Monitoring dialysis outcomes across the world--the MONDO Global Database Consortium.
OBJECTIVE
Dialysis providers frequently collect detailed longitudinal and standardized patient data, providing valuable registries of routine care. However, even large organizations are restricted to certain regions, limiting their ability to separate effects of local practice from the pathophysiology shared by most dialysis patients. To overcome this limitation, the MONDO (MONitoring Dialysis Outcomes) research consortium has created a platform for the joint analysis of data from almost 200,000 dialysis patients worldwide.


METHODS
We examined design and operation of MONDO as well as its methodology with respect to patient inclusion, descriptive data and other study parameters.


RESULTS
MONDO partners contribute primary databases of anonymized patient data and collaboratively analyze populations across national and regional boundaries. To that end, datasets from different electronic health record systems are converted into a uniform structure. Patients are enrolled without systematic exclusions into open cohorts representing the diversity of patients. A large number of patient level treatment and outcome data is recorded frequently and can be analyzed with little delay. Detailed variable definitions are used to determine if a parameter can be studied in a subset or all databases.


CONCLUSIONS
MONDO has created a large repository of validated dialysis data, expanding the opportunities for outcome studies in dialysis patients. The density of longitudinal information facilitates in particular trend analysis. Limitations include the paucity of uniform definitions and standards regarding descriptive information (e.g. comorbidities), which limits the identification of patient subsets. Through its global outreach, depth, breadth and size, MONDO advances the observational study of dialysis patients and care.
Cologne University Medical Center, Cologne, Germany.
Gero D
GD
von Gersdorff
Len
L
Usvyat
Daniele
D
Marcelli
Aileen
A
Grassmann
Cristina
C
Marelli
Michael
M
Etter
Jeroen P
JP
Kooman
Albert
A
Power
Ted
T
Toffelmire
Yosef S
YS
Haviv
Adrian
A
Guinsburg
Claudia
C
Barth
Mathias
M
Schaller
Inga
I
Bayh
Laura
L
Scatizzi
Adam
A
Tashman
Stephan
S
Thijssen
Nathan W
NW
Levin
Frank M
FM
van der Sande
Charles
C
Pusey
Yuedong
Y
Wang
Peter
P
Kotanko
D016208:Databases, Factual / Q000592:standards; D014943:Global Health; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D012042:Registries; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D015203:Reproducibility of Results