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The investigators will assess the prediction performance of the modified Surprise Question (Will the participant be surprised if this patient transfers to hemodialysis in the next 6 months?) for identification of peritoneal dialysis at high risk of transfer to hemodialysis. The investigators will also assess the prediction performance of a modified mortality surprise question (Will the participant be surprised if this patient dies in the next 6 months?).
Physicians and nurses will be asked two questions regarding each of their peritoneal dialysis patients:
Patients will be followed for 6 months for outcomes (with two extra months for ascertainment of outcomes).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Survey | Clinicians will be asked to provide responses to the two surprise questions for each of their PD patients. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| no intervention | Other | Observational Study |
|
| Measure | Description | Time Frame |
|---|---|---|
| Performance measures of the modified surprise question answered by the physicians as a prediction instrument for transfer to hemodialysis of peritoneal dialysis patients in 6 months. | at 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Performance measures of the modified SQ Responses of the nurses to predict Transfers to hemodialysis | at 6 months | |
| Performance measures of the mortality SQ Responses of the physician and nurses to predict death | at 6 months |
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Patients:
Inclusion Criteria:
Exclusion Criteria:
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All patients on peritoneal dialysis receiving care at Satellite Healthcare facilities.
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| Name | Affiliation | Role |
|---|---|---|
| Wael Hussein | Satellite Healthcare | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Satellite Healthcare Inc | San Jose | California | 95128 | United States |
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| Performance of prediction model for transfer to HD developed from variables obtained at baseline. | at 0 months |
| Comparison of performance of baseline variables model to performance of the SQ model, and to a model that combines baseline variables and the SQ. | at 6 month |
| Rate of hospitalizations in patients identified as high risk by the surprise question. | at 6 months |
| Rate of peritonitis in patients identified as high risk by the surprise question. | at 6 months |
| Proportion of patients identified as high risk who transition to HD. | At time of transfer to hemodialysis, for those who transfer to hemodialysis within the observation period, which is 6 months from response to the surprise question |
| Proportion of patients who transition to HD who (i) start Home HD and those who (ii) start HD with AVF/AVG - in the whole group and among those identified high or low risk by the surprise question. | At time of transfer to hemodialysis, for those who transfer to hemodialysis within the observation period, which is 6 months from response to the surprise question |
| Evaluating the agreement of assessments made by the primary nephrologist and the primary nurse of the patient | at baseline |
| Factors associated with predictions made by the MD and nurse. | at baseline |