Outcomes of a provincial home haemodialysis programme--a two-year experience: establishing benchmarks for programme evaluation
Bibliographic record
Abstract
INTRODUCTION: The province of British Columbia has the only coordinated provincial programme for home-based haemodialysis (HHD) in Canada. The centrally coordinated and locally administered programme was initiated in 2002 as a pilot project, and was firmly established with secured funding in 2004. HHD programmes have reported successful outcomes with respect to patients' well-being, haemodynamic stability and improvement of clinical and biochemical parameters in small selected groups of patients. METHODS: This report describes the 2-year outcomes of a provincial programme, in which more liberal criteria for patient selection have been applied, and multiple sites have trained and managed the patients over a large geographic area. As a 'newer' modality, it is important to review outcomes objectively so as to determine the true value of this home-based programme as an alternative to other home-based therapies such as peritoneal dialysis. RESULTS: One hundred and five patients who completed training and commenced home therapy between April 2004 and March 2006 were followed, for a total of 163.23 patient-years (PY). The average age was 52; 71% were male and the majority (58%) were Caucasian. Mean biochemical and clinical parameters were all within provincial and national target ranges at baseline and at the time of study follow-up cessation. Overall, 34 individual patients required hospital admission and 95% of the cohort required at least one in-centre run after training was completed (0.5 hospital admissions and 11 in-centre run per PY of HHD delivered). One- and 2-year technique survivals were 81% and 61% respectively, which were 85% and 74% when censored for transplantation. We were unable to demonstrate any significant predictors of technique survival using demographic, biochemical or other variables. CONCLUSION: This is the first report of HHD programme technique survival in a large provincial cohort. The 2-year technique survival of this cohort is comparable to reports of technique survival in peritoneal dialysis. These data can be used to benchmark programmes, and to foster further research to determine factors that may improve HHD technique survival.
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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 | 0.017 | 0.023 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
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".