan="1" style="text-align:left;vertical-align:top;">Insertion of Tunnelled Central Venous Catheter, 19 years and over</td><td headers="hd_h_ch6.tab5_1_1_1_2 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="6" colspan="1" style="text-align:left;vertical-align:top;">YR41A</td><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Elective inpatient</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">544</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£1,558</td><td headers="hd_h_ch6.tab5_1_1_1_6 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="6" colspan="1" style="text-align:left;vertical-align:top;">£1,149</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-elective long stay</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">280</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£2,157</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-elective short stay</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1,042</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£2,043</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Day case</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3573</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£750</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Regular Day or Night Admissions</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">73</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£1,038</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Out-patient</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£368</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="6" colspan="1" style="text-align:left;vertical-align:top;">Attention to Central Venous Catheter, 19 years and over</td><td headers="hd_h_ch6.tab5_1_1_1_2 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="6" colspan="1" style="text-align:left;vertical-align:top;">YR43A</td><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Elective inpatient</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">752</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£1,062</td><td headers="hd_h_ch6.tab5_1_1_1_6 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="6" colspan="1" style="text-align:left;vertical-align:top;">£383</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-elective long stay</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£3,738</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-elective short stay</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">946</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£917</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Day case</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44697</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£354</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Regular Day or Night Admissions</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10651</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£407</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Out-patient</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">90</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£98</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="6" colspan="1" style="text-align:left;vertical-align:top;">Removal of Central Venous Catheter, 19 years and over</td><td headers="hd_h_ch6.tab5_1_1_1_2 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="6" colspan="1" style="text-align:left;vertical-align:top;">YR44A</td><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Elective inpatient</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">314</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£1,043</td><td headers="hd_h_ch6.tab5_1_1_1_6 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="6" colspan="1" style="text-align:left;vertical-align:top;">£570</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-elective long stay</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£4,336</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-elective short stay</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">797</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£1,109</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Day case</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6880</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£459</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Regular Day or Night Admissions</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">793</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£727</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Out-patient</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">95</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£198</td></tr><tr><th headers="hd_h_ch6.tab5_1_1_1_1 hd_h_ch6.tab5_1_1_1_2 hd_h_ch6.tab5_1_1_1_3 hd_h_ch6.tab5_1_1_1_4 hd_h_ch6.tab5_1_1_1_5 hd_h_ch6.tab5_1_1_1_6" id="hd_b_ch6.tab5_1_1_21_1" colspan="6" rowspan="1" style="text-align:left;vertical-align:top;">Children</th></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_21_1" rowspan="5" colspan="1" style="text-align:left;vertical-align:top;">Insertion of Tunnelled Central Venous Catheter, 18 years and under</td><td headers="hd_h_ch6.tab5_1_1_1_2 hd_b_ch6.tab5_1_1_21_1" rowspan="5" colspan="1" style="text-align:left;vertical-align:top;">YR41B</td><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Elective inpatient</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">114</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£2,886</td><td headers="hd_h_ch6.tab5_1_1_1_6 hd_b_ch6.tab5_1_1_21_1" rowspan="5" colspan="1" style="text-align:left;vertical-align:top;">£2,367</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-elective long stay</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£5,926</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-elective short stay</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">77</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£2,536</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Day case</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">145</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£1,640</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Regular Day or Night Admissions</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£343</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_21_1" rowspan="5" colspan="1" style="text-align:left;vertical-align:top;">Attention to Central Venous Catheter, 18 years and under</td><td headers="hd_h_ch6.tab5_1_1_1_2 hd_b_ch6.tab5_1_1_21_1" rowspan="5" colspan="1" style="text-align:left;vertical-align:top;">YR43B</td><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Elective inpatient</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">95</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£1,209</td><td headers="hd_h_ch6.tab5_1_1_1_6 hd_b_ch6.tab5_1_1_21_1" rowspan="5" colspan="1" style="text-align:left;vertical-align:top;">£650</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-elective