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Effects of a Nationwide Predialysis Educational Program on Modality Choice, Vascular Access, and Patient Outcomes  Eduardo Lacson, MD, MPH, Weiling Wang,

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Presentation on theme: "Effects of a Nationwide Predialysis Educational Program on Modality Choice, Vascular Access, and Patient Outcomes  Eduardo Lacson, MD, MPH, Weiling Wang,"— Presentation transcript:

1 Effects of a Nationwide Predialysis Educational Program on Modality Choice, Vascular Access, and Patient Outcomes  Eduardo Lacson, MD, MPH, Weiling Wang, MS, Cari DeVries, Keith Leste, MA, Raymond M. Hakim, MD, PhD, Michael Lazarus, MD, Joseph Pulliam, MD  American Journal of Kidney Diseases  Volume 58, Issue 2, Pages (August 2011) DOI: /j.ajkd Copyright © 2011 National Kidney Foundation, Inc. Terms and Conditions

2 Figure 1 Population flow chart with results of an immediate posteducation session survey of which treatment modality the attendees would choose for end-stage renal disease at that time. The primary analyses compared incident patients followed up with usual care against treatment options program (TOPs) attendees from patients who initiated dialysis therapy between January 1 and December 31, 2008, first including all patients and then in a 1:1 matched cohort sample. *FMCNA, Fresenius Medical Care, North America; **the first known TOPs attendee initiated dialysis therapy on this date. American Journal of Kidney Diseases  , DOI: ( /j.ajkd ) Copyright © 2011 National Kidney Foundation, Inc. Terms and Conditions

3 Figure 2 Kaplan-Meier survival curves comparing treatment options program (TOPs; solid line) and non-TOPs (broken line) patients in the overall cohort ([A] 27,052 non-TOPs and 3,165 TOPs patients) and cohort matched 1:1 by age, sex, race, and diabetes, and area ([B] 2,800 non-TOPs and 2,800 TOPs patients). American Journal of Kidney Diseases  , DOI: ( /j.ajkd ) Copyright © 2011 National Kidney Foundation, Inc. Terms and Conditions

4 Figure 3 Cox proportional hazard models for mortality in incident patients during their first 90 days, comparing treatment options program (TOPs) and non-TOPs attendees (including the sensitivity analysis in a propensity score–matched cohort with fewer patients). Relative risk of mortality is shown; non-TOPs attendees make up the reference group. ^Additional case-mix adjustment for body surface area and number of comorbid conditions. American Journal of Kidney Diseases  , DOI: ( /j.ajkd ) Copyright © 2011 National Kidney Foundation, Inc. Terms and Conditions

5 Figure 4 Modality distribution at the end of 90 days comparing treatment options program (TOPs; top charts) and non-TOPs attendees (bottom charts) for active patients as of day 91. The charts on the right-hand side indicate modality after 90 days for those who initially choose in-center hemodialysis (HD) therapy, whereas those on the left-hand side indicate results for those who in initially opted for peritoneal dialysis (PD) therapy. For comparison, baseline values are given in the text above each chart. American Journal of Kidney Diseases  , DOI: ( /j.ajkd ) Copyright © 2011 National Kidney Foundation, Inc. Terms and Conditions


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