Evidence map›Paper›PMID 34227221›Full record

ArticleHemodialysis international. International Symposium on Home Hemodialysis2022

Does experience matter? The relationship between nephrologist characteristics and end stage kidney disease patient outcomes.

Scott Reule, Robert Foley, Daniel Shaughnessy, Paul Drawz, Areef Ishani, Mark Rosenberg

Abstract read
In one paragraph

Article in Hemodialysis international. International Symposium on Home Hemodialysis, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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

1 citing paper in PubMed.

  1. Article
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.

Scott ReuleDepartment of Medicine, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA.
Robert FoleyDepartment of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
Daniel ShaughnessySchool of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.ORCID 0000-0001-7248-4882
Paul DrawzDepartment of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
Areef IshaniDepartment of Medicine, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA.
Mark RosenbergDepartment of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.

Funding

University of Minnesota Clinical and Translational Science Institute (UMN CTSI)UL1TR002494 · NCATS · UNIVERSITY OF MINNESOTA · PI BLAZAR, BRUCE R, WEISDORF, DANIEL J · 2018 to 2022
$34.9M
NCATS NIH HHS UL1 TR002494
6 · The paper itself

Abstract

backgroundNephrology offers the unique opportunity to directly link patients to providers, allowing the study of patient outcomes at the provider level. The purpose of this analysis was to determine whether nephrologist experience, defined as years in nephrology practice, was associated with clinical outcomes.

designPhysician data contained within the American Medical Association (AMA) Physician Masterfile was combined with patient and Medicare claims data from the United States Renal Data System (USRDS) for the calendar year 2012, with follow up extending through June 30, 2014. Associations with important healthcare outcomes including mortality in patients receiving maintenance renal replacement therapy (RRT), waitlisting for kidney transplantation, and receipt of a kidney transplant were determined with broad adjustment for both patient and provider level variables, with attention on tertile of provider time in practice.

resultsWe identified 256,324 patients on maintenance RRT cared for by 6193 nephrologists. Nephrologists with the least experience were more likely to be female, reside in a region with ≥1,000,000 people, have a Doctor of Osteopathic Medicine degree, and have a listed maintenance of certification status as "yes." Overall, 30.2% of the cohort died at a mean follow up of 1.99 years. Compared to those with the 0-10 years of experience, receipt of care from nephrologists with more experience was associated with lower mortality (AHR 0.97 CI 0.94-0.99 for nephrologists with 11-20 years) and increased listing for kidney transplantation (AHR 1.10; CI 1.01-1.21 for nephrologists with >21 years experience). Experience level did not result in a difference in kidney transplantation rates.

conclusionsReceipt of maintenance RRT from nephrologists with greater experience was associated with decreased mortality and increased listing for kidney transplantation, an effect that remained significant after multiple adjustments for important patient and nephrologist variables.

Indexed as

Kidney Failure, ChronicNephrologyAgedFemaleHumansMaleMedicareNephrologistsRenal DialysisUnited Statesdialysisoutcomesprovider experience

Identifiers

PMID34227221
PMCPMC8724381

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Registered trials

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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.