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Update RICH-Q. Advisory Board Meeting October 2011. RICH-Q 1 → RICH-Q 2. -Goals and achievements -Publications -Current number of patients. Goals RICH-Q 1. To establish the current quality of care in children with ESRD in the Netherlands and Belgium

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Update rich q

Update RICH-Q

Advisory Board Meeting

October 2011


Rich q 1 rich q 2
RICH-Q 1 → RICH-Q 2

-Goals and achievements

-Publications

-Current number of patients


Goals rich q 1
Goals RICH-Q 1

  • To establish the current quality of care in children with ESRD in the Netherlands and Belgium

  • To increase the quality of care of children with ESRD by frequent peer review and discussions of local outcomes

  • To build up a comprehensive database on treatment characteristics and outcomes in order to conduct prospective outcomes studies

  • To foster clinical studies


Achieved
Achieved

  • Database and website

  • Survey of treatment policies

  • Advisory board meetings (8)

  • 11 centers: Cologne

  • Consensus meetings of quality indicators/ benchmarks

  • 2SR’s

    management of children with ESRD

    PWV measurement instruments.

  • Assessment of the reproducibility and validity of PWV and echocardiogram measurements

  • Add-on studies

  • Study groups

  • Several presentations

  • Papers


What have we learned 1
What have we learned? (1)

  • Important differences in dialysis policies:

    - between centres

    - between policy and actual care

  • 17 guidelines, 369 recommendations

    only 6% evidence based

  • Immigrants

    - Tx: less pre-emptive and living donor

    higher risk for acute rejection

    - Dialysis: more HD (less PD)

    longer HD, more ROD, more peritonitis


Update rich q

What have we learned? (2)

  • Pulse Wave Velocity

    • Smallest Detectable Change 1.05 m/s

  • Echocardiogram

    • low agreement diagnosis LVH

    • Smallest Detectable Change 1.6 mm

  • Tissue doppler: more detection of DD compared to conventional echocardiogram


Not yet achieved
Not yet achieved

  • Change in QoC

    • (guideline implementation and benchmarks)

  • Useful outcome measures

  • Continuation of the add-on studies



Accepted
Accepted

  • Comparison of two instruments measuring carotid-femoral pulse wave velocity: Vicorder versus SphygmoCor JoH

  • Lessons learned from efforts to improve the quality of care in children with end-stage renal disease in the Netherlands and Belgium. ADC

  • Important differences in management policies for children with end-stage renal disease in the Netherlands and Belgium – Report from the RICH-Q study. NDT

  • Less pre-emptive renal transplantations and more rejections in immigrant children compared to native Dutch and Belgian children. NDT


Submitted
Submitted

  • Scope and foundation of current guidelines for the management of chronic dialysis in children; a systematic review: a systematic review. NDT

  • Reproducibility of pulse wave velocity measurement in children with end-stage renal disease. Ped Neph

  • Chronic dialysis treatment and outcomes differ between immigrant and native Dutch and Belgian children. Ped Neph

  • Clinimetric characteristics of instruments that measure pulse wave velocity in adults and children are poorly reported: a systematic review. J. Clin epi.


In progress
In progress

  • Low agreement between cardiologists diagnosing LVH in children with ESRD

  • Does Tissue Doppler measurement lead to earlier detection of diastolic dysfunction in children with ESRD than conventional ultrasound measurement of E/A ratio?

  • Important differences in management policies for renal transplantation in children in the Netherlands and Belgium -Report from the RICH-Q study

  • The RICH-Q effect of 4 years feedback of care information, peer discussion and guideline development on standard of care in centres for RRT in children

  • Quality of life in Dutch and Belgian children with End Stage Renal Disease



Therapy at start richq

Total: 260

HD: 91

PD: 114

TX: 55

Therapy at start RICHQ

Total: 230

HD: 77PD: 105

TX: 48


Current therapy

Total: 215

HD: 32

PD: 40

TX: 143

Current therapy


Outflow n 45
Outflow (n=45)

  • Deceased: 6

  • - Primary disease (2): Complications of cong. heart disease operation, - Wilmstumor with metastasis,

    - Secondary disease (4):

    Pulmonary hypertension, - Postoperative complication after changing a hemodialysis catheter (no autopsy),

    -2x Respiratory insufficiency (1x no informed consent)

  • Adult care: 34

  • No informed consent: 3

  • Pre emptive Tx failure without cRRT: 1

  • Moved: 1


Patients missing
Patients missing?

Year of inclusion

Centre


Data entry delay
Data entry delay

Measurements points: 141 missing

  • HD: 36

  • PD: 58

  • Tx (without M0 and M3) : 47


Update rich q

NfN indicators

(dialysis)




Thesis of marieke tromp
Thesis of Marieke Tromp

  • Manuscript? Adres

    Friday 25 nov. 2011

  • Thesis defence and reception:

    12.00, Amsterdam.

  • Party 21.00, Amsterdam


Thank you gift
Thank you gift

RICH-Q Book.

  • pictures/ stories/ drawings from children/ personal note/ etc…

  • Please email me your personal message to Marieke before November 1th.