long stay</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£4,672</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-elective short stay</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">232</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£712</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Day case</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2392</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£654</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Regular Day or Night Admissions</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">353</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£342</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_21_1" rowspan="5" colspan="1" style="text-align:left;vertical-align:top;">Removal of Central Venous Catheter, 18 years and under</td><td headers="hd_h_ch6.tab5_1_1_1_2 hd_b_ch6.tab5_1_1_21_1" rowspan="5" colspan="1" style="text-align:left;vertical-align:top;">YR44B</td><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Elective inpatient</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">172</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£1,533</td><td headers="hd_h_ch6.tab5_1_1_1_6 hd_b_ch6.tab5_1_1_21_1" rowspan="5" colspan="1" style="text-align:left;vertical-align:top;">£1,323</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-elective long stay</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£16,682</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-elective short stay</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">164</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£1,243</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Day case</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">894</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£1,163</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Regular Day or Night Admissions</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">80</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_21_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£708</td></tr><tr><th headers="hd_h_ch6.tab5_1_1_1_1 hd_h_ch6.tab5_1_1_1_2 hd_h_ch6.tab5_1_1_1_3 hd_h_ch6.tab5_1_1_1_4 hd_h_ch6.tab5_1_1_1_5 hd_h_ch6.tab5_1_1_1_6" id="hd_b_ch6.tab5_1_1_37_1" colspan="6" rowspan="1" style="text-align:left;vertical-align:top;">HD access: AV fistula or graft</th></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_37_1" rowspan="6" colspan="1" style="text-align:left;vertical-align:top;">Open Arteriovenous Fistula, Graft or Shunt Procedures</td><td headers="hd_h_ch6.tab5_1_1_1_2 hd_b_ch6.tab5_1_1_37_1" rowspan="6" colspan="1" style="text-align:left;vertical-align:top;">YQ42Z</td><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Elective inpatient</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2735</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£2,451</td><td headers="hd_h_ch6.tab5_1_1_1_6 hd_b_ch6.tab5_1_1_37_1" rowspan="6" colspan="1" style="text-align:left;vertical-align:top;">£2,012</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-elective long stay</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">144</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£3,661</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-elective short stay</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">306</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£1,826</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Day case</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5291</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£1,763</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Regular Day or Night Admissions</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£665</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Out-patient</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£199</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_37_1" rowspan="6" colspan="1" style="text-align:left;vertical-align:top;">Attention to Arteriovenous Fistula, Graft or Shunt</td><td headers="hd_h_ch6.tab5_1_1_1_2 hd_b_ch6.tab5_1_1_37_1" rowspan="6" colspan="1" style="text-align:left;vertical-align:top;">YR48Z</td><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Elective inpatient</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">647</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£1,715</td><td headers="hd_h_ch6.tab5_1_1_1_6 hd_b_ch6.tab5_1_1_37_1" rowspan="6" colspan="1" style="text-align:left;vertical-align:top;">£1,433</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-elective long stay</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">140</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£2,824</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-elective short stay</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">359</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£2,079</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Day case</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2978</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£1,235</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Regular Day or Night Admissions</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£523</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Out-patient</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_37_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£228</td></tr><tr><th headers="hd_h_ch6.tab5_1_1_1_1 hd_h_ch6.tab5_1_1_1_2 hd_h_ch6.tab5_1_1_1_3 hd_h_ch6.tab5_1_1_1_4 hd_h_ch6.tab5_1_1_1_5 hd_h_ch6.tab5_1_1_1_6" id="hd_b_ch6.tab5_1_1_50_1" colspan="6" rowspan="1" style="text-align:left;vertical-align:top;">PD access: PD catheter</th></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_1 hd_b_ch6.tab5_1_1_50_1" rowspan="6" colspan="1" style="text-align:left;vertical-align:top;">Renal Replacement Peritoneal Dialysis Associated Procedures</td><td headers="hd_h_ch6.tab5_1_1_1_2 hd_b_ch6.tab5_1_1_50_1" rowspan="6" colspan="1" style="text-align:left;vertical-align:top;">LA05Z</td><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_50_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Elective inpatient</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_50_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">892</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_50_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£1,819</td><td headers="hd_h_ch6.tab5_1_1_1_6 hd_b_ch6.tab5_1_1_50_1" rowspan="6" colspan="1" style="text-align:left;vertical-align:top;">£1,148</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_50_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-elective long stay</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_50_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_50_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£5,701</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_50_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-elective