Evidence map›Paper›PMID 31521124›Full record

ArticleBMC nephrology2019

Lab-based and diagnosis-based chronic kidney disease recognition and staging concordance.

Clarissa J Diamantidis, Sarah L Hale, Virginia Wang, Valerie A Smith, Sarah Hudson Scholle, Matthew L Maciejewski

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

Article in BMC nephrology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 1 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

20 citing papers in PubMed, 1 synthesis or guideline pooled it.

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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

6 authors.

Clarissa J DiamantidisDivision of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, USA.
Sarah L HaleDepartment of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, USA.
Virginia WangDivision of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, USA.
Valerie A SmithDivision of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, USA.
Sarah Hudson ScholleNational Committee for Quality Assurance, Washington, DC, USA.
Matthew L MaciejewskiDivision of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, USA. mlm34@duke.edu.ORCID 0000-0003-1765-5938

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChronic kidney disease (CKD) is often under-recognized and poorly documented via diagnoses, but the extent of under-recognition is not well understood among Medicare beneficiaries. The current study used claims-based diagnosis and lab data to examine patient factors associated with clinically recognized CKD and CKD stage concordance between claims- and lab-based sources in a cohort of Medicare beneficiaries.

methodsIn a cohort of fee-for-service (FFS) beneficiaries with CKD based on 2011 labs, we examined the proportion with clinically recognized CKD via diagnoses and factors associated with clinical recognition in logistic regression. In the subset of beneficiaries with CKD stage identified from both labs and diagnoses, we examined concordance in CKD stage from both sources, and factors independently associated with CKD stage concordance in logistic regression.

resultsAmong the subset of 206,036 beneficiaries with lab-based CKD, only 11.8% (n = 24,286) had clinically recognized CKD via diagnoses. Clinical recognition was more likely for beneficiaries who had higher CKD stages, were non-elderly, were Hispanic or non-Hispanic Black, lived in core metropolitan areas, had multiple chronic conditions or outpatient visits in 2010, or saw a nephrologist. In the subset of 18,749 beneficiaries with CKD stage identified from both labs and diagnoses, 70.0% had concordant CKD stage, which was more likely if beneficiaries were older adults, male, lived in micropolitan areas instead of non-core areas, or saw a nephrologist.

conclusionsThere is significant under-diagnosis of CKD in Medicare FFS beneficiaries, which can be addressed with the availability of lab results.

Indexed as

Medicare Part BAgedAged, 80 and overClinical Laboratory TechniquesCohort StudiesFee-for-Service PlansFemaleHumansMaleRenal Insufficiency, ChronicUnited StatesBeneficiaryChronic kidney diseaseMedicareNephrology

Identifiers

PMID31521124
PMCPMC6744668

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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.