Evidence map›Paper›PMID 20529495›Full record

ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2010

How ready is general practice to improve quality in chronic kidney disease? A diagnostic analysis.

Iain Crinson, Hugh Gallagher, Nicola Thomas, Simon de Lusignan

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
43citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

43 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Trial
  6. Trial
  7. Effect of shared care on blood pressure in patients with chronic kidney disease: a cluster randomised controlled trial.The British journal of general practice : the journal of the Royal College of General Practitioners · 2013
    Trial
  8. Trial
  9. Trial
  10. Trial
  11. Observational
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. CKD Awareness Among US Adults by Future Risk of Kidney Failure.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2020
    Article
  19. Using chronic kidney disease trigger tools for safety and learning: a qualitative evaluation in East London primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019
    Article
  20. Improving coding and primary care management for patients with chronic kidney disease: an observational controlled study in East London.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019
    Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Iain CrinsonSt Georges, University of London, London.
Hugh Gallagher
Nicola Thomas
Simon de Lusignan

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChronic kidney disease (CKD) is associated with increased cardiovascular mortality and morbidity as well as progression to established renal failure. Interventions in primary care, particularly the lowering of blood pressure in individuals with CKD and proteinuria and diabetes, can slow disease progression. This evidence base is codified in national guidance and in a simplified form in pay-for-performance targets. Prior to conducting the QICKD study - a cluster of quality-improvement interventions with reduction of blood pressure as its primary outcome measure - a diagnostic analysis was conducted to assess the relevance of the intended interventions.

aimTo understand practitioners' views of CKD and its management.

methodFocus groups were held in five locations across England. Experienced facilitators developed a standardised approach and analysed data using the 'framework' approach.

resultsPractitioners varied in their views of CKD and their embracing of the guidance. Some sought to implement the full guidance, others only the pay-for-performance targets. Nearly all practitioners had reservations as to whether CKD was really a disease; problematised the diagnosis of CKD purely on an estimate of glomerular filtration rate; questioned whether CKD in older people was part of natural ageing; and had experienced difficulty in explaining the condition to patients without frightening them. Most reported both problems and scepticism concerning the blood pressure targets, and acknowledged educational gaps.

conclusionPractitioners have disparate views about CKD. The quality-improvement interventions in the QICKD study will need to incorporate a large element of education. CKD guidelines may have been introduced without sufficient educational support.

Indexed as

Attitude of Health PersonnelDisease ProgressionFamily PracticeFocus GroupsHumansPhysician-Patient RelationsProfessional PracticeQuality of Health CareRenal Insufficiency, Chronic

Identifiers

PMID20529495
PMCPMC2880740

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.