Skip to main content

Choice of statistical models for assessing the clinical outcomes of the efforts to provide high quality care for the ESRD patient

  • Chapter
Book cover Quality Assurance in Dialysis

Part of the book series: Developments in Nephrology ((DINE,volume 39))

Abstract

The role of quality assurance (QA) and continuous quality improvement (CQI) in the managed care of ESRD patients is closely linked with the ideas of evidence- based clinical practice and outcomes research. With concerns over rising costs in the treatment of ESRD patients, evidence-based clinical practice provides a mechanism whereby clinicians can choose a cost effective treatment or therapy for a group or subgroup of patients while optimizing select patient outcomes (e.g. improved patient survival, better quality of life, reduced patient hospitalization, etc.). This chapter provides some basic statistical principles, methods and models which clinicians can use in pursuit of evidence based clinical practice, quality assurance, CQI and/or outcomes research. Specific attention will be paid to the use of proper statistical methods for collecting, analyzing and summarizing patient-specific outcomes as they relate to a set of explanatory variables (i.e. independent variables or covariates).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Twardowski ZJ, Nolph KD, Khanna R et al. Peritoneal equilibration test. Perit Dial Bull 1987; 7(3): 138–47.

    Google Scholar 

  2. Conover WJ. Practical nonparametric statistics, 2nd ed. New York: John Wiley & Sons, 1980.

    Google Scholar 

  3. Lehmann EL. Nonparametrics: statistical methods based on ranks. San Francisco: Holden-Day, 1975.

    Google Scholar 

  4. Friedman GD. Primer of epidemiology. New York: McGraw-Hill, 1974.

    Google Scholar 

  5. Monson RR. Occupational epidemiology. Boca Raton: CRC Press, 1980.

    Google Scholar 

  6. Breslow NE and Day NE. Statistical methods in cancer research, volume 1: the analysis of case-control studies. Lyon: IARC Scientific Publications No. 32, 1980.

    Google Scholar 

  7. Diggle PJ, Liang K.-Y and Zeger SL. Analysis of longitudinal data. Oxford: Clarendon Press, 1994.

    Google Scholar 

  8. Davidian M and Giltinan DM. Nonlinear models for repeated measurement data, 1st edition. New York: Chapman and Hall, 1995.

    Google Scholar 

  9. Vonesh EF and Chinchilli VM. Linear and nonlinear models for the analysis of repeated measurements 1st edition. New York: Marcel Dekker, 1997.

    Google Scholar 

  10. SAS Institute Inc. Master Index to SAS System Documentation, Version 6. 3rd edition. Cary: SAS Institute Inc., 1991.

    Google Scholar 

  11. Vonesh EF. Estimating rates of recurrent peritonitis for patients on CAPD. Perit Dial Bull 1985; 5:59–65.

    Google Scholar 

  12. Vonesh EF. Modeling peritonitis rates and associated risk factors for individuals on continuous ambulatory peritoneal dialysis. Stat Med 1990; 9:263 71.

    Article  PubMed  Google Scholar 

  13. Luzar MA, Coles GA, Faller B et al. Staphylococcus aureus nasal carriage and infection in patients on continuous ambulatory peritoneal dialysis. N Engl J Med 1990; 322:505–9.

    Article  PubMed  CAS  Google Scholar 

  14. Tranaeus A, Heimburger O and Lindholm B. Peritonitis during continuous ambulatory peritoneal dialysis (CAPD): risk factors, clinical severity, and pathogenetic aspects. Perit Dial Int 1988; 8:253–63.

    Google Scholar 

  15. Vonesh EF. Which statistical method to use when analyzing the incidence of peritoneal dialysis related infections? Perit Dial Int 1991; 11:301–4.

    PubMed  CAS  Google Scholar 

  16. Holford TR. The analysis of rates and of survivorship using log-linear models. Biometrics 1980; 36:299–305.

    Article  PubMed  CAS  Google Scholar 

  17. Berry G. The analysis of mortality by the subject-years method. Biometrics 1983; 39:173–80.

    Article  PubMed  CAS  Google Scholar 

  18. Frome EL. The analysis of rates using Poisson regression models. Biometrics 1983; 39:665–74.

    Article  PubMed  CAS  Google Scholar 

  19. Fenton SSA, Schaubel DE, Desmeules M et al. Hemodialysis versus peritoneal dialysis: a comparison of adjusted mortality rates. Am J Kidney Disease 1997; 30:334–42.

