Exploring Preconceptions in Peritoneal Dialysis Eligibility: The PD Myths Survey
Bibliographic record
Abstract
Background: Peritoneal dialysis (PD) is underutilized globally. A contributory factor may be myths around its use, some of which are mistaken as evidence after being shared routinely, gaining credence with repetition. Methods: An online global survey (in English and Thai) was administered for completion by nephrologists and trainees, to ascertain decisions on choosing PD as a treatment modality in various clinical settings. Ethical approval was granted by the University of Alberta, Canada. Informed consent was obtained prior to survey completion from each participant. The obtained outcomes were further evaluated according to status (nephrologist vs. trainee), experience, region and income group of the country. Results: In total, 645 participants (522 nephrologists; 123 trainees; 56% male) from 54 countries completed the survey. Participants were mostly 36-45 years old (36%) with 0-5 years experience in nephrology (39%) and from high-income countries (HIC; 66%). In general, PD was recommended for most scenarios, including repeated exposures to heavy lifting, swimming (especially in a private pool and ocean), among patients with cirrhosis or cognitive impairment with available support, and those living with a pet if a physical separation can be achieved during PD. Divergent responses were observed in other scenarios, including patients with BMI>40 whereby PD was discouraged by clinicians from low-income countries (75%) but not from HIC (21%). Certain abdominal surgeries were more acceptable to proceed with PD (hysterectomy 90%) compared to others (hemicolectomy 45%). Similar variation was noted for different types of stomas (nephrostomies 74%; suprapubic catheters 53%; ileostomies 27%). The probability of recommending PD in various scenarios was greater among clinicians from HIC, larger units and consultants with longer years of clinical experience. Conclusions: There is a huge disparity in approach to recommending PD across various clinical scenarios driven by experience, unit-level characteristics and region of practice. Globally, evidence-informed education is warranted to rectify misconceptions to enable greater PD uptake.
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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 | 0.006 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".