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We want to hear from you!
If you have a question or a comment, please send it to Communications@ArborResearch.org
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We're Hiring!
Arbor Research is growing. We currently offer excellent opportunities for candidates with skills in biostatistics, health economics, health services research, and project support. Please click here to view a full list of current openings. |
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Greetings!
Welcome to the September issue of the Arbor Research newsletter. In this issue, we highlight new resources and recent publications. |
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The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) at the National Institutes for Health (NIH) recently awarded a grant to the University of Michigan and Arbor Research to serve as the Data Coordinating Center (DCC) for a multicenter five-year cohort study of glomerular disease patients. The GDPrime study will include a larger sample of patients and longer follow-up than prior studies of these relatively uncommon but important kidney diseases. To learn more about this project, please click here. |
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Arbor Research Seeks Staff to Support Growth
Arbor Research has grown steadily over the past 16 years. Today, our diverse portfolio of projects includes research of
on chronic disease, as well as health policy. As we expand our work, we are committed to our vision of being a global leader in research focused on reducing the health and economic burden of chronic diseases and improving the delivery of care.
We are looking for bright, dedicated individuals to join us in our mission. We currently have career opportunities available in a range of scientific roles for individuals with skills in biostatistics, health economics, health services research, and nephrology. To learn more about the positions available, and the benefits of working at Arbor Research, please click here. |
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Emerging trends in hemodialysis care through April 2013, based on a sample of U.S. dialysis facilities, are included in the latest update to the DOPPS Practice Monitor (DPM, at DOPPS.org/DPM). To read a summary of the data trends, please click here.
The DOPPS hosted a Web conference to discuss the latest data available from the DPM on Thursday, September 5, 2013. Mark Neumann, executive editor of Nephrology News & Issues, moderated the discussion. To listen to a recording of this conference, please click here. |
ESRD Technical Expert Panel Report Available
Under the ESRD Quality Measures Development and Maintenance contract, Arbor Research convened four Technical Expert Panels (TEP) in April 2013 to consider evidence and other information in the areas of mineral and bone disorder, dialysis adequacy, preventive care, and pediatric peritoneal dialysis adequacy. The TEP Summary Reports for each measure area summarize the proceedings and recommendations of these panels.
Please click here to download the report from the CMS website. Select "ESRD Quality Measures TEP Summary Reports." |
Charitable Giving at Arbor Research
Arbor Research believes in giving back. We developed a charitable giving program to establish a level of philanthropy at Arbor Research that reflects both the mission of the organization and the community interests of our staff. Our charitable activities include institutional donations, a program to match individual employee donations, disaster relief, and charitable drives. In August, 31 members of our staff and the University of Michigan Credit Union donated blood at our first Red Cross blood drive. For more information about the Arbor Research charitable giving program, please click here.
Arbor Research also supports the volunteer activities of our staff. Chris Pustulka, a Senior Project Assistant at Arbor Research, is raising a golden retriever puppy for Leader Dogs for the Blind (leaderdog.org). Bowie is a rambunctious 4-month old puppy. A very important part of raising a puppy for Leader Dogs is consistent socialization of the puppy starting at a very young age. Chris says, "Arbor Research has been great in that they are allowing me to bring Bowie into the office frequently, not only to work on his socialization, but also to practice his obedience and 'working' skills. It has been a great experience for me and Bowie and I know several Arbor employees that would agree as well!"
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 Major bleeding events and risk stratification of antithrombotic agents in hemodialysis: results from the DOPPS
Sood MM, et al; Kidney Int.
Benefits and risks of antithrombotic agents remain unclear in the hemodialysis population. To help clarify this we determined variation in antithrombotic agent use, rates of major bleeding events, and factors predictive of stroke and bleeding in 48,144 patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS) phases I-IV. Antithrombotic agents including oral anticoagulants (OACs), aspirin (ASA), and anti-platelet agents (APAs) were recorded along with comorbidities at study entry, and clinical events including hospitalization due to bleeding were then collected every 4 months. There was wide variation in OAC (0.3-18%), APA (3-25%), and ASA use (8-36%), and major bleeding rates (0.05-0.22 events/year) among countries. All-cause mortality, cardiovascular mortality, and bleeding events requiring hospitalization were elevated in patients prescribed OACs across adjusted models. The CHADS2 score predicted the risk of stroke in atrial fibrillation patients. Gastrointestinal bleeding in the past 12 months was highly predictive of major bleeding events; for patients with previous gastrointestinal bleeding, the rate of bleeding exceeded the rate of stroke by at least twofold across all categories of CHADS2 score, including patients at high stroke risk. Appropriate risk stratification and a cautious approach should be considered before OAC use in the dialysis population. |
Changes in dialysis treatment modalities during institution of flat rate reimbursement and quality assurance programs
Kleophas W, et al; Kidney Int.
Dialysis procedure rates in Germany were changed in 2002 from per-session to weekly flat rate payments, and quality assurance was introduced in 2009 with defined treatment targets for spKt/V, dialysis frequency, treatment time, and hemoglobin. In order to understand trends in treatment parameters before and after the introduction of these changes, we analyzed data from 407 to 618 prevalent patients each year (hemodialysis over 90 days) in 14-21 centers in cross-sections of the Dialysis Outcomes and Practice Patterns Study (phases 1-4, 1998-2011). Descriptive statistics were used to report differences over time in the four quality assurance parameters along with erythropoietin-stimulating agent (ESA) and intravenous iron doses. Time trends were analyzed using linear mixed models adjusted for patient demographics and comorbidities. The proportion of patients with short treatment times and low spKt/V improved throughout the study and was lowest after implementation of quality assurance. Hemoglobin levels have increased since 1998 and remained consistent since 2005. About 90 percent of patients were prescribed ESAs, with the dose declining since peaking in 2006. Intravenous iron use was highest in 2011. Hence, trends to improve quality metrics for hemodialysis have been established in Germany even after introduction of flat rate reimbursement. Thus, analysis of facility practice patterns is needed to maintain quality of care in a cost-containment environment. |
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