    CAS  Google Scholar 

  20. Canada-USA (CANUSA) Peritoneal Dialysis Study Group. Adequacy of dialysis and nutrition in continuous peritoneal dialysis: Association with clinical outcomes. J Am Soc Nephrol 1996; 7:198–207.

    Google Scholar 

  21. Fleiss JL. Statistical methods for rates and proportions, 2nd edition. New York: John Wiley & Sons, 1981; 237–55.

    Google Scholar 

  22. Dean CB and Balshaw R. Efficiency lost by analyzing counts rather than event times in Poisson and overdispersed Poisson regression models. J Am Stat Assoc 1997; 92:1387–98.

    Article  Google Scholar 

  23. Allison PD. Survival analysis using the SAS system: a practical guide. Cary, NC: SAS Institute Inc.. 1995.

    Google Scholar 

  24. Kaplan EL and Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958; 53:457 81.

    Article  Google Scholar 

  25. Cox DR. Regression models and life tables (with discussion). J Royal Stat Society 1972; B34:187–220.

    Google Scholar 

  26. Kalbfleisch JD and Prentice RL. The statistical analysis of failure time data. New York: John Wiley & Sons, Inc.. 1980.

    Google Scholar 

  27. Malorca R, Vonesh E, Cancarini CG et al. A six year comparison of patient and technique survivals in CAPD and HD. Kidney Int 1988; 34:518–24.

    Article  Google Scholar 

  28. Serkes KD, Blagg CR, Nolph KD, Vonesh EF and Shapiro F. Comparison of patient and technique survival in continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis: a multicenter study. Perit Dial Int 1989; 10:15–19.

    Google Scholar 

  29. Maiorca R, Vonesh EF, Cavilli P et al. A multicenter selection-adjusted comparison of patient and technique survivals on CAPD and hemodialysis. Perit Dial Int 1991; 11:118–17.

    PubMed  CAS  Google Scholar 

  30. Held PJ, Port FK, Turenne MN, Gaylin DS, Hamburger RJ and Wolfe RA. Continuous ambulatory peritoneal dialysis and hemodialysis: comparison of patient mortality with adjustment for comorbid conditions. Kidney Int 1994; 45:1163–9.

    Article  PubMed  CAS  Google Scholar 

  31. Wolfe RA and Strawderman RL. Logical and statistical fallacies in the use of Cox regression models. Am J Kidney Dis 1996; 27:124–9.

    PubMed  CAS  Google Scholar 

  32. Nelson CB, Port FK, Wolfe RA and Guire KE. Comparison of continuous ambulatory peritoneal dialysis and hemodialysis patient survival with evaluation of trends during the 1980s. J Am Soc Nephrol 1992; 3:1147–55.

    PubMed  CAS  Google Scholar 

  33. Nelson CB, Port FK, Wolfe RA and Guire KE. Dialysis patient survival: evaluation of CAPD versus HD using 3 techniques [Abstract]. Perit Dial Int 1992: 12:144.

    Google Scholar 

  34. Fisher LD, Dixon DO, Herson J et al. Intention to treat in clinical trials. In Peace KE, editor. Statistical issues in drug research and development. New York: Marcel Dekker, 1990.

    Google Scholar 

  35. Vonesh EF. Relative risks can be risky. Perit Dial Int 1993; 13:5–9.

    PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1999 Kluwer Academic Publishers

About this chapter

Cite this chapter

Vonesh, E.F. (1999). Choice of statistical models for assessing the clinical outcomes of the efforts to provide high quality care for the ESRD patient. In: Henderson, L.W., Thuma, R.S. (eds) Quality Assurance in Dialysis. Developments in Nephrology, vol 39. Springer, Dordrecht. https://doi.org/10.1007/978-0-585-28312-8_4

Download citation

  • DOI: https://doi.org/10.1007/978-0-585-28312-8_4

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-0-7923-5281-5

  • Online ISBN: 978-0-585-28312-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics