Skip to main content
SpringerLink
Log in

Clinical Practice Guidelines in Nephrology

  • Chapter
Book cover Modeling and Control of Dialysis Systems

Part of the book series: Studies in Computational Intelligence ((SCI,volume 405))

Abstract

The pursuit of evidence for the effectiveness of medical interventions was an early characteristic of western medicine. The development of scientific methods to identify the most effective treatment modalities culminated in the concepts and paradigms of evidence-based medicine (EBM) in the second half of the 20th century. The premise of Archie Cochrane, a founder of EBM, that “all treatment must be proved to be effective” is still valid today. Meanwhile, the increasing awareness that many patients do not receive the best standard of care as determined by scientific evidence raised questions on how to better assist physicians in their clinical decision making. This brought the attention to clinical practice guidelines (CPGs), which include graded recommendations developed by experts based on the quality of the available scientific evidence. CPGs are considered one of the most potential tools in helping to improve patient outcomes by providing doctors and patients with information on best-practice standards. While previous approaches for guideline development were often based on tradition or authority, the recommendations found in modern best-practice guidelines are based on standardized methods for grading quality of evidence and strength of recommendation.

In Nephrology this has inspired the development of guidelines by different organizations. While this has certainly led to some improvement in patient care, the uncoordinated approach to guideline development has led to redundancy in some areas of kidney disease management. Therefore, a new initiative, Kidney Disease: Improving Global Outcomes (KDIGO), was founded in 2003 in order to globally coordinate and promote the development of CPGs in nephrology. However, despite the improvement in the development process, there still remain obstacles to the implementation of CPG recommendations.

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

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
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

  • Abel, U., Koch, A.: The role of randomization in clinical studies: myths and beliefs. J. Clin. Epidemiol. 52(6), 487–497 (1999)

    Article  Google Scholar 

  • American College of Physicians. Guidelines for counseling postmenopausal women about preventive hormone therapy. Ann. Intern. Med. 117(12), 1038–1041 (1992)

    Google Scholar 

  • Antman, E.M., Lau, J., Kupelnick, B., et al.: A comparison of results of meta-analyses of randomized control trials and recommendations of clinical experts. Treatments for myocardial infarction. JAMA 268(2), 240–248 (1992)

    Article  Google Scholar 

  • Atkins, D., Best, D., Briss, P.A., et al.: Grading quality of evidence and strength of recommendations. BMJ 328(7454), 1490 (2004)

    Article  Google Scholar 

  • Audet, A.M., Greenfield, S., Field, M.: Medical practice guidelines: current activities and future directions. Ann. Intern. Med. 113(9), 709–714 (1990)

    Article  Google Scholar 

  • Begg, C., Cho, M., Eastwood, S., et al.: Improving the quality of reporting of randomized controlled trials. The CONSORT statement. JAMA 276(8), 637–639 (1996)

    Article  Google Scholar 

  • Benson, K., Hartz, A.J.: A comparison of observational studies and randomized, controlled trials. N. Engl. J. Med. 342(25), 1878–1886 (2000)

    Article  Google Scholar 

  • Bodenheimer, T.: The American health care system–the movement for improved quality in health care. N. Engl. J. Med. 340(6), 488–492 (1999)

    Article  Google Scholar 

  • Briss, P.A., Zaza, S., Pappaioanou, M., et al.: Developing an evidence-based Guide to Community Preventive Services–methods. The Task Force on Community Preventive Services. Am. J. Prev. Med. 18(suppl. 1), 35–43 (2000)

    Article  Google Scholar 

  • Byar, D.P., Simon, R.M., Friedewald, W.T., et al.: Randomized clinical trials. Perspectives on some recent ideas. N. Engl. J. Med. 295(2), 74–80 (1976)

    Article  Google Scholar 

  • Cabana, M.D., Rand, C.S., Powe, N.R., et al.: Why don’t physicians follow clinical practice guidelines? A framework for improvement. JAMA 282(15), 1458–1465 (1999)

    Article  Google Scholar 

  • Chan, A.W., Altman, D.G.: Epidemiology and reporting of randomised trials published in PubMed journals. Lancet 365(9465), 1159–1162 (2005)

    Article  Google Scholar 

  • Chassin, M.R., Kosecoff, J., Solomon, D.H., Brook, R.H.: How coronary angiography is used. Clinical determinants of appropriateness. JAMA 258(18), 2543–2547 (1987)

    Article  Google Scholar 

  • Chertow, G.M., Levin, N.W., Beck, G.J., et al.: In-center hemodialysis six times per week versus three times per week. N. Engl. J. Med. 363(24), 2287–2300 (2010)

    Article  Google Scholar 

  • Claridge, J.A., Fabian, T.C.: History and development of evidence-based medicine. World J. Surg. 29(5), 547–553 (2005)

    Article  Google Scholar 

  • Collins, A.J., Roberts, T.L., St Peter, W.L., et al.: United States Renal Data System assessment of the impact of the National Kidney Foundation-Dialysis Outcomes Quality Initiative guidelines. Am. J. Kidney Dis. 39(4), 784–795 (2002)

    Article  Google Scholar 

  • Concato, J., Shah, N., Horwitz, R.I.: Randomized, controlled trials, observational studies, and the hierarchy of research designs. N. Engl. J. Med. 342(25), 1887–1892 (2000)

    Article  Google Scholar 

  • Dharmarajan, T.S., Nanda, A., Agarwal, B., et al.: Prevention of Venous Thromboembolism in Long-Term Care: Results of a Multicenter Educational Intervention Using Clinical Practice Guidelines: Part 2 of 2 (an AMDA Foundation Project). J. Am. Med. Dir. Assoc. (2011)

    Google Scholar 

  • Eccles, M., Clapp, Z., Grimshaw, J., et al.: North of England evidence based guidelines development project: methods of guideline development. BMJ 312(7033), 760–762 (1996)

    Article  Google Scholar 

  • Echt, D.S., Liebson, P.R., Mitchell, L.B., et al.: Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The Cardiac Arrhythmia Suppression Trial. N. Engl. J. Med. 324(12), 781–788 (1991)

    Article  Google Scholar 

  • Eckardt, K.U., Kasiske, B.L.: Kidney disease: improving global outcomes. Nat. Rev. Nephrol. 5(11), 650–657 (2009)

    Article  Google Scholar 

  • Eddy, D.M.: Evidence-based medicine: a unified approach. Health Aff. (Millwood) 24(1), 9–17 (2005)

    Article  Google Scholar 

  • Eddy, D.M.: Variations in physician practice: the role of uncertainty. Health Aff. (Millwood) 3(2), 74–89 (1984)

    Article  Google Scholar 

  • Eknoyan, G., Beck, G.J., Cheung, A.K., et al.: Effect of dialysis dose and membrane flux in maintenance hemodialysis. N. Engl. J. Med. 347(25), 2010–2019 (2002)

    Article  Google Scholar 

  • Elstein, A.S.: On the origins and development of evidence-based medicine and medical decision making. Inflamm. Res. 53(suppl. 2), S184–S189 (2004)

    Google Scholar 

  • Engels, E.A., Falagas, M.E., Lau, J., Bennish, M.L.: Typhoid fever vaccines: a meta-analysis of studies on efficacy and toxicity. BMJ 316(7125), 110–116 (1998)

    Article  Google Scholar 

  • Feinstein, A.R.: Current problems and future challenges in randomized clinical trials. Circulation 70(5), 767–774 (1984)

    Article  Google Scholar 

  • Glasziou, P., Meats, E., Heneghan, C., Shepperd, S.: What is missing from descriptions of treatment in trials and reviews? BMJ 336(7659), 1472–1474 (2008)

    Article  Google Scholar 

  • Greer, N., Mosser, G., Logan, G., Halaas, G.W.: A practical approach to evidence grading. Jt. Comm. J. Qual. Improv. 26(12), 700–712 (2000)

    Google Scholar 

  • Grol, R.: Successes and failures in the implementation of evidence-based guidelines for clinical practice. Med. Care 39(8 suppl. 2), II46–II54 (2001)

    Google Scholar 

  • Grol, R., Grimshaw, J.: From best evidence to best practice: effective implementation of change in patients’ care. Lancet 362(9391), 1225–1230 (2003)

    Article  Google Scholar 

  • Grol, R., Wensing, M.: What drives change? Barriers to and incentives for achieving evidence-based practice. Med. J. Aust. 180(6), S57–S60 (2004)

    Google Scholar 

  • Guyatt, G., Vist, G., Falck-Ytter, Y., et al.: An emerging consensus on grading recommendations? Evid. Based Med. 11(1), 2–4 (2006)

    Article  Google Scholar 

  • Guyatt, G.H., Oxman, A.D., Vist, G.E., et al.: GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 336(7650), 924–926 (2008)

    Article  Google Scholar 

  • Guyatt, G.H., Sackett, D.L., Sinclair, J.C., et al.: Users’ guides to the medical literature. IX. A method for grading health care recommendations. Evidence-Based Medicine Working Group. JAMA 274(22), 1800–1804 (1995)

