Examining the Relationship between Hygiene Practices and Clinical Outcomes in Patients on Peritoneal Dialysis: Insights from the Thailand PDOPPS Initiative
Bibliographic record
Abstract
Background: Peritonitis is a leading cause of hemodialysis (HD) transfer and mortality. We investigated the association between hygiene behavior and clinical outcomes in patients on PD. Methods: Personal hygiene was assessed in patients across 22 facilities in Thailand Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS) during 2016-2021. Hygiene behavior was assessed using a short-form hygiene behavioral questionnaire comprising 8 domains (physical hygiene, prevention of contamination, and PD procedure/protocol) with a yes/no answer format. Poor hygiene behavior was defined as a cumulative score of ≥3. Cox proportional hazards model regression and Poisson regression incidence rate ratio (IRR) were employed to estimate associations between hygiene behavior and clinical outcomes, including mortality, HD transfer, and peritonitis. Results: Of 1566 randomly selected patients on PD from 22 facilities, 669 consented and reported their hygiene behavior. Poor hygiene behavior was prevalent in the PD population (6%), especially in patients with diabetes and caregiver dependence. Poorer self-reported hygiene behavior at baseline was significantly associated with a higher rate of peritonitis and a shorter time to HD transfer but not death. This association persisted after adjusting for age, gender, PD vintage, comorbidities, shared frailty by study sites, and serum albumin. Conclusion: Personal hygiene behavior was independently associated with higher risk of peritonitis and shorter time to HD transfer, but not death. The findings could potentially pave the way for evaluating hygiene standards using this tool, which could aid in identifying patients at a heightened risk (risk stratification) and determining those who would benefit from preventive measures.
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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 | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.002 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".