ArticleClinical journal of the American Society of Nephrology : CJASN2009
The costs and benefits of automatic estimated glomerular filtration rate reporting.
Article in Clinical journal of the American Society of Nephrology : CJASN, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- Methods Used in Economic Evaluations of Chronic Kidney Disease Testing - A Systematic Review.PloS one · 2015Pooled it
- Accuracy of glomerular filtration rate estimation using creatinine and cystatin C for identifying and monitoring moderate chronic kidney disease: the eGFR-C study.Health technology assessment (Winchester, England) · 2024Article
- Early Detection of CKD: Implications for Low-Income, Middle-Income, and High-Income Countries.Journal of the American Society of Nephrology : JASN · 2020Review
- Article
- Nephrology care prior to end-stage renal disease and outcomes among new ESRD patients in the USA.Clinical kidney journal · 2015Article
- Clinician's use of automated reports of estimated glomerular filtration rate: a qualitative study.BMC nephrology · 2012Article
- Evaluation of dose requirements for prolonged bivalirudin administration in patients with renal insufficiency and suspected heparin-induced thrombocytopenia.Journal of thrombosis and thrombolysis · 2012Article
- Article
- Comparison of CKD awareness in a screening population using the Modification of Diet in Renal Disease (MDRD) study and CKD Epidemiology Collaboration (CKD-EPI) equations.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2011Article
- Development and results of a kidney disease knowledge survey given to patients with CKD.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2011Article
- Cystatin C identifies chronic kidney disease patients at higher risk for complications.Journal of the American Society of Nephrology : JASN · 2011Article
- Race differences in prevalence of chronic kidney disease among young adults using creatinine-based glomerular filtration rate-estimating equations.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2010Article
- Imprecision of creatinine-based GFR estimates in uninephric kidney donors.Clinical journal of the American Society of Nephrology : CJASN · 2010Article
- Chronic kidney disease: Automated eGFR reporting: good for the patient?Nature reviews. Nephrology · 2009Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesThe prevalence of chronic kidney disease (CKD) has increased over the past two decades. The sensitivity of serum creatinine (sCr) to identify CKD is low. As a result, many healthcare centers report estimated GFR (eGFR) with routine blood work. The aim of this study was to determine the cost-effectiveness of automatic eGFR reporting compared with reporting sCr alone. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A Markov model was designed to evaluate the cost-effectiveness of reporting eGFR compared with reporting sCr alone in a hypothetical cohort of 60-yr-old individuals undergoing annual blood chemistry testing over 18 yr. Paths and path probabilities were identical between the two arms, except for the sensitivity and specificity of eGFR and sCr to detect CKD.
resultseGFR reporting was dominant with a cost/effectiveness ratio of $16,751/quality-adjusted life year (QALY) versus $16,779/QALY for sCr reporting. Monte Carlo microsimulations in a hypothetical cohort of 10,000 patients demonstrated that over 18 yr, an average of 13 fewer deaths, 29 fewer ESRD events, and 11,348 more false positive CKD (FP-CKD) cases occurred with eGFR reporting. A sensitivity analysis revealed that decreasing the FP-CKD quality of life by > 2% rendered sCr reporting more cost-effective than eGFR reporting. If FP-CKD reduced quality of life by 5%, the incremental cost-effectiveness ratio for sCr reporting versus eGFR reporting would be $4367/QALY.
conclusionA decision analysis suggests that reporting eGFR may be beneficial, but this limited benefit was reversed with virtually any reduction in quality of life caused by incorrect diagnosis of CKD.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.