Evidence map›Paper›PMID 34937718›Full record

ArticleBMJ open2021

Anaesthesia Choice for Creation of Arteriovenous Fistula (ACCess) study protocol : a randomised controlled trial comparing primary unassisted patency at 1 year of primary arteriovenous fistulae created under regional compared to local anaesthesia.

Alan Jr Macfarlane, Rachel J Kearns, Marc James Clancy, David Kingsmore, Karen Stevenson, Andrew Jackson, Patrick Mark, Margaret Aitken, Ramani Moonesinghe, Cecilia Vindrola-Padros and 17 more

Abstract readClinical Trial Protocol
In one paragraph

Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

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

  1. Pooled it
  2. Trial
  3. Article
  4. Regional anaesthesia research - where to now?British journal of pain · 2022
    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

27 authors.

Alan Jr MacfarlaneDepartment of Anaesthesia, NHS Greater Glasgow and Clyde, Glasgow, UK alan.macfarlane@glasgow.ac.uk.ORCID 0000-0003-3858-6468
Rachel J KearnsDepartment of Anaesthesia, NHS Greater Glasgow and Clyde, Glasgow, UK.
Marc James ClancyDepartment of Renal Surgery, Queen Elizabeth University Hospital, Glasgow, UK.
David KingsmoreInstitute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
Karen StevensonDepartment of Renal Surgery, Queen Elizabeth University Hospital, Glasgow, UK.
Andrew JacksonDepartment of Renal Surgery, Queen Elizabeth University Hospital, Glasgow, UK.
Patrick MarkInstitute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
Margaret AitkenDepartment of Renal Surgery, Queen Elizabeth University Hospital, Glasgow, UK.
Ramani MoonesingheCentre for Perioperative Medicine, University College London, London, UK.
Cecilia Vindrola-PadrosRapid Research Evaluation and Appraisal Lab, University College London, London, UK.ORCID 0000-0001-7859-1646
Lucian GaianuIndependent Health Economist, Healthonomics UK Ltd, Reading, UK.
Gavin PettigrewDepartment of Surgery, Cambridge University, Cambridge, UK.
Reza MotallebzadehDepartment of Nephrology and Transplantation, Royal Free London NHS Foundation Trust, London, UK.
Nikolaos KarydisDepartment of Transplantation, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Alex VeseyDepartment of Vascular Surgery, University Hospital Hairmyres, East Kilbride, UK.
Rita SinghDepartment of Anaesthesia, Freeman Hospital, Newcastle upon Tyne, UK.
Thalakunte MunirajuDepartment of Nephrology, Dumfries and Galloway Acute Hospitals, Dumfries, UK.
Stuart SuttieDepartment of Vascular Surgery, Ninewells Hospital and Medical School, Dundee, UK.
Alex McConnachieRobertson Centre for Biostatistics, University of Glasgow, Glasgow, UK.ORCID 0000-0002-7262-7000
Kirsty WetherallRobertson Centre for Biostatistics, University of Glasgow, Glasgow, UK.
Kariem El-BoghdadlyDepartment of Anaesthesia and Perioperative Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK.ORCID 0000-0002-9912-717X
Rosemary HoggDepartment of Anaesthesia, Belfast Health and Social Care Trust, Belfast, UK.
Iain ThomsonDepartment of Anaesthesia, Queen Elizabeth University Hospital, Glasgow, UK.
Vishal NangaliaDepartment of Anaesthesia, Royal Free London NHS Foundation Trust, London, UK.
Emma AitkenDepartment of Renal Surgery, Queen Elizabeth University Hospital, Glasgow, UK.
Access collaborative group
ACCess collaborative group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionArteriovenous fistulae (AVF) are the 'gold standard' vascular access for haemodialysis. Universal usage is limited, however, by a high early failure rate. Several small, single-centre studies have demonstrated better early patency rates for AVF created under regional anaesthesia (RA) compared with local anaesthesia (LA). The mechanistic hypothesis is that the sympathetic blockade associated with RA causes vasodilatation and increased blood flow through the new AVF. Despite this, considerable variation in practice exists in the UK. A high-quality, adequately powered, multicentre randomised controlled trial (RCT) is required to definitively inform practice. METHODS AND ANALYSIS: The Anaesthesia Choice for Creation of Arteriovenous Fistula (ACCess) study is a multicentre, observer-blinded RCT comparing primary radiocephalic/brachiocephalic AVF created under regional versus LA. The primary outcome is primary unassisted AVF patency at 1 year. Access-specific (eg, stenosis/thrombosis), patient-specific (including health-related quality of life) and safety secondary outcomes will be evaluated. Health economic analysis will also be undertaken. ETHICS AND DISSEMINATION: The ACCess study has been approved by the West of Scotland Research and ethics committee number 3 (20/WS/0178). Results will be published in open-access peer-reviewed journals within 12 months of completion of the trial. We will also present our findings at key national and international renal and anaesthetic meetings, and support dissemination of trial outcomes via renal patient groups. TRIAL REGISTRATION NUMBER: ISRCTN14153938. SPONSOR: NHS Greater Glasgow and Clyde GN19RE456, Protocol V.1.3 (8 May 2021), REC/IRAS ID: 290482.

Indexed as

Arteriovenous FistulaArteriovenous Shunt, SurgicalKidney Failure, ChronicAnesthesia, LocalHumansMulticenter Studies as TopicRandomized Controlled Trials as TopicRenal DialysisRetrospective StudiesTreatment OutcomeVascular Patencyadult anaesthesiaend-stage renal failuretransplant surgeryvascular surgery

Identifiers

PMID34937718
PMCPMC8704953

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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.