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Assessing consensus between UK renal clinicians on listing for kidney Transplantation : a modified Delphi Study

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ATTOM Investigators (Including: Tonkin-Crine, Sarah, Pruthi, Rishi, Taylor, Dominic M., Leydon, Geraldine M., Calestani, Melania, Oniscu, Gabriel C., Bradley, J. Andrew, Tomson, Charles R., Bradley, Clare, Dudley, Christopher, Watson, Christopher J. E., Draper, Heather, Johnson, Rachel J., Metcalfe, Wendy, Fogarty, Damian G., Ravanan, Rommel and Roderick, Paul). (2018) Assessing consensus between UK renal clinicians on listing for kidney Transplantation : a modified Delphi Study. Transplantation Direct, 4 (5). e343. doi:10.1097/TXD.0000000000000782 ISSN 2373-8731.

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Official URL: https://doi.org/10.1097/TXD.0000000000000782

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Abstract

Background

It is well recognized that there is significant variation between centers in access to kidney transplantation. In the absence of high-grade evidence, it is unclear whether variation is due to patient case mix, othercenter factors, or individual clinician decisions. This study sought consensus between UK clinicians on factors that should influence access to kidney transplantation. Methods. As part of the Access to Transplantation and Transplant Outcome Measures project, consultant nephrologists and transplant surgeons in 71 centers were invited to participate in a Delphi study involving 2 rounds. During rounds 1 and 2, partic- ipants rated their agreement to 29 statements covering 8 topics regarding kidney transplantation. A stakeholder meeting was used to discuss statements of interest after the 2 rounds

Results

In total, 122 nephrologists and 16 transplant surgeons from 45 units participated in rounds 1 and 2. After 2 rounds, 12 of 29 statements reachedconsensus. Fifty people participated in the stakeholder meeting. After the stakeholder meeting, a further 4 statements reached agreement. Of the 8 topics covered, consensus was reached in 6: use of a transplant protocol, patient age, body mass index, patient compliance with treatment, cardiac workup, and use of multidisciplinary meetings. Consensus was not reached on screening for malignancy and use of peripheral Doppler studies.

Conclusions

The Delphi process identified factors upon which clinicians agreed and areas where consensus could not be achieved. The findings should inform national guidelines to support decision making in the absence of high quality evidence and to guide areas that warrant future research.

Item Type: Journal Article
Subjects: R Medicine > RC Internal medicine
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Social Science & Systems in Health (SSSH)
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
SWORD Depositor: Library Publications Router
Library of Congress Subject Headings (LCSH): Nephrologists -- Decision making, Kidneys -- Transplantation, Medical centers -- Planning, Surgeons
Journal or Publication Title: Transplantation Direct
Publisher: Lippincott, Williams & Wilkins
ISSN: 2373-8731
Official Date: May 2018
Dates:
DateEvent
May 2018Published
18 April 2018Available
12 January 2018Accepted
Volume: 4
Number: 5
Article Number: e343
DOI: 10.1097/TXD.0000000000000782
Status: Peer Reviewed
Publication Status: Published
Reuse Statement (publisher, data, author rights):
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 26 June 2018
Date of first compliant Open Access: 26 June 2018
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
RP-PG-0109-10116[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
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