Defining Key Elements of Communication after AKI: A Modified Delphi Process by the AKINow Workgroup
Bibliographic record
Abstract
Background: Lack of consensus exists on the key elements of communication about an AKI event between inpatient and outpatient care teams and the information that should be provided to patients and their care partners. We aim to develop and refine standardized communication tools that promote AKI awareness and management based on consensus stakeholder feedback. Methods: We conducted the first of three semi-structured sessions using the modified Delphi process. We recruited stakeholders through purposive and snowball sampling and surveyed them on a 5-point Likert scale (1-strongly disagree to 5-strongly agree) the population that should receive AKI education and the key elements of post-AKI communication. We then conducted virtual discussions to gather additional insights. Results: The first session had 36 stakeholders from 7 countries, including 22 physicians (18 nephrologists), 4 nurses, 3 pharmacists, 2 physician assistants, 1 physical therapist, 3 patients with history of AKI, and 1 caregiver. The stakeholders strongly agreed (median rating 5) that AKI education should be provided to patients with AKI stage 2-3, AKI requiring dialysis (AKI-D), AKI with only partial recovery by discharge, and AKI in the setting of CKD stage 3-5. On communication between inpatient and outpatient care teams, the most strongly agreed upon elements were medications to be resumed (94%), baseline creatinine (88%) and discharge creatinine (85%). For patients on dialysis, last dialysis date (94%) and dialysis initiation date (91%) were important. On communication between care teams and AKI survivors, the most strongly agreed upon elements were medication changes (91%) and nephrotoxins to avoid (91%). For patients on dialysis, dialysis appointment (94%), AKI-D education (88%), and catheter care (85%) were important. Qualitative evaluation showed the need to further define who provides post-AKI education and care, preferred communication methods and timing, and actionable guidance on managing post AKI sequelae, especially medications and diet. Conclusion: In the first of three sessions, stakeholders showed consensus on many key elements of AKI communication for care teams and patients. Subsequent sessions will refine standardized communication tools for clinical use. Funding: NIDDK Support
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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 | 0.199 | 0.117 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.006 | 0.004 |
| Science and technology studies | 0.011 | 0.009 |
| Scholarly communication | 0.004 | 0.007 |
| Open science | 0.004 | 0.019 |
| Research integrity | 0.004 | 0.005 |
| Insufficient payload (model declined to judge) | 0.006 | 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".