Should measuring haemoglobin among chronic kidney disease patients be a performance measure?

Micah L. Thorp, David H. Smith, Eric S. Johnson, Jessica Weiss, Suma Vupputuri, Amanda F. Petrik, Xiu Hai Yang

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: We attempted to: (1) to assess whether or not adequate evidence exists to advocate the measurement of anaemia in chronic kidney disease as a performance measure; and (2) to determine what the appropriate benchmarks might be for health systems seeking to implement this performance measure. Design: Our study was conducted in two phases: (1) we used the United States Preventive Service Task Force chain of evidence methodology to determine six key questions that were subsequently reviewed to determine if adequate evidence existed to recommend haemoglobin testing among patients with chronic kidney disease; and (2) in order to establish a benchmark for a potential performance measure we measured the number of patients who had a test for anaemia during the preceding year and during the preceding three years. We established these benchmarks using chronic kidney disease defined both by estimated glomerular filtration rate and ICD-9 codes. Setting: Benchmarking was undertaken at Kaiser Permanente Northwest, which serves the Portland, Oregon and Vancouver, Washington metropolitan area, and Kaiser Permanente Georgia, which serves the Atlanta metropolitan area. Participants: Patients with chronic kidney disease identified by either estimated glomerular filtration rate or ICD-9 code. Main Outcomes Measurement: Serum haemoglobin Intervention: This was an observational study. Results: Our review of the evidence found no direct evidence that testing for anaemia among patients with chronic kidney disease improved patient morbidity or mortality. The ideal test for anaemia was serum haemoglobin. We found that available treatments of anaemia improve fatigue, but may increase mortality and stoke. We also found that an overwhelming majority of patients with chronic kidney disease defined by either estimated glomerular filtration rate or ICD-9 codes, over one or three years had had a haemoglobin measurement. Conclusion: There is currently inadequate evidence to recommend haemoglobin measurement among patients with chronic kidney disease as a performance measure. In addition, most patients with chronic kidney disease have already had haemoglobin measurement, minimizing the potential benefit of a performance measure.

Original languageEnglish (US)
Pages (from-to)194-204
Number of pages11
JournalJournal of Evidence-Based Medicine
Volume5
Issue number4
DOIs
StatePublished - Nov 2012

Fingerprint

Chronic Renal Insufficiency
Hemoglobins
International Classification of Diseases
Benchmarking
Anemia
Glomerular Filtration Rate
Mortality
Advisory Committees
Serum
Observational Studies
Fatigue
Morbidity
Health

Keywords

  • Anaemia
  • Chronic kidney disease
  • Hemoglobin and performance measure

ASJC Scopus subject areas

  • Medicine(all)
  • Health Policy

Cite this

Thorp, M. L., Smith, D. H., Johnson, E. S., Weiss, J., Vupputuri, S., Petrik, A. F., & Yang, X. H. (2012). Should measuring haemoglobin among chronic kidney disease patients be a performance measure? Journal of Evidence-Based Medicine, 5(4), 194-204. https://doi.org/10.1111/jebm.12005

Should measuring haemoglobin among chronic kidney disease patients be a performance measure? / Thorp, Micah L.; Smith, David H.; Johnson, Eric S.; Weiss, Jessica; Vupputuri, Suma; Petrik, Amanda F.; Yang, Xiu Hai.

In: Journal of Evidence-Based Medicine, Vol. 5, No. 4, 11.2012, p. 194-204.

Research output: Contribution to journalArticle

Thorp, Micah L. ; Smith, David H. ; Johnson, Eric S. ; Weiss, Jessica ; Vupputuri, Suma ; Petrik, Amanda F. ; Yang, Xiu Hai. / Should measuring haemoglobin among chronic kidney disease patients be a performance measure?. In: Journal of Evidence-Based Medicine. 2012 ; Vol. 5, No. 4. pp. 194-204.
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