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Mitchell JW, Sossi F, Miller I, Jaber PB, Das-Gupta Z, Fialho LS, Amos A, Austin JK, Badzik S, Baker G, Ben Zeev B, Bolton J, Chaplin JE, Cross JH, Chan D, Gericke CA, Husain AM, Lally L, Mbugua S, Megan C, Mesa T, Nuñez L, von Oertzen TJ, Perucca E, Pullen A, Ronen GM, Sajatovic M, Singh MB, Wilmshurst JM, Wollscheid L, Berg AT. Development of an International Standard Set of Outcomes and Measurement Methods for Routine Practice for Infants, Children, and Adolescents with Epilepsy: The International Consortium for Health Outcomes Measurement Consensus Recommendations. Epilepsia 2024. [PMID: 38758635 DOI: 10.1111/epi.17976] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 03/24/2024] [Accepted: 03/25/2024] [Indexed: 05/19/2024]
Abstract
At present, there is no internationally accepted set of core outcomes or measurement methods for epilepsy clinical practice. The International Consortium for Health Outcomes Measurement (ICHOM) convened an international working group of experts in epilepsy, people with epilepsy, and their representatives to develop minimum sets of standardized outcomes and outcome measurement methods for clinical practice. Using modified Delphi consensus methods with consecutive rounds of online voting over 12 months, a core set of outcomes and corresponding measurement tool packages to capture the outcomes were identified for infants, children, and adolescents with epilepsy. Consensus methods identified 20 core outcomes. In addition to the outcomes identified for the ICHOM Epilepsy adult standard set, behavioral, motor, and cognitive/language development outcomes were voted as essential for all infants and children with epilepsy. The proposed set of outcomes and measurement methods will facilitate the implementation of the use of patient-centered outcomes in daily practice.
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Affiliation(s)
- James W Mitchell
- Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, UK
| | - Frieda Sossi
- International Consortium for Health Outcomes Measurement, London, UK
| | - Isabel Miller
- International Consortium for Health Outcomes Measurement, London, UK
| | | | - Zofia Das-Gupta
- International Consortium for Health Outcomes Measurement, London, UK
| | - Luz Sousa Fialho
- International Consortium for Health Outcomes Measurement, London, UK
| | - Action Amos
- International Bureau for Epilepsy, Africa Region, University of Edinburgh, Edinburgh, UK
| | - Joan K Austin
- Indiana University School of Nursing, Indianapolis, Indiana, USA
| | - Scott Badzik
- Lived experience representative, Cincinnati, Ohio, USA
| | - Gus Baker
- University of Liverpool, Liverpool, UK
| | - Bruria Ben Zeev
- Sheba Medical Center, Edmond and Lilly Safra Children's Hospital, Tel Hashomer, Israel
| | | | | | - J Helen Cross
- Developmental Neurosciences Department, University College London Great Ormond Street Institute of Child Health, London, UK
| | - Derrick Chan
- KK Women's and Children's Hospital, Duke-NUS, Singapore, Singapore
| | | | - Aatif M Husain
- Duke University Medical Center and Veterans Affairs Medical Center, Durham, North Carolina, USA
| | - Lorraine Lally
- LLM (International Human Rights Law), LLM (Financial Services Law), Galway, Ireland
| | | | | | - Tomás Mesa
- Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Lilia Nuñez
- Centro Medico Nacional 20 de Noviembre, Médica Sur, Mexico City, Mexico
| | - Tim J von Oertzen
- Department of Neurology 1, Kepler University Hospital, Johannes Kepler University, Linz, Austria
| | - Emilio Perucca
- Department of Medicine (Austin Health), University of Melbourne, Melbourne, Victoria, Australia
| | | | - Gabriel M Ronen
- Department of Pediatrics, CanChild Centre for Childhood Disability Research, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Martha Sajatovic
- Departments of Psychiatry and Neurology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Mamta B Singh
- All Indian Institute of Medicine Sciences, New Delhi, India
| | - Jo M Wilmshurst
- Red Cross War Memorial Children's Hospital, Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | | | - Anne T Berg
- Department of Neurology, Northwestern Feinberg School of Medicine, Chicago, Illinois, USA
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2
