Differences in quality of life across renal replacement therapies: A meta-analytic comparison

dc.contributor.authorCameron, Jill
dc.contributor.authorWhiteside, Catherine
dc.contributor.authorKatz, Joel
dc.contributor.authorDevins, Gerald M.
dc.date.accessioned2011-05-18T19:20:32Z
dc.date.available2011-05-18T19:20:32Z
dc.date.issued1999
dc.description.abstractA meta-analysis compared emotional distress and psychological well-being across renal replacement therapies (RRTs) and examined whether differences could be explained by: (1) treatment modalities, (2) case mix, or (3) methodologic rigor. Standard meta-analytic procedures were used to evaluate published comparative studies. Successful renal transplantation was associated with: (1) lower distress (effect size, d = −0.43 SD) and greater well-being (d = 0.62 SD) than incenter hemodialysis (CHD) and (2) lower distress (d = −0.29 SD) and greater well-being (d = 0.53 SD) than continuous ambulatory peritoneal dialysis (CAPD). CAPD was characterized by greater well-being (d = 0.18 SD) than CHD and CHD was associated with greater distress (d = 0.16 SD) than home hemodialysis. Although methodologic rigor and case-mix differences did not correlate with the magnitude of psychosocial differences across RRTs, 10 of the 12 comparisons (83%) were threatened by publication bias (ie, that nonsignificant comparisons may have been underrepresented in the published literature). Thus, although significant quality-of-life differences were evident across treatment groups, the types of patients representative of the various RRTs also differed significantly in terms of case-mix variables relevant to psychosocial well-being and emotional distress. Published findings indicating differential quality of life across RRTs may thus be attributable to: (1) valid differences in effective renal replacement, reduced medical complications, and lifestyles afforded by these treatment modalities; (2) case-mix differences in the patient samples selected to represent them in research comparisons; or (3) both of these alternative explanations.en
dc.identifier.citationAmerican Journal of Kidney Disease, 35(4), 629-637. (2000)
dc.identifier.urihttp://hdl.handle.net/10315/7950
dc.language.isoenen
dc.publisherElsevieren
dc.rights.articlehttp://www.sciencedirect.com/science?_ob=MImg&_imagekey=B6W9N-4HGN4PF-9-1&_cdi=6687&_user=866177&_pii=S0272638600700096&_origin=gateway&_coverDate=04%2F30%2F2000&_sk=999649995&view=c&wchp=dGLbVlz-zSkWb&md5=35ed28b4da1b00d34454d9eabff002a1&ie=/sdarticle.pdf
dc.rights.journalhttp://www.elsevier.com/wps/find/journaldescription.cws_home/623276/description#descriptionen
dc.rights.publisherhttp://www.elsevier.comen
dc.subjectcase mixen
dc.subjectpsychosocialen
dc.subjectcomparative studiesen
dc.subjectrenal replacement therapy (RRT)en
dc.subjectmeta-analysisen
dc.subjectquality of lifeen
dc.titleDifferences in quality of life across renal replacement therapies: A meta-analytic comparison
dc.typeArticleen

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