SP597DEVELOPING A CORE OUTCOME MEASURE FOR VASCULAR ACCESS FOR TRIALS IN HAEMODIALYSIS: AN INTERNATIONAL MULTISTAKEHOLDER CONSENSUS WORKSHOP
Bibliographic record
Abstract
INTRODUCTION AND AIMS: Vascular access is a critically important outcome domain for patients and clinicians but is infrequently and inconsistently reported across trials in haemodialysis. As part of the Standardised Outcomes in Nephrology - Haemodialysis (SONG-HD) initiative, we convened an international consensus workshop to discuss the development of a core outcome measure for vascular access. METHODS: In total, 13 patients/caregivers and 46 health professionals (nephrologists, radiologists, nurses, policy makers, industry, and researchers) from 12 countries attended. In facilitated breakout groups, participants discussed the development and implementation of a core outcome measure for vascular access. RESULTS: There was strong agreement that function was the most important vascular access outcome and should be included in a core outcome set for haemodialysis trials. From the discussion, we identified 4 themes. Participants reiterated the broad relevance of function given the applicability to all access types, the multidisciplinary involvement to achieve a functioning access and the multidimensionality of this outcome by capturing important aspects such as needling, interventions, dialysis adequacy, and patients’ well-being. With regards to establishing a measure of function, absolute feasibility was paramount to implementation and thus participants advocated for a simple, parsimonious measure requiring minimal resources with an operational and consistent definition that can be applied in routine practice, and across different clinical settings, countries and trials. Most attendees agreed that an outcome definition that ensures patient-centeredness, reliability and validity should include “uninterrupted use of the access without need for interventions” whilst “achieving prescribed dialysis”. Considerations were given to the importance of “changes in access blood flow” to assess function but feasibility, reliability, and measurement errors were identified as potential limitations. For other outcomes such as aneurysms (patients) or steal syndrome (clinicians), stakeholders identified that experiential relevance and severity could influence the prioritisation process. CONCLUSIONS: Patients, caregivers and health professionals support the relevance and inclusion of vascular access function in a core outcome set for haemodialysis. Workshop participants agreed that the measure for function needs to be feasible, patient-centered, clearly defined, reliable and pragmatic. These measurement properties may foster acceptance and optimise the implementation of vascular access function as part of a core outcome set for haemodialysis, leading to more informative research, better treatment, and improved patient outcomes.
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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 | 0.520 | 0.451 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.005 | 0.010 |
| Bibliometrics | 0.009 | 0.006 |
| Science and technology studies | 0.006 | 0.008 |
| Scholarly communication | 0.012 | 0.012 |
| Open science | 0.014 | 0.024 |
| Research integrity | 0.019 | 0.033 |
| Insufficient payload (model declined to judge) | 0.007 | 0.004 |
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; the direct Gemma label and the distilled Codex classifier agree on what is shown here.
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".