short stay</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_50_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">297</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_50_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£1,288</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_50_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Day case</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_50_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1,588</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_50_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£996</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_50_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Regular Day or Night Admissions</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_50_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_50_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£339</td></tr><tr><td headers="hd_h_ch6.tab5_1_1_1_3 hd_b_ch6.tab5_1_1_50_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Out-patient</td><td headers="hd_h_ch6.tab5_1_1_1_4 hd_b_ch6.tab5_1_1_50_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">470</td><td headers="hd_h_ch6.tab5_1_1_1_5 hd_b_ch6.tab5_1_1_50_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£71</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">Source: NHS reference costs 2015/16<a class="bibr" href="#ch6.ref1" rid="ch6.ref1"><sup>1</sup></a></p></div></dd></dl><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">Abbreviations: FCE = finished consultant episodes</p></div></dd></dl><dl class="bkr_refwrap"><dt>(a)</dt><dd><div id="ch6.tab5_1"><p class="no_margin">HRG YR43A/B Attention to Central Venous Catheter, includes OPCS L921 Fibrin sheath stripping of access catheter, L922 Wire brushing of access catheter, L923 Thrombolysis of access catheter, L928 Other specified unblocking of access catheter, L929 Unspecified unblocking of access catheter, L913 Attention to central venous catheter NEC</p></div></dd></dl><dl class="bkr_refwrap"><dt>(b)</dt><dd><div id="ch6.tab5_2"><p class="no_margin">HRG YQ42 includes OPCS L746 Creation of graft fistula for dialysis, L741 Insertion of arteriovenous prosthesis, L742 Creation of arteriovenous fistula NEC, L743 Attention to arteriovenous shunt, L744 Banding of arteriovenous fistula, L745 Thrombectomy of arteriovenous fistula, L748 Other specified arteriovenous shunt, L749 Unspecified arteriovenous shunt, L752 Repair of acquired arteriovenous fistula</p></div></dd></dl><dl class="bkr_refwrap"><dt>(c)</dt><dd><div id="ch6.tab5_3"><p class="no_margin">HRG YR48 includes OPCS L746 Injection of radiocontrast substance into arteriovenous fistula</p></div></dd></dl><dl class="bkr_refwrap"><dt>(d)</dt><dd><div id="ch6.tab5_4"><p class="no_margin">HRG LA05 includes OPCS X411 Insertion of ambulatory peritoneal dialysis catheter, X412 Removal of ambulatory peritoneal dialysis catheter, X418 Other specified placement of ambulatory apparatus for compensation for renal failure, X419 Unspecified placement of ambulatory apparatus for compensation for renal failure, X421 Insertion of temporary peritoneal dialysis catheter, X428 Other specified placement of other apparatus for compensation for renal failure, X429 Unspecified placement of other apparatus for compensation for renal failure.</p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch6tab6"><div id="ch6.tab6" class="table"><h3><span class="label">Table 6</span><span class="title">Routine ultrasound mapping of veins prior to creation of vascular access for haemodialysis: threshold cost calculation</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577492/table/ch6.tab6/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.tab6_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch6.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></th><th id="hd_h_ch6.tab6_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Comparator</p>
|
|
<p>(No US / selective US)</p>
|
|
</th><th id="hd_h_ch6.tab6_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Routine US</th><th id="hd_h_ch6.tab6_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<p>Difference</p>
|
|
<p>Routine – comparator (no US / selective US)</p>
|
|
</th></tr></thead><tbody><tr><th headers="hd_h_ch6.tab6_1_1_1_1" id="hd_b_ch6.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">US use<sup>(a)</sup></th><td headers="hd_h_ch6.tab6_1_1_1_2 hd_b_ch6.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">0% / 34%</td><td headers="hd_h_ch6.tab6_1_1_1_3 hd_b_ch6.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">100%</td><td headers="hd_h_ch6.tab6_1_1_1_4 hd_b_ch6.tab6_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">100% / 66%</td></tr><tr><th headers="hd_h_ch6.tab6_1_1_1_1" id="hd_b_ch6.tab6_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Average US cost per patient (use % x unit cost of ultrasound £58<sup>(b)</sup>)</th><td headers="hd_h_ch6.tab6_1_1_1_2 hd_b_ch6.tab6_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£0 / £20</td><td headers="hd_h_ch6.tab6_1_1_1_3 hd_b_ch6.tab6_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£58</td><td headers="hd_h_ch6.tab6_1_1_1_4 hd_b_ch6.tab6_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£58 / £38</td></tr><tr><th headers="hd_h_ch6.tab6_1_1_1_1" id="hd_b_ch6.tab6_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">AVF failure<sup>(a)</sup></th><td headers="hd_h_ch6.tab6_1_1_1_2 hd_b_ch6.tab6_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">358 per 1000</td><td headers="hd_h_ch6.tab6_1_1_1_3 hd_b_ch6.tab6_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">261 per1000</td><td headers="hd_h_ch6.tab6_1_1_1_4 hd_b_ch6.tab6_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">97 fewer per 1000</td></tr><tr><th headers="hd_h_ch6.tab6_1_1_1_1 hd_h_ch6.tab6_1_1_1_2 hd_h_ch6.tab6_1_1_1_3" id="hd_b_ch6.tab6_1_1_4_1" colspan="3" rowspan="1" style="text-align:left;vertical-align:top;">Cost of AVF failure that would result in no difference in costs for routine US</th><td headers="hd_h_ch6.tab6_1_1_1_4 hd_b_ch6.tab6_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">£593 / £391</td></tr><tr><th headers="hd_h_ch6.tab6_1_1_1_1 hd_h_ch6.tab6_1_1_1_2 hd_h_ch6.tab6_1_1_1_3" id="hd_b_ch6.tab6_1_1_5_1" colspan="3" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<i>Sensitivity analysis where the cost of ultrasound is £39 (lower quartile in reference costs)</i>
|
|
<sup>
|
|
(b)
|
|
</sup>
|
|
</th><td headers="hd_h_ch6.tab6_1_1_1_4 hd_b_ch6.tab6_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<i>£403 / £266</i>
|
|
</td></tr><tr><th headers="hd_h_ch6.tab6_1_1_1_1 hd_h_ch6.tab6_1_1_1_2 hd_h_ch6.tab6_1_1_1_3" id="hd_b_ch6.tab6_1_1_6_1" colspan="3" rowspan="1" style="text-align:left;vertical-align:top;">
|
|
