tag:blogger.com,1999:blog-4230162007222918868.post8785520677542204260..comments2023-09-19T05:50:03.130-04:00Comments on Renal Fellow Network: Risk score for predicting ESRD in CKD patientsGearoid McMahonhttp://www.blogger.com/profile/08049723797363526138noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-4230162007222918868.post-26951381440907766172011-04-13T17:44:03.160-04:002011-04-13T17:44:03.160-04:00Thanks for the comment.
I agree there could possi...Thanks for the comment.<br /><br />I agree there could possibly be some circularity introduced if the model were used for planning cadaveric renal transplantation, where the outcome is determined by one's place on a list (i.e. the algorithm says patient x should go here on the list, which then becomes self-fulfilling). <br /><br />I don't forsee this being an issue in the setting of live donor transplantation or dialysis initiation. These outcomes are ultimately determined by near-term clinical need rather than by "what the model says", and the algorithm's role here would probably be in access planning, or timing of txp work-up, referral etc. As clinical need will typically be determined due to the combined effects of the risk factors included in the prediction model, I don't think the outcome would be affected. Time will tell.<br /><br />It will be interesting to see how this pans out - clearly the next step is to test its utility in the real world. If the score requires revision in the future because it has changed patient outcomes, I would view it as a sign of success rather than failure!Conall O' Seaghdhahttps://www.blogger.com/profile/02591806942414088134noreply@blogger.comtag:blogger.com,1999:blog-4230162007222918868.post-57606999026098781092011-04-13T16:13:26.936-04:002011-04-13T16:13:26.936-04:00Would not the validity of this tool depend on &quo...Would not the validity of this tool depend on "business as usual" treatment practices?<br />i.e, USING the tool alters treatment *decisions* in ways which *change* outcomes, thus invalidating the model on which the tool is based?Anonymousnoreply@blogger.com