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Mitchell JW, Sossi F, Miller I, Jaber PB, Das-Gupta Z, Fialho LS, Amos A, Austin JK, Badzik S, Baker G, Zeev BB, Bolton J, Chaplin JE, Cross JH, Chan D, Gericke CA, Husain AM, Lally L, Mbugua S, Megan C, Mesa T, Nuñez L, von Oertzen TJ, Perucca E, Pullen A, Ronen GM, Sajatovic M, Singh MB, Wilmshurst JM, Wollscheid L, Berg AT. Development of an International Standard Set of Outcomes and Measurement Methods for Routine Practice for Adults with Epilepsy: The International Consortium for Health Outcomes Measurement Consensus Recommendations. Epilepsia 2024. [PMID: 38738754 DOI: 10.1111/epi.17971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 03/19/2024] [Accepted: 03/19/2024] [Indexed: 05/14/2024]
Abstract
At present, there is no internationally accepted set of core outcomes or measurement methods for epilepsy clinical practice. Therefore, the International Consortium for Health Outcomes Measurement (ICHOM) convened an international working group of experts in epilepsy, people with epilepsy and their representatives to develop minimum sets of standardized outcomes and outcomes measurement methods for clinical practice that support patient-clinician decision-making and quality improvement. Consensus methods identified 20 core outcomes. Measurement tools were recommended based on their evidence of strong clinical measurement properties, feasibility, and cross-cultural applicability. The essential outcomes included many non-seizure outcomes: anxiety, depression, suicidality, memory and attention, sleep quality, functional status, and the social impact of epilepsy. The proposed set will facilitate the implementation of the use of patient-centered outcomes in daily practice, ensuring holistic care. They also encourage harmonization of outcome measurement, and if widely implemented should reduce the heterogeneity of outcome measurement, accelerate comparative research, and facilitate quality improvement efforts.
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Affiliation(s)
- James W Mitchell
- Institute of Systems, Molecular and Integrative Biology (ISMIB), University of Liverpool, Liverpool, UK
| | - Frieda Sossi
- International Consortium for Health Outcomes Measurement, London, UK
| | - Isabel Miller
- International Consortium for Health Outcomes Measurement, London, UK
| | | | - Zofia Das-Gupta
- International Consortium for Health Outcomes Measurement, London, UK
| | - Luz Sousa Fialho
- International Consortium for Health Outcomes Measurement, London, UK
| | - Action Amos
- International Bureau for Epilepsy, Africa Region, University of Edinburgh, Edinburgh, UK
| | - Joan K Austin
- Indiana University School of Nursing, Indianapolis, Indiana, USA
| | - Scott Badzik
- Lived Experience Representative, Cincinnati, Ohio, USA
| | - Gus Baker
- University of Liverpool, Liverpool, UK
| | - Bruria Ben Zeev
- The Edmond and Lilly Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel
| | | | | | - J Helen Cross
- Developmental Neurosciences Dept, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Derrick Chan
- KK Women's and Children's Hospital, Duke-NUS, Singapore
| | - Christian A Gericke
- The University of Queensland Medical School, Brisbane, Queensland, Australia
| | - Aatif M Husain
- Duke University Medical Center and Veterans Affairs Medical Center, Durham, North Carolina, USA
| | - Lorraine Lally
- LLM (International Human Rights Law), LLM (Financial Services Law), Galway, Ireland
| | | | | | - Tomás Mesa
- Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Lilia Nuñez
- Centro Medico Nacional 20 de Noviembre, Médica Sur, Mexico City, Mexico
| | - Tim J von Oertzen
- Department of Neurology 1, Kepler University Hospital, Johannes Kepler University, Linz, Austria
| | - Emilio Perucca
- Department of Medicine (Austin Health), The University of Melbourne, Melbourne, Victoria, Australia
| | | | - Gabriel M Ronen
- Department of Pediatrics, CanChild Centre for Childhood Disability Research, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Martha Sajatovic
- Departments of Psychiatry and of Neurology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Mamta B Singh
- All Indian Institute of Medicine Sciences, New Delhi, India
| | - Jo M Wilmshurst
- Red Cross War Memorial Children's Hospital, Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | | | - Anne T Berg
- Department of Neurology, Northwestern Feinberg School of Medicine, Chicago, Illinois, USA