<i>Sensitivity analysis where the cost of ultrasound is £70 (upper quartile in reference costs)</i>
|
|
<sup>
|
|
(b)
|
|
</sup>
|
|
</th><td headers="hd_h_ch6.tab6_1_1_1_4 hd_b_ch6.tab6_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<i>£721 / £476</i>
|
|
</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_margin">Abbreviations: AVF: arteriovenous fistula; US: ultrasound.</p></div></dd></dl><dl class="bkr_refwrap"><dt>(a)</dt><dd><div id="ch6.tab6_1"><p class="no_margin">From clinical review in <a href="#ch6.s1.4">Section 1.4</a></p></div></dd></dl><dl class="bkr_refwrap"><dt>(b)</dt><dd><div id="ch6.tab6_2"><p class="no_margin">NHS reference costs 2015/16<a class="bibr" href="#ch6.ref1" rid="ch6.ref1"><sup>1</sup></a></p></div></dd></dl></dl></div></div></div></article><article data-type="table-wrap" id="figobch6appatab1"><div id="ch6.appa.tab1" class="table"><h3><span class="label">Table 7</span><span class="title">Review protocol: how to assess people for RRT</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577492/table/ch6.appa.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.appa.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_ch6.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Field</th><th id="hd_h_ch6.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_ch6.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Review question</td><td headers="hd_h_ch6.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">How should people progressing through later stages of CKD be assessed for RRT?</td></tr><tr><td headers="hd_h_ch6.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_ch6.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_ch6.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_ch6.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Provide evidence for recommendations about what should occur during the “assessment” for RRT period</td></tr><tr><td headers="hd_h_ch6.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_ch6.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Children, young people and adults with CKD stage 3 to 5</p>
|
|
<p>Stratified by:
|
|
<ul id="ch6.l7"><li id="ch6.lt22" class="half_rhythm"><div>Age (<2, 2 to <18, 18 to <70, ≥70)</div></li><li id="ch6.lt23" class="half_rhythm"><div>BAME vs non-BAME</div></li><li id="ch6.lt24" class="half_rhythm"><div>DM vs no DM</div></li></ul></p>
|
|
</td></tr><tr><td headers="hd_h_ch6.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Eligibility criteria – intervention(s) / exposure(s) / prognostic factor(s)</td><td headers="hd_h_ch6.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:bottom;">Assessment:
|
|
<ul id="ch6.l8"><li id="ch6.lt25" class="half_rhythm"><div>Cardiac assessment (as minimum stress test/echocardiogram)</div></li><li id="ch6.lt26" class="half_rhythm"><div>US of iliac vessels</div></li><li id="ch6.lt27" class="half_rhythm"><div>US mapping of vascular access sites</div></li><li id="ch6.lt28" class="half_rhythm"><div>Psychological assessment for live donor pair or recipient only(including checking for adherence)</div></li></ul></td></tr><tr><td headers="hd_h_ch6.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_ch6.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Any of the above strategies (alone or in combination) compared with any other or usual care/sham</td></tr><tr><td headers="hd_h_ch6.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_ch6.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"><p>Critical
|
|
<ul id="ch6.l9"><li id="ch6.lt29" class="half_rhythm"><div>Patient, family/carer health-related QoL (continuous)</div></li><li id="ch6.lt30" class="half_rhythm"><div>Symptom scores and functional measures (continuous)</div></li><li id="ch6.lt31" class="half_rhythm"><div>Mortality (dichotomous and time to event)</div></li><li id="ch6.lt32" class="half_rhythm"><div>Hospitalisation (rates or continuous)</div></li><li id="ch6.lt33" class="half_rhythm"><div>Time to failure of RRT form (time to event)</div></li></ul></p>
|
|
<p>Important
|
|
<ul id="ch6.l10"><li id="ch6.lt34" class="half_rhythm"><div>Psychological distress and mental wellbeing (continuous)</div></li><li id="ch6.lt35" class="half_rhythm"><div>Cognitive impairment (dichotomous)</div></li><li id="ch6.lt36" class="half_rhythm"><div>Patient, family/carer experience of care (continuous)</div></li><li id="ch6.lt37" class="half_rhythm"><div>Growth (continuous)</div></li><li id="ch6.lt38" class="half_rhythm"><div>Malignancy (dichotomous)</div></li><li id="ch6.lt39" class="half_rhythm"><div>Adverse events
|
|
<ul id="ch6.l11" class="circle"><li id="ch6.lt40" class="half_rhythm"><div>Infections (dichotomous)</div></li><li id="ch6.lt41" class="half_rhythm"><div>Vascular access issues (dichotomous)</div></li><li id="ch6.lt42" class="half_rhythm"><div>Dialysis access issues (dichotomous)</div></li><li id="ch6.lt43" class="half_rhythm"><div>Acute transplant rejection episodes (dichotomous)</div></li></ul></div></li></ul></p>
|
|
<p>When outcomes are reported at multiple timepoints, the later timepoints will be prioritised. All outcomes must be reported after at least 4 weeks of the intervention under investigation. The outcomes of mortality and hospitalisation must be reported after at least 6 months.</p><p>For quality of life, symptom scores/functional measures, psychological distress/mental wellbeing and experience of care, any validated measures 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_ch6.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_ch6.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, non-randomised studies will be considered but only if outcomes are adjusted for the following key confounders
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<ul id="ch6.l12"><li id="ch6.lt44" class="half_rhythm"><div>Age</div></li><li id="ch6.lt45" class="half_rhythm"><div>Health at baseline</div></li><li id="ch6.lt46" class="half_rhythm"><div>Co-morbidities</div></li><li id="ch6.lt47" class="half_rhythm"><div>Ethnicity</div></li></ul></td></tr><tr><td headers="hd_h_ch6.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_ch6.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_ch6.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_ch6.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="ch6.l13"><li id="ch6.lt48" class="half_rhythm"><div>Different modalities of RRT</div></li></ul></td></tr><tr><td headers="hd_h_ch6.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_ch6.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No duplicate screening was deemed necessary for this question, for more information please see the separate Methods report for this guideline.</td></tr><tr><td headers="hd_h_ch6.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_ch6.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="ch6.l14"><li id="ch6.lt49" class="half_rhythm"><div>Pairwise meta-analyses were performed using Cochrane Review Manager (RevMan5).</div></li><li id="ch6.lt50" class="half_rhythm"><div>GRADEpro was used to assess the quality of evidence for each outcome.</div></li><li id="ch6.lt51" class="half_rhythm"><div>Endnote was used for bibliography, citations, sifting and reference management.</div></li></ul></td></tr><tr><td headers="hd_h_ch6.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_ch6.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Clinical search databases to be used: Medline, Embase, Cochrane Library</p>
