Renal Association Clinical Practice Guideline on Haemodialysis
Bibliographic record
Abstract
The basis for the management of advanced chronic kidney disease is the seamless integration of renal replacement therapy (HD, peritoneal dialysis, and transplantation) with evidence based medical treatment of its complications. The National Service Framework Part 1: Dialysis and Transplantation has stressed the need for a patient-centred approach in the planning and provision of renal replacement therapy with an emphasis on patient education and choice as well as the provision of adequate resources for elective access surgery, dialysis and transplantation [1]. It also identified that a small proportion of patients after counselling may opt for optimal conservative medical therapy without planning to initiate dialysis. It is estimated that there are more than 1.5 million patients with established renal failure who are treated with HD. Innovations and changes in HD practice have seldom been underpinned by adequately powered randomised trials. Nevertheless, day-to-day clinical decisions on HD are required and standards need to be set on the best available evidence. Consequently clinical practice guidelines for HD have been developed in Australasia, Canada, Europe and the USA [2–5] as well as the UK. These guidelines serve to identify and promote best practice in the delivery of HD and have set clinical standards to allow comparative audit of the key aspects of the HD prescription, laboratory data and patient outcomes. The reports of the UK Renal Registry, Scottish Renal Registry and NHS Quality Improvement Scotland have demonstrated the benefits of performing regular audit to improve clinical standards in HD. This module provides an update of the 2007 RA clinical practice guidelines in HD and, most importantly, modification of the current guidelines whenever indicated by evidence from new studies. In preparation of this update the authors performed a Medline and Pubmed search of all articles published on HD since the
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.033 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.003 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.005 | 0.003 |
| Research integrity | 0.007 | 0.010 |
| Insufficient payload (model declined to judge) | 0.028 | 0.024 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".