    Article  Google Scholar 

  • Harrison, J.: Oxford handbook of key clinical evidence. Oxford University Press, Oxford (2009)

    Google Scholar 

  • Hirsh, J., Guyatt, G.: Clinical experts or methodologists to write clinical guidelines. Lancet 374(9686), 273–275 (2009)

    Article  Google Scholar 

  • Hornberger, J.C.: The hemodialysis prescription and cost effectiveness. Renal Physicians Association Working Committee on Clinical Guidelines. J. Am. Soc. Nephrol. 4(4), 1021–1027 (1993)

    Google Scholar 

  • Hulley, S., Grady, D., Bush, T., et al.: Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. Heart and Estrogen/progestin Replacement Study (HERS) Research Group. JAMA 280(7), 605–613 (1998)

    Article  Google Scholar 

  • Humphrey, L.L., Chan, B.K., Sox, H.C.: Postmenopausal hormone replacement therapy and the primary prevention of cardiovascular disease. Ann. Intern. Med. 137(4), 273–284 (2002)

    Article  Google Scholar 

  • Ioannidis, J.P., Haidich, A.B., Pappa, M., et al.: Comparison of evidence of treatment effects in randomized and nonrandomized studies. JAMA 286(7), 821–830 (2001)

    Article  Google Scholar 

  • Juni, P., Altman, D.G., Egger, M.: Systematic reviews in health care: Assessing the quality of controlled clinical trials. BMJ 323(7303), 42–46 (2001)

    Article  Google Scholar 

  • K/DOQI Workgroup. K/DOQI Clinical practice guidelines for cardiovascular disease in dialysis patients. Am. J. Kidney Dis. 45(4 suppl. 3), S1–S153 (2005)

    Google Scholar 

  • K/DOQI Workgroup. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am. J. Kidney Dis. 39(2 suppl. 1), S1–S266 (2002)

    Google Scholar 

  • K/DOQI Workgroup. K/DOQI clinical practice guidelines for vascular access. National Kidney Foundation-Dialysis Outcomes Quality Initiative. Am. J. Kidney Dis. 30(3), S150–S191 (1997)

    Google Scholar 

  • Lesho, E.P., Myers, C.P., Ott, M., et al.: Do clinical practice guidelines improve processes or outcomes in primary care? Mil. Med. 170(3), 243–246 (2005)

    Google Scholar 

  • Lusted, L.B.: Introduction to medical decision making. Charles C Thomas Pub. Ltd., Springfield (1968)

    Google Scholar 

  • Meehl, P.E.: Clinical versus statistical prediction; a theoretical analysis and a review of the evidence. University of Minnesota Press, Minneapolis (1954)

    Book  Google Scholar 

  • Medical Research Council. STREPTOMYCIN treatment of pulmonary tuberculosis. Br. Med. J. 2(4582), 769–782 (1948)

    Google Scholar 

  • Moher, D., Tetzlaff, J., Tricco, A.C., et al.: Epidemiology and reporting characteristics of systematic reviews. PLoS Med. 4(3), e78 (2007)

    Article  Google Scholar 

  • Naylor, C.D., Guyatt, G.H.: Users’ guides to the medical literature. X. How to use an article reporting variations in the outcomes of health services. The Evidence-Based Medicine Working Group. JAMA 275(7), 554–558 (1996)

    Article  Google Scholar 

  • Oh, S.W., Lee, H.J., Chin, H.J., Hwang, J.I.: Adherence to clinical practice guidelines and outcomes in diabetic patients. Int. J. Qual. Health Care 23(4), 413–419 (2011)

    Article  Google Scholar 

  • Paniagua, R., Amato, D., Vonesh, E., et al.: Effects of increased peritoneal clearances on mortality rates in peritoneal dialysis: ADEMEX, a prospective, randomized, controlled trial. J. Am. Soc. Nephrol. 13(5), 1307–1320 (2002)

    Google Scholar 

  • Ploeg, J., Davies, B., Edwards, N., et al.: Factors influencing best-practice guideline implementation: lessons learned from administrators, nursing staff, and project leaders. Worldviews Evid. Based Nurs. 4(4), 210–219 (2007)

    Article  Google Scholar 

  • PLoS Medicine Editors. Many reviews are systematic but some are more transparent and completely reported than others. PLoS Med. 4(3), e147 (2007)