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<p>Date: All years</p>
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<p>Health economics search databases to be used: Medline, Embase, NHSEED, HTA</p>
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<p>Date: Medline, Embase from 2014</p>
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<p>NHSEED, HTA – all years</p>
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<p>Language: Restrict to English only</p>
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<p>Supplementary search techniques: backward citation searching</p>
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<p>Key papers: Not known</p>
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</td></tr><tr><td headers="hd_h_ch6.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_ch6.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_ch6.appa.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Author contacts</td><td headers="hd_h_ch6.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<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>
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</td></tr><tr><td headers="hd_h_ch6.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_ch6.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_ch6.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_ch6.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">For details please see the separate search strategy appendix for the guideline.</td></tr><tr><td headers="hd_h_ch6.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_ch6.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_ch6.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_ch6.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="#ch6.appd">Appendix D</a> (clinical evidence tables) or <a href="#ch6.apph">H</a> (health economic evidence tables) of the evidence report.</td></tr><tr><td headers="hd_h_ch6.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_ch6.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
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<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>
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<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>
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</td></tr><tr><td headers="hd_h_ch6.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_ch6.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_ch6.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_ch6.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_ch6.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_ch6.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_ch6.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_ch6.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_ch6.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_ch6.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 report.</td></tr><tr><td headers="hd_h_ch6.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_ch6.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>A multidisciplinary committee developed the guideline. The committee was convened by 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>
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<p>Staff from NGC undertook systematic literature searches, appraised the evidence, conducted meta-analysis and cost-effectiveness analysis where appropriate, and drafted the guideline in collaboration with the committee. For details please see the separate Methods report for this guideline.</p>
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</td></tr><tr><td headers="hd_h_ch6.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_ch6.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_ch6.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_ch6.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_ch6.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_ch6.appa.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NICE funds NGC to develop guidelines for the NHS in England.</td></tr><tr><td headers="hd_h_ch6.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_ch6.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></article><article data-type="table-wrap" id="figobch6appatab2"><div id="ch6.appa.tab2" class="table"><h3><span class="label">Table 8</span><span class="title">Health economic review protocol</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577492/table/ch6.appa.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.appa.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_ch6.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:middle;">Review question</th><th id="hd_h_ch6.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_ch6.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Objectives</b>
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</td><td headers="hd_h_ch6.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_ch6.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Search criteria</b>
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</td><td headers="hd_h_ch6.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="ch6.l15"><li id="ch6.lt52" class="half_rhythm"><div>Populations, interventions and comparators must be as specified in the individual review protocol above.</div></li><li id="ch6.lt53" 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="ch6.lt54" 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="ch6.lt55" class="half_rhythm"><div>Unpublished reports will not be considered unless submitted as part of a call for evidence.</div></li><li id="ch6.lt56" class="half_rhythm"><div>Studies must be in English.</div></li></ul></td></tr><tr><td headers="hd_h_ch6.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Search strategy</b>
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</td><td headers="hd_h_ch6.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="#ch6.appb.s2">Appendix B.2</a> Health economics literature search strategy.</td></tr><tr><td headers="hd_h_ch6.appa.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<b>Review strategy</b>
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</td><td headers="hd_h_ch6.appa.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<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>
