A Pilot Randomized Control Trial of an Energy Management Program for Adults on Chronic Hemodialysis with Fatigue: The Fatigue-HD Study
Bibliographic record
Abstract
Background: How to reduce fatigue and its impact on life participation is a topten unanswered research question among patients treated with chronic hemodialysis. We aimed to determine the feasibility of conducting a randomized controlled trial, to investigate an energy management education program for the chronic hemodialysis population. Methods: We conducted a parallel-arm, 1:1, blinded pilot RCT at six hemodialysis units in Calgary, Canada. Patients who had moderate or severe fatigue on the Fatigue Severity Scale, and met other study eligibility criteria, were invited to participate. Consenting participants were randomized to general self-management education or the Personal Energy Planning (PEP) program, a tailored 7-9 week energy management program that guides participants in practicing efficient energy expenditure during valued life activities. We assessed study eligibility, recruitment and attrition rates. We then computed standardized intervention effects (Cohen’s D statistic) on self-reported fatigue and life participation measures, compared to control, at immediate post-intervention and 12 weeks post-intervention. Results: Of 253 people on hemodialysis screened, 153 were eligible to be approached (clinically stable and English-speaking). 42 (26%) were interested and consented to participate, and 30 met all study eligibility criteria were enrolled (mean age 62.4, 60% male). 22 (73%) enrolled participants completed all study procedures. Medium intervention effects were observed compared to control on the global life participation scale, global life participation satisfaction scale, and COPM-Performance Scale at immediate post-intervention follow-up. At 12-week post-intervention, large and very large intervention effects were observed on the COPM Performance and Satisfaction Scales, respectively, compared to control. Minimal to no intervention effects were seen on other life participation or fatigue measures. Conclusions: We have shown it is feasible to enroll and follow patients on hemodialysis with fatigue in a randomized controlled trial of an energy management intervention. Since the intervention led to improved life participation on some scales, we have justified the need for, and feasibility of, a larger trial. Funding: Government Support - Non-U.S.
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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 | 0.005 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
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".