Evidence map›Paper›PMID 39329073›Full record

ArticleClinical kidney journal2024

Validation of arteriovenous access stage (AVAS) classification: a prospective, international multicentre study.

Katerina Lawrie, Petr Waldauf, Peter Balaz, Ricardo Lacerda, Emma Aitken, Krzysztof Letachowicz, Mario D'Oria, Vittorio Di Maso, Pavel Stasko, Antonio Gomes and 5 more

Registry-linked trialAbstract read
In one paragraph

Article in Clinical kidney journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04796558 (Validation of Arterio Venous Access Stage Classification by Using Machine Learning in Prediction of Vascular Access Creation and Uninterrupted Use of the Vascular Access for Dialysis), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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.

NCT04796558 unknown statusnot on this map

Validation of Arterio Venous Access Stage Classification by Using Machine Learning in Prediction of Vascular Access Creation and Uninterrupted Use of the Vascular Access for Dialysis

Typeobservational_patient_registrySponsorVascular surgery, University hospital Královské Vinohrady, PragueRan2021 to 2024Enrolled800ConditionsArteriovenous Graft, Arteriovenous Fistula, Dialysis Access Malfunction, Kidney FailureArmsAVAS Classification
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. 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

15 authors.

Katerina LawrieDepartment of Transplantation Surgery, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.ORCID https://orcid.org/0000-0002-1923-3459
Petr WaldaufThird Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.ORCID https://orcid.org/0000-0003-4668-5837
Peter BalazThird Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.ORCID https://orcid.org/0000-0002-4547-0714
Ricardo LacerdaRL Vascular Surgery and Interventional Radiology, Private Practice, Salvador, Brazil.
Emma AitkenDepartment of Renal Surgery, Queen Elizabeth University Hospital, Glasgow, UK.
Krzysztof LetachowiczDepartment of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland.
Mario D'OriaDivision of Vascular and Endovascular Surgery, Cardio-Thoracic-Vascular Department, University Hospital of Trieste, Trieste, Italy.
Vittorio Di MasoNephrology and Dialysis Unit, Department of Medicine, ASUGI - University Hospital of Trieste, Trieste, Italy.
Pavel StaskoAdNa s.r.o., Vascular Surgery Clinic, Košice, Slovakia.
Antonio GomesDepartment of General Surgery, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal.
Joana FontainhasDepartment of General Surgery, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal.
Matej PekarCentre for Vascular and Mini-invasive Surgery, Hospital AGEL, Třinec-Podlesí, Czech Republic.
Alena SrdelicDivision of Nephrology and Haemodialysis, Internal Medicine Department, University Hospital of Split, Split, Croatia.
VAVASC Study Group
Stephen O'NeillCentre for Medical Education, Queen's University Belfast, Belfast, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The arteriovenous access stage (AVAS) classification provides evaluation of upper extremity vessels for vascular access (VA) suitability. It divides patients into classes within three main groups: suitable for native fistula (AVAS1) or prosthetic graft (AVAS2), and patients not suitable for conventional native or prosthetic VA (AVAS3). We validated this system on a prospective dataset. Methods: A prospective, international observational study (NCT04796558) involved 11 centres from 8 countries. Patient recruitment was from March 2021 to January 2024. Demographic data, risk factors, vessels parameters, VA types, AVAS class and early VA failure were collected. Percentage agreement was used to assess predictive ability of AVAS (comparison of AVAS and created VA) and consistency of AVAS assessment between evaluators. Pearson's Chi-squared test was used for comparison of early failure rate of conventional (predicted by AVAS) and unconventional (not predicted by AVAS) VA. Results: From 1034 enrolled patients, 935 had arteriovenous fistula or graft, 99 patients did not undergo VA creation due opting for alternative renal replacement therapies, experiencing health complications, death or non-compliance. AVAS1 had 91.2%, AVAS2 7.2% and AVAS3 1.6% of patients. Agreement between evaluators was 89%. The most frequently created VAs were radial-cephalic (46%) and brachial-cephalic (27%) fistulae. The accuracy of AVAS versus created access was 79%. In comparison, VA predicted by clinicians versus created access was 62.1%. Inaccuracy of AVAS prediction was more common with higher AVAS classes, and the most common reason for inaccuracy was creation of distal VA despite less favourable anatomy (17%). Patients with unconventional VA had higher early failure rate than patients with conventional VA (20% vs 9.3%, respectively, Conclusion: AVAS is effective in predicting VA creation, but overall accuracy is reduced at higher AVAS classes when the complexity of decision-making increases and proximal vessels require preservation. When AVAS was followed by clinicians, early failure was significantly decreased.

Indexed as

arteriovenous fistulaclassification systemhaemodialysis accessmulticentre studyvascular mapping

Identifiers

PMID39329073
PMCPMC11426276

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Registered trials

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.