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<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="#ch6.appg">Appendix G</a> of the 2012 NICE guidelines manual.<a class="bibr" href="#ch6.ref4" rid="ch6.ref4"><sup>4</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="#ch6.appi">Appendix I</a>.</p>
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<p><b>Inclusion and exclusion criteria</b>
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<ul id="ch6.l16"><li id="ch6.lt57" 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="ch6.lt58" 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="ch6.lt59" 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>
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</p>
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<p>
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<b>Where there is discretion</b>
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</p>
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<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>
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<p>The health economist will be guided by the following hierarchies.</p>
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<p><i>Setting:</i>
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<ul id="ch6.l17"><li id="ch6.lt60" class="half_rhythm"><div>UK NHS (most applicable).</div></li><li id="ch6.lt61" class="half_rhythm"><div>OECD countries with predominantly public health insurance systems (for example, France, Germany, Sweden).</div></li><li id="ch6.lt62" class="half_rhythm"><div>OECD countries with predominantly private health insurance systems (for example, Switzerland).</div></li><li id="ch6.lt63" 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>
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</p>
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<p><i>Economic study type:</i>
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<ul id="ch6.l18"><li id="ch6.lt64" class="half_rhythm"><div>Cost-utility analysis (most applicable).</div></li><li id="ch6.lt65" class="half_rhythm"><div>Other type of full economic evaluation (cost-benefit analysis, cost-effectiveness analysis, cost-consequences analysis).</div></li><li id="ch6.lt66" class="half_rhythm"><div>Comparative cost analysis.</div></li><li id="ch6.lt67" 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>
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</p>
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<p><i>Year of analysis:</i>
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<ul id="ch6.l19"><li id="ch6.lt68" class="half_rhythm"><div>The more recent the study, the more applicable it will be.</div></li><li id="ch6.lt69" 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="ch6.lt70" class="half_rhythm"><div>Studies published before 2001 will have been excluded before being assessed for applicability and methodological limitations.</div></li></ul>
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</p>
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<p><i>Quality and relevance of effectiveness data used in the economic analysis:</i>
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<ul id="ch6.l20"><li id="ch6.lt71" 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="ch6.lt72" 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>
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</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch6appbtab1"><div id="ch6.appb.tab1" 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/NBK577492/table/ch6.appb.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.appb.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_ch6.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Database</th><th id="hd_h_ch6.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dates searched</th><th id="hd_h_ch6.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_ch6.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Medline (OVID)</td><td headers="hd_h_ch6.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_ch6.appb.tab1_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>Randomised controlled trials</p>
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<p>Systematic review studies</p>
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<p>Observational studies</p>
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</td></tr><tr><td headers="hd_h_ch6.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Embase (OVID)</td><td headers="hd_h_ch6.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_ch6.appb.tab1_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>Randomised controlled trials</p>
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<p>Systematic review studies</p>
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<p>Observational studies</p>
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</td></tr><tr><td headers="hd_h_ch6.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_ch6.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Cochrane Reviews to 2017</p>
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<p>Issue 12 of12</p>
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<p>CENTRAL to 2017 Issue 11 of12</p>
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<p>DARE, and NHSEED to 2015</p>
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<p>Issue 2 of 4</p>
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<p>HTA to 2016 Issue 4 of 4</p>
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</td><td headers="hd_h_ch6.appb.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch6appbtab2"><div id="ch6.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/NBK577492/table/ch6.appb.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.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="bibr" href="#ch6.ref1" rid="ch6.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></article><article data-type="table-wrap" id="figobch6appbtab3"><div id="ch6.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/NBK577492/table/ch6.appb.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.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="bibr" href="#ch6.ref1" rid="ch6.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></article><article data-type="table-wrap" id="figobch6appbtab4"><div id="ch6.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/NBK577492/table/ch6.appb.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.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></article><article data-type="table-wrap" id="figobch6appbtab5"><div id="ch6.appb.tab5" class="table"><h3><span class="label">Table 10</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/NBK577492/table/ch6.appb.tab5/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.appb.tab5_lrgtbl__"><table><thead><tr><th id="hd_h_ch6.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Database</th><th id="hd_h_ch6.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dates searched</th><th id="hd_h_ch6.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_ch6.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Medline & Embase</td><td headers="hd_h_ch6.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_ch6.appb.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<p>Exclusions</p>
