Evidence map›Paper›PMID 36517942›Full record

ArticleThe journal of vascular access2024

Hemodialysis Arteriovenous Access Cosmesis Scale (AVACS): A new measure for vascular access.

Theodore H Yuo, Charles Y Kim, Dheeraj K Rajan, Vandana D Niyyar, Marianna Murea, Ellen D Dillavou, Peter R Bream, Lesley C Dinwiddie, Stephen E Hohmann, Karen Woo and 9 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The journal of vascular access, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Quality Metrics in Dialysis: A Welcome Change for Vascular Access.Advances in kidney disease and health · 2025
    Review
  3. 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

19 authors.

Theodore H YuoDivision of Vascular Surgery, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.ORCID 0000-0001-8542-3130
Charles Y KimDivision of Interventional Radiology, Duke University Medical Center, Durham, NC, USA.ORCID 0000-0002-8687-1522
Dheeraj K RajanDivision of Vascular & Interventional Radiology, Department of Medical Imaging, University of Toronto, University Health Network, Toronto, ON, Canada.ORCID 0000-0001-9291-6195
Vandana D NiyyarDivision of Nephrology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.ORCID 0000-0003-1743-5345
Marianna MureaSection on Nephrology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Ellen D DillavouWakeMed Hospital System, Raleigh, NC, USA.
Peter R BreamVascular and Interventional Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Lesley C DinwiddieVascular Access for Hemodialysis: Education and Research, Cary, NC, USA.
Stephen E HohmannTexas Vascular Associates, Dallas, TX, USA.
Karen WooDivision of Vascular Surgery, Department of Surgery, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, CA, USA.ORCID 0000-0002-6148-9757
Tushar VachharajaniDepartment of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
Cynthia RobertsRenal Research Institute, University of North Carolina at Chapel Hill Nephrology and Hypertension Division, Chapel Hill, NC, USA.
Christie GoodenNorth Texas Dialysis Access Clinic, Medical City Dallas, TX, USA.ORCID 0000-0002-3805-2557
George Wj WrightEVERSANA, Burlington, ON, Canada.ORCID 0000-0002-7089-1203
Andrew J HoganEVERSANA, Burlington, ON, Canada.
Nicole C FerkoEVERSANA, Burlington, ON, Canada.
Erin KahleAmerican Association of Kidney Patients, Tampa, FL, USA.
Diana ClynesAmerican Association of Kidney Patients, Tampa, FL, USA.
Charmaine E LokDepartment of Medicine, University of Toronto, Toronto, ON, Canada.ORCID 0000-0001-5365-0064

Funding

A Randomized Trial of Fistula vs. Graft Arteriovenous Vascular Access in Older Adults with End-Stage Kidney Disease on Hemodialysis: The AV ACCESS TrialR01AG071803 · NIA · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI ALLON, MICHAEL, MUREA, MARIANA · 2021 to 2025
$5.6M
NIA NIH HHS R01 AG071803
6 · The paper itself

Abstract

RATIONALE AND

objectiveThis study aimed to develop a cosmesis scale to evaluate the cosmetic appearance of hemodialysis (HD) arteriovenous (AV) accesses from the perspective of the patient and clinician, which could be incorporated into clinical trials. STUDY

designUsing a modified Delphi process, two AV access cosmesis scale (AVACS) components were developed in a four-round Delphi panel consisting of two surveys and two consensus meetings with two rounds of patient consultation. SETTING AND

participantsThe Delphi panel consisted of 15 voting members including five interventional or general nephrologists, five vascular surgeons, three interventional radiologists, and two vascular access nurse coordinators. Four patients experienced with vascular access were involved in patient question development. ANALYTICAL APPROACH: For a component to be included in the AVACS, it had to meet the prespecified panel consensus agreement of ⩾70%.

resultsThe clinician component of the AVACS includes nine questions on the following AV access features: scarring, skin discoloration, aneurysm/pseudoaneurysms and megafistula appearance. The patient component includes six questions about future vascular access decisions, interference with work or leisure activities, clothing choices, self-consciousness or attractiveness, emotional impact, and overall appearance. LIMITATIONS: Delphi panel methods are subjective by design, but with expert clinical opinion are used to develop classification systems and outcome measures. The developed scale requires further validation testing but is available for clinical trial use.

conclusionsWhile safety and efficacy are the primary concerns when evaluating AV access for HD, cosmesis is an important component of the ESKD patient experience. The AVACS has been designed to assess this important domain; it can be used to facilitate patient care and education about vascular access choice and maintenance. AVACS can also be used to inform future research on developing new techniques for AV access creation and maintenance, particularly as relates to AV access cosmesis.

Indexed as

Arteriovenous Shunt, SurgicalConsensusDelphi TechniqueRenal DialysisAttitude of Health PersonnelBody ImageEstheticsFemaleHumansPredictive Value of TestsTreatment OutcomeArteriovenous accessclinician instrumentcosmesismodified Delphi panel approachpatient satisfactionquestionnaire

Identifiers

PMID36517942
PMCPMC11308273

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.