Clinicians' and researchers' perspectives on establishing and implementing core outcomes in haemodialysis: Semistructured interview study

Allison Tong, Sally Crowe, John S. Gill, Tess Harris, Brenda R. Hemmelgarn, Braden Manns, Roberto Pecoits-Filho, Peter Tugwell, Wim Van Biesen, Angela Yee Moon Wang, David C. Wheeler, Wolfgang C. Winkelmayer, Talia Gutman, Angela Ju, Emma O'Lone, Benedicte Sautenet, Andrea Viecelli, Jonathan C. Craig

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Objectives: To describe the perspectives of clinicians and researchers on identifying, establishing and implementing core outcomes in haemodialysis and their expected impact. Design: Face-to-face, semistructured interviews; thematic analysis. Setting: Twenty-seven centres across nine countries. Participants: Fifty-eight nephrologists (42 (72%) who were also triallists). Results: We identified six themes: reflecting direct patient relevance and impact (survival as the primary goal of dialysis, enabling well-being and functioning, severe consequences of comorbidities and complications, indicators of treatment success, universal relevance, stakeholder consensus); amenable and responsive to interventions (realistic and possible to intervene on, differentiating between treatments); reflective of economic burden on healthcare; feasibility of implementation (clarity and consistency in definition, easily measurable, requiring minimal resources, creating a cultural shift, aversion to intensifying bureaucracy, allowing justifiable exceptions); authoritative inducement and directive (endorsement for legitimacy, necessity of buy-in from dialysis providers, incentivising uptake); instituting patient-centredness (explicitly addressing patient-important outcomes, reciprocating trial participation, improving comparability of interventions for decision-making, driving quality improvement and compelling a focus on quality of life). Conclusions: Nephrologists emphasised that core outcomes should be relevant to patients, amenable to change, feasible to implement and supported by stakeholder organisations. They expected core outcomes would improve patient-centred care and outcomes.

Original languageEnglish
Article numbere021198
Number of pages12
JournalBMJ Open
Issue number4
Publication statusPublished - 20 Apr 2018
Externally publishedYes

Bibliographical note

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.


  • Chronic renal failure
  • Dialysis
  • Haemodialysis
  • Nephrology
  • Trials
  • Patient-centred care


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