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A programme to spread eGFR graph surveillance for the early identification, support and treatment of people with progressive chronic kidney disease (ASSIST-CKD): protocol for the stepped wedge…

Overview of attention for article published in BMC Nephrology, April 2017
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (85th percentile)

Mentioned by

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18 tweeters

Citations

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18 Dimensions

Readers on

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111 Mendeley
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Title
A programme to spread eGFR graph surveillance for the early identification, support and treatment of people with progressive chronic kidney disease (ASSIST-CKD): protocol for the stepped wedge implementation and evaluation of an intervention to reduce late presentation for renal replacement therapy
Published in
BMC Nephrology, April 2017
DOI 10.1186/s12882-017-0522-9
Pubmed ID
Authors

Hugh Gallagher, Shona Methven, Anna Casula, Nicola Thomas, Charles R. V. Tomson, Fergus J. Caskey, Tracey Rose, Stephen J. Walters, David Kennedy, Anne Dawnay, Martin Cassidy, Richard Fluck, Hugh C. Rayner, Michael Nation

Abstract

Patients who start renal replacement therapy (RRT) for End-Stage Kidney Disease (ESKD) without having had timely access to specialist renal services have poor outcomes. At one NHS Trust in England, a community-wide CKD management system has led to a decline in the incident rate of RRT and the lowest percentage of patients presenting within 90 days of starting RRT in the UK. We describe the protocol for a quality improvement project to scale up and evaluate this innovation. The intervention is based upon an off-line database that integrates laboratory results from blood samples taken in all settings stored under different identifying labels relating to the same patient. Graphs of estimated glomerular filtration rate (eGFR) over time are generated for patients <65 years with an incoming eGFR <50 ml/min/1.73 m(2) and patients >65 years with an incoming eGFR <40 ml/min/1.73 m(2). Graphs where kidney function is deteriorating are flagged by a laboratory scientist and details sent to the primary care doctor (GP) with a prompt that further action may be needed. We will evaluate the impact of implementing this intervention across a large population served by a number of UK renal centres using a mixed methods approach. We are following a stepped-wedge design. The order of implementation among participating centres will be randomly allocated. Implementation will proceed with unidirectional steps from control group to intervention group until all centres are generating graphs of eGFR over time. The primary outcome for the quantitative evaluation is the proportion of patients referred to specialist renal services within 90 days of commencing RRT, using data collected routinely by the UK Renal Registry. The qualitative evaluation will investigate facilitators and barriers to adoption and spread of the intervention. It will include: semi-structured interviews with laboratory staff, renal centre staff and service commissioners; an online survey of GPs receiving the intervention; and focus groups of primary care staff. Late presentation to nephrology for patients with ESKD is a source of potentially avoidable harm. This protocol describes a robust quantitative and qualitative evaluation of a quality improvement intervention to reduce late presentation and improve the outcomes for patients with ESKD.

Twitter Demographics

The data shown below were collected from the profiles of 18 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 111 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 111 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 21 19%
Student > Master 15 14%
Researcher 9 8%
Student > Doctoral Student 8 7%
Student > Ph. D. Student 7 6%
Other 22 20%
Unknown 29 26%
Readers by discipline Count As %
Medicine and Dentistry 35 32%
Nursing and Health Professions 13 12%
Pharmacology, Toxicology and Pharmaceutical Science 5 5%
Social Sciences 5 5%
Psychology 5 5%
Other 17 15%
Unknown 31 28%

Attention Score in Context

This research output has an Altmetric Attention Score of 13. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 February 2018.
All research outputs
#1,531,193
of 15,920,152 outputs
Outputs from BMC Nephrology
#101
of 1,730 outputs
Outputs of similar age
#39,979
of 268,814 outputs
Outputs of similar age from BMC Nephrology
#1
of 1 outputs
Altmetric has tracked 15,920,152 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 90th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,730 research outputs from this source. They receive a mean Attention Score of 3.8. This one has done particularly well, scoring higher than 94% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 268,814 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 85% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them