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Am J Kidney Dis. 2018 Dec 19. pii: S0272-6386(18)31088-6. doi: 10.1053/j.ajkd.2018.10.007. [Epub ahead of print]

Development of an International Standard Set of Value-Based Outcome Measures for Patients With Chronic Kidney Disease: A Report of the International Consortium for Health Outcomes Measurement (ICHOM) CKD Working Group.

Author information

1
St Antonius Hospital, Nieuwegein, the Netherlands. Electronic address: w.verberne@antoniusziekenhuis.nl.
2
International Consortium for Health Outcomes Measurement, London, United Kingdom.
3
Massachusetts General Hospital, Boston, MA.
4
patient representative, Dutch Kidney Patients Association (NVN), Bussum, the Netherlands.
5
Renal Division, Ghent University Hospital, Ghent, Belgium.
6
University of Guadalajara Health Sciences Center, Hospital Civil de Guadalajara "Fray Antonio Alcalde," Guadalajara, Jalisco, Mexico.
7
Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom (EG).
8
Hospital Universitario Miguel Servet, Zaragoza, Spain.
9
Dutch Renal Registry (Renine), Nefrovisie, Utrecht; Medical Center Leeuwarden, Leeuwarden.
10
ERA-EDTA Registry, Amsterdam UMC, University of Amsterdam, Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
11
Klinikum Coburg, Coburg, Germany; University of Split School of Medicine, Split, Croatia.
12
Dibba Hospital, Dibba Al Fujairah, United Arab Emirates.
13
European Renal Care Providers Association, Brussels, Belgium.
14
Erasmus University Medical Center, Rotterdam, the Netherlands.
15
Providence Medical Research Center, Providence Health Care Kidney Research Institute, Nephrology Division and Institute for Translational Health Sciences, University of Washington, Spokane, WA.
16
Chang Gung Memorial Hospital, Linkou; Chang Gung University, College of Medicine, Taoyuan, Taiwan.
17
Centre for Nephrology, University College London, London, United Kingdom.
18
St Antonius Hospital, Nieuwegein; Leiden University Medical Center, Leiden, the Netherlands.

Abstract

Value-based health care is increasingly promoted as a strategy for improving care quality by benchmarking outcomes that matter to patients relative to the cost of obtaining those outcomes. To support the shift toward value-based health care in chronic kidney disease (CKD), the International Consortium for Health Outcomes Measurement (ICHOM) assembled an international working group of health professionals and patient representatives to develop a standardized minimum set of patient-centered outcomes targeted for clinical use. The considered outcomes and patient-reported outcome measures were generated from systematic literature reviews. Feedback was sought from patients and health professionals. Patients with very high-risk CKD (stages G3a/A3 and G3b/A2-G5, including dialysis, kidney transplantation, and conservative care) were selected as the target population. Using an online modified Delphi process, outcomes important to all patients were selected, such as survival and hospitalization, and to treatment-specific subgroups, such as vascular access survival and kidney allograft survival. Patient-reported outcome measures were included to capture domains of health-related quality of life, which were rated as the most important outcomes by patients. Demographic and clinical variables were identified to be used as case-mix adjusters. Use of these consensus recommendations could enable institutions to monitor, compare, and improve the quality of their CKD care.

KEYWORDS:

Chronic kidney disease (CKD); case-mix adjustment; dialysis; health-related quality of life (HRQoL); kidney transplantation; modified Delphi technique; outcome assessment; patient reported outcome measures (PROMs); patient-centered outcomes; quality of health care; routine clinical practice; shared decision making; value-based health care (VBHC)

PMID:
30579710
DOI:
10.1053/j.ajkd.2018.10.007
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