Informative for Decision Making? The Spectrum and Consistency of Outcomes After Living Kidney Donation Reported in Trials and Observational Studies
Bibliographic record
Abstract
BACKGROUND: Evidence about outcomes after living kidney donation is needed both to inform donor acceptance criteria, and to guide the decisions of potential donors and their healthcare providers about donation. However, the scope and heterogeneity of outcomes reported in research and their relevance to decision making is uncertain. To determine the spectrum and consistency of outcomes reported in randomized trials and observational studies in living kidney donors 18 years or older. METHODS: Electronic databases were searched for randomized trials and observational studies reporting outcomes in adult living kidney donors published from January 2011 to May 2017. All outcome domains and measurements were extracted, and their frequency and characteristics were evaluated. RESULTS: Of the 268 eligible studies, 14 (5%) were randomized and 254 (95%) observational. Overall, 136 (51%) studies were short-term (≤1 year follow up) and reported 109 outcome domains, of which 51 (47%) were classified as clinical, 35 (32%) were surrogate, and 23 (21%) were donor-reported. The 5 most commonly reported domains were kidney function (154, 58%), time to discharge (96, 36%), blood loss (85, 32%), operative time (79, 30%) and blood pressure (74, 28%). Quality of life (13%), mortality (16%), end-stage kidney disease (10%) and cardiovascular events (9%) were reported infrequently. CONCLUSIONS: The outcomes of living kidney donation reported in contemporary trials and observational studies are numerous, heterogeneous, and often focused on short-term surgical complications. Consistent reporting of outcomes relevant to decision making is needed to better inform and prepare donors for outcomes after donation.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".