Kac Para Yarismasi

Arthritis Diet and Exercises

Using data to answer to the vitamin D question for dialysis patients

The question of the Simplified trial is
is aiming to answer is the issue of vitamin D deficiency in patients with
end-stage kidney disease receiving dialysis. In the UK and in most other
parts of the world patients on dialysis receive an active form of vitamin D and
that is because we used to believe that the kidneys can’t activate the vitamin D
that turns out not to be the case and so the question the trial is aiming to
answer is whether inactive or natural vitamin D will improve patient’s health
and lead to improved survival. The secondary outcomes that are important in
the simplified trial include cardiovascular events, fractures, the rate
of infections and the the new incidence of cancer, and all of those are things
that we’re looking at in the trial. Simplified is unique in as much as it
uses routinely collected data sources to collect endpoints and in the trial it is
the first trial of its kind certainly in nephrology in the in the United
Kingdom as there was only one face-to-face visit at the start of the
trial and then all subsequent data entry is done remotely either through remote
questionnaires or through linkage with existing data sources. The data we use
for simplified comes from a variety of sources: firstly we’re very lucky with
doing trials in the NHS we have a single national healthcare provider and
information about hospitalizations, for example, all go to one central place and
that’s administered by NHS digital and we can link with those hospitalizations
datasets to find out where the patients who are participants in our trial have
suffered events like a heart attack or a fracture requiring hospitalization and
so forth. We can also link with the UK renal
registry which collects information on all dialysis patients in the country and
this includes things like their diagnosis, the modality of treatment that
they’re on, what type of dialysis their they’re receiving and then metrics such
as blood pressure and some biochemical variables. The third
component of data is using something called patient view which is a resource
that is also housed by the UK renal registry and that allows patients to
view their own blood results from almost every kidney unit in the country and we
can link to that dataset which very excitingly means that we can get blood
results from patients directly into the trial database through linkage without
the patient ever having to go and see someone for a trials visit and that’s a
very efficient way of doing things it means the patient doesn’t have an extra
study visit and it also means that the site doesn’t have to arrange an extra
study visit so there’s a resource saving and an efficiency to be gained there’s
also the accuracy of the data being directly transferred into the trial
database which means that there aren’t problems with transcribing errors and
such like. The simplified trial is a very exciting development it demonstrates
that we can do trials really efficiently for a very low cost it means that we can
do trials in a way that are not burdensome to patients who might have
multiple morbidities so patients like this this sort of approach and we really
are in a unique position with the the data sources that we have that were able
to link to across the United Kingdom because of the nature of the the NHS is
as a national healthcare provider and that’s a very exciting development it
means that we can answer more questions we can get there more quickly and we can
do things very efficiently.

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