Reducing Disparities in Access to Kidney Transplantation: The RaDIANT Regional Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 440
- 主要终点
- Change in Referral Disparity from baseline
研究概览
简要总结
The purpose of this study is to facilitate coordination of transplant centers in North Carolina, South Carolina, and Georgia to share kidney transplant referral data in patients with End-Stage Renal Disease (ESRD) who are candidates for kidney transplantation.
详细描述
Disparities exist in access to kidney transplantation where poor and minority patients are less likely to access each step of the kidney transplant process. Current national surveillance data does not capture information on transplant referral, and it is unclear to what extent dialysis facility-level factors may influence disparities in access to transplantation. Due to significant variability in the standardized transplant ratios observed at each facility, the investigators hypothesize that there may be facility-related reasons that impact disparities in access to the first step of the kidney transplant process -- referral to the transplant center to undergo an evaluation for the suitability for transplant.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Kidney transplant centers in the geographic area of North Carolina (NC), South Carolina (SC) and Georgia (GA)
- •Low rates of referral for kidney transplantation (6-month crude referral risk mean of 0.06 and all facilities with a crude referral risk less than the mean)
- •The presence of a racial disparity (African American vs. Caucasian) in referrals for kidney transplantation (racial disparity calculated based on the crude referral risk difference and the standardized referral risk difference.)
- •The final pool of 440 facilities will be randomized to either the intervention or control group using a one to one ratio.
排除标准
- •Close out date populated
- •Transplant and hospital-based facility
- •Home dialysis facility
- •Patient census <25
- •>100 miles from nearest transplant center
- •Non-profit facility (except Wake Forest University Dialysis)
结局指标
主要结局
Change in Referral Disparity from baseline
时间窗: Baseline, one year after completion of the intervention
Assessed by referral disparity ratio: percentage of African American patients over percentage of white patients referred (%AA referred/%white referred) to compare across intervention and control facilities at baseline and one year after completion of the intervention. This is a facility level outcome.
次要结局
- Change in number of referrals between Control and Experimental patients from baseline(Baseline, 6 months after referral, one year after referral)
- Change in medical evaluation start racial disparity and waitlisting racial disparity(Baseline, 6 months after referral, one year after the start of medical evaluation)
研究者
Rachel Patzer
Assistant Professor
Emory University