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<p>Health economics studies</p>
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|
</td></tr><tr><td headers="hd_h_ch6.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_ch6.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_ch6.appb.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch6appbtab6"><div id="ch6.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/NBK577492/table/ch6.appb.tab6/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.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></article><article data-type="table-wrap" id="figobch6appbtab7"><div id="ch6.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/NBK577492/table/ch6.appb.tab7/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.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></article><article data-type="table-wrap" id="figobch6appbtab8"><div id="ch6.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/NBK577492/table/ch6.appb.tab8/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.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></article><article data-type="fig" id="figobch6appcfig1"><div id="ch6.appc.fig1" class="figure"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Image%20ch6appcf1&p=BOOKS&id=577492_ch6appcf1.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 data-src="/books/NBK577492/bin/ch6appcf1.jpg" alt="Image ch6appcf1" class="tileshop" title="Click on image to zoom" /></a></div></div></article><article data-type="fig" id="figobch6appefig1"><div id="ch6.appe.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%201.%20AVF%20failure.&p=BOOKS&id=577492_ch6appef1.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 data-src="/books/NBK577492/bin/ch6appef1.jpg" alt="Figure 1. AVF failure." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 1</span><span class="title">AVF failure</span></h3></div></article><article data-type="table-wrap" id="figobch6appftab1"><div id="ch6.appf.tab1" class="table"><h3><span class="label">Table 11</span><span class="title">Clinical evidence profile: US vs PE</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577492/table/ch6.appf.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.appf.tab1_lrgtbl__"><table class="no_bottom_margin"><thead><tr><th id="hd_h_ch6.appf.tab1_1_1_1_1" colspan="7" rowspan="1" style="text-align:center;vertical-align:middle;">Quality assessment</th><th id="hd_h_ch6.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_ch6.appf.tab1_1_1_1_3" colspan="2" rowspan="1" style="text-align:center;vertical-align:middle;">Effect</th><th id="hd_h_ch6.appf.tab1_1_1_1_4" rowspan="2" colspan="1" headers="hd_h_ch6.appf.tab1_1_1_1_4" style="text-align:center;vertical-align:middle;">Quality</th><th id="hd_h_ch6.appf.tab1_1_1_1_5" rowspan="2" colspan="1" headers="hd_h_ch6.appf.tab1_1_1_1_5" style="text-align:center;vertical-align:middle;">Importance</th></tr><tr><th headers="hd_h_ch6.appf.tab1_1_1_1_1" id="hd_h_ch6.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_ch6.appf.tab1_1_1_1_1" id="hd_h_ch6.appf.tab1_1_1_2_2" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Design</th><th headers="hd_h_ch6.appf.tab1_1_1_1_1" id="hd_h_ch6.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_ch6.appf.tab1_1_1_1_1" id="hd_h_ch6.appf.tab1_1_1_2_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Inconsistency</th><th headers="hd_h_ch6.appf.tab1_1_1_1_1" id="hd_h_ch6.appf.tab1_1_1_2_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Indirectness</th><th headers="hd_h_ch6.appf.tab1_1_1_1_1" id="hd_h_ch6.appf.tab1_1_1_2_6" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Imprecision</th><th headers="hd_h_ch6.appf.tab1_1_1_1_1" id="hd_h_ch6.appf.tab1_1_1_2_7" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Other considerations</th><th headers="hd_h_ch6.appf.tab1_1_1_1_2" id="hd_h_ch6.appf.tab1_1_1_2_8" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Ultrasound</th><th headers="hd_h_ch6.appf.tab1_1_1_1_2" id="hd_h_ch6.appf.tab1_1_1_2_9" rowspan="1" colspan="1" style="text-align:center;vertical-align:middle;">Physical examination</th><th headers="hd_h_ch6.appf.tab1_1_1_1_3" id="hd_h_ch6.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_ch6.appf.tab1_1_1_1_3" id="hd_h_ch6.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_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_1 hd_h_ch6.appf.tab1_1_1_2_2 hd_h_ch6.appf.tab1_1_1_2_3 hd_h_ch6.appf.tab1_1_1_2_4 hd_h_ch6.appf.tab1_1_1_2_5 hd_h_ch6.appf.tab1_1_1_2_6 hd_h_ch6.appf.tab1_1_1_2_7 hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_8 hd_h_ch6.appf.tab1_1_1_2_9 hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_10 hd_h_ch6.appf.tab1_1_1_2_11 hd_h_ch6.appf.tab1_1_1_1_4 hd_h_ch6.appf.tab1_1_1_1_5" id="hd_b_ch6.appf.tab1_1_1_1_1" colspan="13" rowspan="1" style="text-align:left;vertical-align:top;">AVF failure (follow-up 1 to 6 months)</th></tr><tr><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_1 hd_b_ch6.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_2 hd_b_ch6.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomised trials</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_3 hd_b_ch6.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">no serious risk of bias</td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_4 hd_b_ch6.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_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_5 hd_b_ch6.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_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_6 hd_b_ch6.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">serious<sup>1</sup></td><td headers="hd_h_ch6.appf.tab1_1_1_1_1 hd_h_ch6.appf.tab1_1_1_2_7 hd_b_ch6.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">none</td><td headers="hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_8 hd_b_ch6.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>44/168</p>
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<p>(26.2%)</p>
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</td><td headers="hd_h_ch6.appf.tab1_1_1_1_2 hd_h_ch6.appf.tab1_1_1_2_9 hd_b_ch6.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">35.8%</td><td headers="hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_10 hd_b_ch6.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">RR 0.73 (0.53 to 1.01)</td><td headers="hd_h_ch6.appf.tab1_1_1_1_3 hd_h_ch6.appf.tab1_1_1_2_11 hd_b_ch6.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">97 fewer per 1000 (from 168 fewer to 4 more)</td><td headers="hd_h_ch6.appf.tab1_1_1_1_4 hd_b_ch6.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<p>⊕⊕⊕◯</p>
