Predicting Transfers to Hemodialysis in Peritoneal Dialysis Patients Using the Surprise Question

Study Overview
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Brief Summary
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The investigators will assess the prediction performance of the modified Surprise Question (Will the participant be surprised if this patient transfers to hemodialysis in the next 6 months?) for identification of peritoneal dialysis at high risk of transfer to hemodialysis. The investigators will also assess the prediction performance of a modified mortality surprise question (Will the participant be surprised if this patient dies in the next 6 months?).

Detailed Description
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Physicians and nurses will be asked two questions regarding each of their peritoneal dialysis patients: Will the participant be surprised if this patient transfers to hemodialysis in the next 6 months? Will the participant be surprised if this patient dies in the next 6 months? Patients will be followed for 6 months for outcomes (with two extra months for ascertainment of outcomes).

Official Title
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Predicting Transfers to Hemodialysis in Peritoneal Dialysis Patients Using the Surprise Question

Conditions
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Peritoneal Dialysis

Intervention / Treatment
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* Other: no intervention


Participation Criteria
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Eligibility Criteria
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Patients: Inclusion Criteria: Incident and prevalent PD population at Satellite Healthcare Exclusion Criteria: Age < 18 years Patients already enrolled in hospice Patients on PD training Patients on backup hemodialysis

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Survey<br>Clinicians will be asked to provide responses to the two surprise questions for each of their PD patients. | Other: no intervention<br>* Observational Study<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Performance measures of the modified surprise question answered by the physicians as a prediction instrument for transfer to hemodialysis of peritoneal dialysis patients in 6 months. |  | at 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Performance measures of the modified SQ Responses of the nurses to predict Transfers to hemodialysis |  | at 6 months | 
| Performance measures of the mortality SQ Responses of the physician and nurses to predict death |  | at 6 months | 
| Performance of prediction model for transfer to HD developed from variables obtained at baseline. |  | at 0 months | 
| Comparison of performance of baseline variables model to performance of the SQ model, and to a model that combines baseline variables and the SQ. |  | at 6 month | 
| Rate of hospitalizations in patients identified as high risk by the surprise question. |  | at 6 months | 
| Rate of peritonitis in patients identified as high risk by the surprise question. |  | at 6 months | 
| Proportion of patients identified as high risk who transition to HD. |  | At time of transfer to hemodialysis, for those who transfer to hemodialysis within the observation period, which is 6 months from response to the surprise question | 
| Proportion of patients who transition to HD who (i) start Home HD and those who (ii) start HD with AVF/AVG - in the whole group and among those identified high or low risk by the surprise question. |  | At time of transfer to hemodialysis, for those who transfer to hemodialysis within the observation period, which is 6 months from response to the surprise question | 
| Evaluating the agreement of assessments made by the primary nephrologist and the primary nurse of the patient |  | at baseline | 
| Factors associated with predictions made by the MD and nurse. |  | at baseline | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Surprise Question