Nephrology Dialysis Transplantation, Vol 12, Issue 10 2060-2063, Copyright © 1997 by Oxford University Press
N Levin, G Eknoyan, M Pipp and E Steinberg
Background: The NKF-DOQ™ (National Kidney
Foundation-dialysis Outcomes Quality Initiative) began in March 1995 with
the following objectives: To improve end-stage renal disease (ESRF) patient
survival, to reduce patient morbidity, to increase efficiency of care, and
to improve quality of life for ESRF patients. Methods:
The development of the NKF-DOQ Clinical Practice Guidelines focused on
haemodialysis adequacy, peritoneal dialysis adequacy, vascular access, and
anaemia. Principles guiding the methodology included scientific and
methodological rigour, interdisciplinary approach, independence of the Work
Groups, and an open review process. Unique features of this evidence-based
guideline development process included the use of mock guidelines and
rationales to guide the literature research, and an unprecedented
three-stage review process. Results: Work Groups
reviewed more than 11 000 articles. A total of 114 clinical practice
guidelines were developed by the Work Groups; these have been reviewed by
more than 1200 professionals and patients. Conclusion:
The NKF-DOQI Clinical Practice Guidelines has been a unifying effort for
the entire renal community. The guidelines are a important step in the
process of improving the quality of dialysis practice and improving ESRF
patient outcomes. Priorities for implementation of the guidelines include
education of ESRF professionals and patients, working with providers and
insurers to encourage compliance, and follow-up evaluation of patient
outcomes to quantify compliance results. Keywords:
dialysis; ESRF; guidelines; methodology; NKF-DOQI™; renal
INVITED COMMENTS
National kidney foundation: dialysis outcome quality initiative-development of methodology for clinical practice guidelines
Albert Einstein College of Medicine, Chief Division of Nephrology and Hypertension, Beth Israel Medical Center, 350 East 167th Street, 17th Floor Baird Hall, New York, NY 10003, USA; Baylor College of Medicine, Houston, TX, USA; Medical Education Institute Inc., Madison, Wisconsin, USA; Covance Health Economics and Outcomes Services, Inc., Washington, DC, USA; Corresponding author
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