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Description

The key theme emerging from discussions about the future of the dashboard statistics is the necessity to align core offerings with RSTP measures. These measures have been carefully considered and can be easily defended. Currently, the dashboard statistics library already covers a significant portion of these measures, specifically the numerators on a per unit basis. Utilizing the well-established numerators and denominators from RSTP should be the foundation of the new stats. However, their integration requires interpreting the numerators and denominators within the context of the UKRDC dataset.

Since the UKRDC dataset differs from the RSTP dataset, adaptations will be necessary in most cases. When data is unavailable in the UKRDC, conscious decisions should be made to identify suitable substitutes. For example, in the case of CKD metrics, where we lack the total number of patients registered at a GP surgery, we can use the number of patients from whom we have received tests at that surgery instead.

It is crucial to effectively integrate the ability to compare these metrics, which is addressed in a separate use case found here:

https://renalregistry.atlassian.net/l/cp/1SzQuMX1

This will include both peer group and longitudinal comparisons. The integration with the current UI layout will be planned at a later date.

RSTP Measure

Type

Numerator

UKRDC Numerator Interpretation

Denominator

UKRDC Denominator Interpretation

Current Dashboard Stats Calculator

Comments

Adult CKD 1 low eGFR

CKD

Of the denominator those who have received a kidney function monitoring test for eGFR in the previous 12 months.

Should we use the creatinine results? or specifically eGFR

Patients aged 18 and over, with GP recorded CKD categories G3a to G5 (previously stage 3 to 5) and no subsequent CKD resolved code.

Living patients over a specified age with a primary renal diagnosis (3-5). Does action code need to be included?

No coverage - to be included in CKD calculator

Adult CKD 1 low eGFR

CKD

Patients aged 18 and over with two eGFRs <60ml/min/1.73m2 more than 3 months apart, but with no record of CKD categories G3a to G5 diagnosis in the GP record.

Total number of patients registered with a GP practice aged 18 and over

I think maybe we should do a process of elimination to identify the cohort. i.e patients who are not receiving RRT or transplant.

No coverage - to be included in CKD calculator

This metric could potentially be interpreted on a sending facility basis or be broken down by gpsurgeries within

Adult CKD Prevalence

CKD

Patients with a GP recorded diagnosis of Chronic Kidney Disease G3a to G5 (previously stages 3-5) who had no record of resolution

Total number of patients registered with a GP practice aged 18 and over

No coverage - to be included in CKD calculator

Adult CKD with hypertension and proteinurea medicated

CKD

Of the denominator those who have received a kidney function monitoring test for eGFR in the previous 12 months.

Total number of patients aged 18 years and above with GP recorded CKD categories G3a to G5 (previously stage 3 to 5), and GP recorded hypertension and proteinuria/albuminuria (as defined in the NDA proteinuria code set). NICE guidance suggests that a conf

Living patients in ukrdc over the age of 18 with a PRD of

No coverage- to be included in CKD calculator

Proportion of Dialysis Patients on Home therapies

Dialysis

 Prevalent home therapies (home HD and PD) patients.

prevalent adult dialysis patients

RRT Calculator

Proportion of Dialysis Patients on PD

Dialysis

 Prevalent PD patients.

prevalent adult dialysis patients

RRT Calculator

Proportion of Dialysis patients presenting late

Dialysis

Incident patients referred < 90 days before starting renal replacement therapy

 Incident patients referred < 90 days before starting KRT.

RRT Calculator

Definitive Vascular Access

Dialysis

Patients starting on AVF/AVG/PD

Incident dialysis adult patients starting KRT for the first time

RRT Calculator

Total Admitted Days for Dialysis Patients

Dialysis

Total admitted days (at any time)

Incident haemodialysis and peritoneal dialysis patients

RRT Calculator

Median time from dialysis start to transplant, excluding pre-emptive transplants

Transplant

Median time from dialysis start to transplant excluding pre emptive transplants

Total days from start of dialysis to transplant excluding pre emptive

RRT Calculator

Median time from dialysis start to transplant, including pre-emptive transplants

Transplant

Median time from dialysis start to transplant excluding pre emptive transplants

Total days from start of dialysis to transplant

RRT Calculator

Proportion RRT patients transplanted or listed

Transplant

RRT Calculator

Transplant rate per 100 RRT patients

Transplant

RRT Calculator

Target User(s)

Components/Dependencies

Libraries

(delete where appropriate)

  • dashboard stats

  • ukrdc fastapi

  • ukrdc UI

UKRDC stats dependencies

  • abc base class

Steps

  • Sprint where CKD calculator is written from scratch
  • review of changes that need to be made
  • adapt remaining calculators to include remaining RSTP measures
  •  

James Medcalf

Retha Steenkamp

George Swinnerton

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