title: Comparative effectiveness studies to improve clinical outcomes in end stage renal disease: the DEcIDE patient outcomes in end stage renal disease study.
abstract: BACKGROUND
  Evidence is lacking to inform providers' and patients' decisions about many common treatment strategies for patients with end stage renal disease (ESRD).
  
  
  METHODS
  The DEcIDE Patient Outcomes in ESRD Study is funded by the United States (US) Agency for Health Care Research and Quality to study the comparative effectiveness of: 1) antihypertensive therapies, 2) early versus later initiation of dialysis, and 3) intravenous iron therapies on clinical outcomes in patients with ESRD. Ongoing studies utilize four existing, nationally representative cohorts of patients with ESRD, including (1) the Choices for Healthy Outcomes in Caring for ESRD study (1041 incident dialysis patients recruited from October 1995 to June 1999 with complete outcome ascertainment through 2009), (2) the Dialysis Clinic Inc (45,124 incident dialysis patients initiating and receiving their care from 2003-2010 with complete outcome ascertainment through 2010), (3) the United States Renal Data System (333,308 incident dialysis patients from 2006-2009 with complete outcome ascertainment through 2010), and (4) the Cleveland Clinic Foundation Chronic Kidney Disease Registry (53,399 patients with chronic kidney disease with outcome ascertainment from 2005 through 2009). We ascertain patient reported outcomes (i.e., health-related quality of life), morbidity, and mortality using clinical and administrative data, and data obtained from national death indices. We use advanced statistical methods (e.g., propensity scoring and marginal structural modeling) to account for potential biases of our study designs. All data are de-identified for analyses. The conduct of studies and dissemination of findings are guided by input from Stakeholders in the ESRD community.
  
  
  CONCLUSIONS
  The DEcIDE Patient Outcomes in ESRD Study will provide needed evidence regarding the effectiveness of common treatments employed for dialysis patients. Carefully planned dissemination strategies to the ESRD community will enhance studies' impact on clinical care and patients' outcomes.
authors.affiliation: Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, 2024 E, Monument Street, Baltimore, MD 21205, USA. lboulwa@jhmi.edu
authors.forename: L Ebony
authors.initials: LE
authors.lastname: Boulware
authors.forename: Navdeep
authors.initials: N
authors.lastname: Tangri
authors.forename: Patti L
authors.initials: PL
authors.lastname: Ephraim
authors.forename: Julia J
authors.initials: JJ
authors.lastname: Scialla
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Sozio
authors.forename: Deidra C
authors.initials: DC
authors.lastname: Crews
authors.forename: Tariq
authors.initials: T
authors.lastname: Shafi
authors.forename: Dana C
authors.initials: DC
authors.lastname: Miskulin
authors.forename: Jiannong
authors.initials: J
authors.lastname: Liu
authors.forename: Wendy
authors.initials: W
authors.lastname: St Peter
authors.forename: Bernard G
authors.initials: BG
authors.lastname: Jaar
authors.forename: Albert W
authors.initials: AW
authors.lastname: Wu
authors.forename: Neil R
authors.initials: NR
authors.lastname: Powe
authors.forename: Sankar D
authors.initials: SD
authors.lastname: Navaneethan
authors.forename: Karen
authors.initials: K
authors.lastname: Bandeen-Roche
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy / Q000401:mortality; D005260:Female; D006801:Humans; D007275:Injections, Intravenous / Q000401:mortality; D007501:Iron / Q000008:administration & dosage*; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D058996:Quality Improvement / Q000706:statistics & numerical data*; D012042:Registries; D006435:Renal Dialysis / Q000401:mortality*; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents; D007501:Iron