Development of a Clinical Decision Support System for Living Kidney Donor Assessment Based on National Guidelines

Transplantation
Simon R KnightJohn Fox

Abstract

Live donor nephrectomy is an operation that places the donor at risk of complications without the possibility of medical benefit. Rigorous donor selection and assessment is therefore essential to ensure minimization of risk and for this reason robust national guidelines exist. Previous studies have demonstrated poor adherence to donor guidelines. We developed a clinical decision support system (CDSS), based on national living donor guidelines, to facilitate the identification of contraindications, additional investigations, special considerations, and the decision as to nephrectomy side in potential living donors. The CDSS was then tested with patient data from 45 potential kidney donors. The CDSS comprises 17 core tasks completed by either patient or nurse, and 17 optional tasks that are triggered by certain patient demographics or conditions. Decision rules were able to identify contraindications, additional investigations, special considerations, and predicted operation side in our patient cohort. Seventeen of 45 patients went on to donate a kidney, of whom 7 had major contraindications defined in the national guidelines, many of which were not identified by the clinical team. Only 43% of additional investigations recommende...Continue Reading

References

Jun 17, 2003·Journal of the American Medical Informatics Association : JAMIA·David R Sutton, John Fox
Mar 10, 2005·JAMA : the Journal of the American Medical Association·Amit X GargR Brian Haynes
Aug 5, 2005·The New England Journal of Medicine·Robert D Truog
May 10, 2013·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Chera ArunachalamAimun Ahmed
Sep 12, 2013·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·C ThiessenS Kulkarni
Sep 12, 2013·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·A TongJ C Craig
Feb 25, 2017·Journal of Biomedical Informatics·John Fox
Mar 1, 2017·International Journal of Medical Informatics·Zahra NiazkhaniParviz Rashidi Khazaee
Aug 30, 2017·Transplant International : Official Journal of the European Society for Organ Transplantation·Emma K MasseyUNKNOWN ELPAT Psychosocial Care for Living Donors and Recipients Working Group
Nov 19, 2017·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Judi M Graham, Aisling E Courtney

❮ Previous
Next ❯

Citations

Sep 26, 2020·Clinical Journal of the American Society of Nephrology : CJASN·Steven HabbousAmit X Garg
Dec 6, 2020·Kidney International·Edward G Clark, Greg Knoll
Oct 29, 2020·Transplant International : Official Journal of the European Society for Organ Transplantation·Wiebke DuettmannKlemens Budde
Feb 20, 2021·Transplantation Reviews·Videha SharmaTitus Augustine

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.