    Google Scholar 

  • Port, F.K., Pisoni, R.L., Bragg-Gresham, J.L., et al.: DOPPS estimates of patient life years attributable to modifiable hemodialysis practices in the United States. Blood Purif. 22(1), 175–180 (2004)

    Article  Google Scholar 

  • Rangachari, P.K.: Evidence-based medicine: old French wine with a new Canadian label? J. R. Soc. Med. 90(5), 5–280 (1997)

    Google Scholar 

  • Rossouw, J.E., Anderson, G.L., Prentice, R.L., et al.: Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women’s Health Initiative randomized controlled trial. JAMA 288(3), 321–333 (2002)

    Article  Google Scholar 

  • Sackett, D.L., Rosenberg, W.M., Gray, J.A., et al.: Evidence based medicine: what it is and what it isn’t. BMJ 312(7023), 71–72 (1996)

    Article  Google Scholar 

  • Sacks, H., Chalmers, T.C., Smith Jr., H.: Randomized versus historical controls for clinical trials. Am. J. Med. 72(2), 233–240 (1982)

    Article  Google Scholar 

  • Schulz, K.F., Altman, D.G., Moher, D.: CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ 340, c332 (2010)

    Article  Google Scholar 

  • Schuster, M.A., Mcglynn, E.A., Brook, R.H.: How good is the quality of health care in the United States? Milbank Q. 76(4), 517–563 (1998)

    Article  Google Scholar 

  • Strippoli, G.F., Craig, J.C., Schena, F.P.: The number, quality, and coverage of randomized controlled trials in nephrology. J. Am. Soc. Nephrol. 15(2), 411–419 (2004)

    Article  Google Scholar 

  • Sung, N.S., Crowley Jr., W.F., Genel, M., et al.: Central challenges facing the national clinical research enterprise. JAMA 289(10), 1278–1287 (2003)

    Article  Google Scholar 

  • Taylor, M., Dlamini, S.B., Kagoro, H., et al.: Understanding high school students’ risk behaviors to help reduce the HIV/AIDS epidemic in KwaZulu-Natal, South Africa. J. Sch. Health. 73(3), 97–100 (2003)

    Article  Google Scholar 

  • Timmermans, S., Mauck, A.: The promises and pitfalls of evidence-based medicine. Health Aff. (Millwood) 24(1), 18–28 (2005)

    Article  Google Scholar 

  • Uhlig, K., Macleod, A., Craig, J., et al.: Grading evidence and recommendations for clinical practice guidelines in nephrology. A position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 70(12), 2058–2065 (2006)

    Google Scholar 

  • Weingarten, S.: Using practice guideline compendiums to provide better preventive care. Ann. Intern. Med. 130(5), 454–458 (1999)

    Article  Google Scholar 

  • Wennberg, J., Gittelsohn, A.: Small area variations in health care delivery. Science 182(117), 1102–1108 (1973)

    Article  Google Scholar 

  • West, S., King, V., Carey, T.S., et al.: Systems to rate the strength of scientific evidence. Evid. Rep. Technol. Assess. (Summ) 47, 1–11 (2002)

    Google Scholar 

  • Westfall, J.M., Mold, J., Fagnan, L.: Practice-based research–"Blue Highways on the NIH roadmap. JAMA 297(4), 403–406 (2007)

    Article  Google Scholar 

  • Wikstrom, B., Jacobson, S.H., Bragg-Gresham, J., et al.: Dialysis Outcomes and Practice Patterns Study estimate of patient life-years attributable to modifiable haemodialysis practices in Sweden. Scand J. Urol. Nephrol. 44(2), 113–120 (2010)

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Divison of Nephrology, McGill University, Lyman Duff Medical Building, Montreal, Quebec, Canada

    Thomas M. Kitzler

  2. Renal Research Institite, New York, USA

    Nathan W. Levin

Authors
  1. Thomas M. Kitzler
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nathan W. Levin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Thomas M. Kitzler .

Editor information

Editors and Affiliations

  1. Faculty of Engineering,, Misr University for Science &, Computer and Software Engineering Depart, Al-Motamayez District, 6th of October City, 12566, Egypt

    Ahmad Taher Azar

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Kitzler, T.M., Levin, N.W. (2013). Clinical Practice Guidelines in Nephrology. In: Azar, A. (eds) Modeling and Control of Dialysis Systems. Studies in Computational Intelligence, vol 405. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-27558-6_18

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-27558-6_18

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-27557-9

  • Online ISBN: 978-3-642-27558-6

  • eBook Packages: EngineeringEngineering (R0)

Publish with us

Policies and ethics

Search

Navigation