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<p>MODERATE</p>
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</td><td headers="hd_h_ch6.appf.tab1_1_1_1_5 hd_b_ch6.appf.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">IMPORTANT</td></tr></tbody></table></div><div class="tblwrap-foot"><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt>1</dt><dd><div id="ch6.appf.tab1_1"><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></dl></div></div></div></article><article data-type="fig" id="figobch6appgfig1"><div id="ch6.appg.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%2057.%20Flow%20chart%20of%20economic%20study%20selection%20for%20the%20guideline.&p=BOOKS&id=577492_ch6appgf1.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 data-src="/books/NBK577492/bin/ch6appgf1.jpg" alt="Figure 57. Flow chart of economic study selection for the guideline." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 57</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>▬</p></div></div></article><article data-type="table-wrap" id="figobch6appitab1"><div id="ch6.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/NBK577492/table/ch6.appi.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.appi.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Exclusion reason</th></tr></thead><tbody><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Mihmanli 2001<a class="bibr" href="#ch6.ref3" rid="ch6.ref3"><sup>3</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Less than minimum duration</td></tr><tr><td headers="hd_h_ch6.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Zhang 2006<a class="bibr" href="#ch6.ref7" rid="ch6.ref7"><sup>7</sup></a></td><td headers="hd_h_ch6.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not in English</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch6appitab2"><div id="ch6.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/NBK577492/table/ch6.appi.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.appi.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_ch6.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Reference</th><th id="hd_h_ch6.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_ch6.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td><td headers="hd_h_ch6.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobch6appjtab1"><div id="ch6.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/NBK577492/table/ch6.appj.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ch6.appj.tab1_lrgtbl__"><table><tbody><tr><th id="hd_b_ch6.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">PICO question</th><td headers="hd_b_ch6.appj.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<p>Population: Children young people and adults with CKD stage 3 to 5 being assessed for possible renal transplant</p>
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<p>Intervention/comparison:
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<ul id="ch6.l22"><li id="ch6.lt74" class="half_rhythm"><div>Cardiac assessment (including at least a cardiac stress test or echocardiogram) before transplantation</div></li><li id="ch6.lt75" class="half_rhythm"><div>No/low intensity cardiac assessment (e.g. ECG only) before transplantation</div></li></ul>
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</p>
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<p>Outcomes: Patient, family/carer health-related QoL, proportion going on to receive renal transplant, proportion of pre-emptive transplants, mortality, cardiovascular events, resource use, time to failure of RRT form, psychological distress and mental wellbeing, patient, family/carer experience of care</p>
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</td></tr><tr><th id="hd_b_ch6.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_ch6.appj.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Research in this area could establish if there is a justification for intensive cardiac assessment prior to transplant, if that is the case it could help reduce the cardiac risk of people who receive renal transplants and potentially prevent people in whom cardiac risk is too high from undergoing the additional risk of transplantation. If cardiac assessment is found to have no clinically important benefit, this could remove a barrier to timely transplantation</td></tr><tr><th id="hd_b_ch6.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_ch6.appj.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">There is current uncertainty about the clinical and cost effectiveness of cardiac assessment before transplantation.</td></tr><tr><th id="hd_b_ch6.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_ch6.appj.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Research in this area will inform NICE recommendations for service delivery and provide information about clinical and cost-effectiveness.</td></tr><tr><th id="hd_b_ch6.appj.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Current evidence base</th><td headers="hd_b_ch6.appj.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">There is no evidence specifically assessing the impact of cardiac assessment before transplantation</td></tr><tr><th id="hd_b_ch6.appj.tab1_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Equality</th><td headers="hd_b_ch6.appj.tab1_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not applicable</td></tr><tr><th id="hd_b_ch6.appj.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design</th><td headers="hd_b_ch6.appj.tab1_1_1_7_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">RCT ideally, if not then a non-randomised cohort study with adequate adjustment for key confounders including age, ethnicity, co-morbidities and some measure of baseline health (e.g. quality of life)</td></tr><tr><th id="hd_b_ch6.appj.tab1_1_1_8_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Feasibility</th><td headers="hd_b_ch6.appj.tab1_1_1_8_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">No obvious feasibility issues</td></tr><tr><th id="hd_b_ch6.appj.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Other comments</th><td headers="hd_b_ch6.appj.tab1_1_1_9_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Not applicable</td></tr><tr><th id="hd_b_ch6.appj.tab1_1_1_10_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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Importance
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</th><td headers="hd_b_ch6.appj.tab1_1_1_10_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<ul id="ch6.l23"><li id="ch6.lt76" class="half_rhythm"><div>High: the research is essential to inform future updates of key recommendations in the guideline.</div></li></ul>
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</td></tr></tbody></table></div></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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</html>
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