| アブストラクト | BACKGROUND: Cohort studies are among the most robust of observational studies but have issues with external validity. This study assesses threats to external validity (generalizability) in the European QUALity (EQUAL) study, a cohort study of people >65 years of age with Stage 4/5 chronic kidney disease. METHODS: Patients meeting the EQUAL inclusion criteria were identified in The Health Improvement Network database and stratified into those attending renal units, a secondary care cohort (SCC) and a not primary care cohort (PCC). Survival, progression to renal replacement therapy (RRT) and hospitalization were compared. RESULTS: The analysis included 250, 633 and 2464 patients in EQUAL, PCC and SCC. EQUAL had a higher proportion of men compared with PCC and SCC (60.0% versus 34.8% versus 51.4%). Increasing age >/=85 years {odds ratio [OR] 0.25 [95% confidence interval (CI) 0.15-0.40]} and comorbidity [Charlson Comorbidity Index >/=4, OR 0.69 (95% CI 0.52-0.91)] were associated with non-participation in EQUAL. EQUAL had a higher proportion of patients starting RRT at 1 year compared with SCC (8.1% versus 2.1%; P < 0.001). Patients in the PCC and SCC had increased risk of hospitalization [incidence rate ratio 1.76 (95% CI 1.27-2.47) and 2.13 (95% CI 1.59-2.86)] and mortality at 1 year [hazard ratio 3.48 (95% CI 2.1-5.7) and 1.7 (95% CI 1.1-2.7)] compared with EQUAL. CONCLUSIONS: This study provides evidence of how participants in a cohort study can differ from the broader population of patients, which is essential when considering external validity and application to local practice. |
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| ジャーナル名 | Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association |
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| 投稿日 | 2021/1/12 |
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| 投稿者 | Rao, Anirudh; MacNeill, Stephanie J; van de Luijtgaarden, Moniek W M; Chesnaye, Nicholas C; Drechsler, Christiane; Wanner, Chistoph; Torino, Claudia; Postorino, Maurizio; Szymczak, Maciej; Evans, Marie; Dekker, Friedo W; Jager, Kitty J; Ben-Shlomo, Yoav; Caskey, Fergus J |
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| 組織名 | Department of Nephrology, Liverpool University Hospitals NHS Foundation Trust,;Liverpool, UK.;Population Health Sciences, University of Bristol, Bristol, UK.;Department of Medical Informatics, ERA-EDTA Registry, Academic Medical Center,;Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam,;The Netherlands.;Department of Internal Medicine, University Hospital Wurzburg, Wurzburg, Germany.;Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension,;CNR-IFC, Reggio Calabria, Italy.;Department of Nephrology and Transplantation Medicine, Wroclaw Medical;University, Wroclaw, Poland.;Department of Clinical Science, Division of Renal Medicine, Intervention and;Technology, Karolinska Institutet, Stockholm, Sweden.;Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden,;North Bristol NHS Trust, Bristol, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/33426560/ |
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