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Benning L, Das-Gupta Z, Sousa Fialho L, Wissig S, Tapela N, Gaunt S. Balancing adaptability and standardisation: insights from 27 routinely implemented ICHOM standard sets. BMC Health Serv Res 2022; 22:1424. [PMID: 36443786 PMCID: PMC9703690 DOI: 10.1186/s12913-022-08694-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 10/18/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Healthcare systems around the world experience increasing pressure to control future growth of healthcare expenditures. Among other initiatives, quality and value-based benchmarking has become an important field to inform clinical evaluation and reimbursement questions. The International Consortium for Health Outcomes Measurement (ICHOM) has become one of the driving forces to translate scientific evidence into standardized assessments that are routinely applicable in day-to-day care settings. These aim to provide a benchmarking tool that allows the comparison and competition of health care delivery on the basis of value-based health care principles. METHODS This work focuses on the consolidation of the ICHOM methodology and presents insights from 27 routinely implemented Standard Sets. The analysis is based on a literature review of the ICHOM literature repository, a process document review and key informant interviews with ICHOM's outcomes research and development team. RESULTS Key findings are that the scope of ICHOM Standard Sets shifted from a more static focus on burden of disease and poorly standardized care pathways to a more dynamic approach that also takes into account questions about the setting of care, feasibility of implementing a benchmarking tool and compatibility of different Standard Sets. Although certain overlaps exist with other initiatives in the field of patient reported outcomes (PRO), their scopes differ significantly and they hence rather complement each other. ICHOM pursues a pragmatic approach to enable the benchmarking and the analysis of healthcare delivery following the principles of value-based healthcare. CONCLUSION The ICHOM Standard Sets complement other initiatives in the field of patient-reported outcomes (PRO) and functional reporting by placing a particular focus on healthcare delivery, while other initiatives primarily focus on evaluation of academic endpoints. Although ICHOM promotes a pragmatic approach towards developing and devising its Standard Sets, the definition of standardized decision making processes emerged as one of the key challenges. Furthermore, the consolidation of core metrics across number of disease areas to enable the parallel implementation of different Standard Sets in the same care setting is an important goal that will enable the widespread implementation of patient-reported outcome measures (PROM).
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Affiliation(s)
- Leo Benning
- University Emergency Center, Medical Center - University of Freiburg, Freiburg, Germany.
- Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Zofia Das-Gupta
- International Consortium for Health Outcomes Measurement, London, UK
| | - Luz Sousa Fialho
- International Consortium for Health Outcomes Measurement, London, UK
| | - Stephanie Wissig
- International Consortium for Health Outcomes Measurement, Boston, USA
| | - Neo Tapela
- International Consortium for Health Outcomes Measurement, London, UK
| | - Suzanne Gaunt
- International Consortium for Health Outcomes Measurement, Boston, USA
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Seligman WH, Das-Gupta Z, Jobi-Odeneye AO, Arbelo E, Banerjee A, Bollmann A, Caffrey-Armstrong B, Cehic DA, Corbalan R, Collins M, Dandamudi G, Dorairaj P, Fay M, Van Gelder IC, Goto S, Granger CB, Gyorgy B, Healey JS, Hendriks JM, Hills MT, Hobbs FDR, Huisman MV, Koplan KE, Lane DA, Lewis WR, Lobban T, Steinberg BA, McLeod CJ, Moseley S, Timmis A, Yutao G, Camm AJ. Development of an international standard set of outcome measures for patients with atrial fibrillation: a report of the International Consortium for Health Outcomes Measurement (ICHOM) atrial fibrillation working group. Eur Heart J 2021; 41:1132-1140. [PMID: 31995195 PMCID: PMC7060456 DOI: 10.1093/eurheartj/ehz871] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 10/14/2019] [Accepted: 12/02/2019] [Indexed: 12/28/2022] Open
Abstract
Aims As health systems around the world increasingly look to measure and improve the value of care that they provide to patients, being able to measure the outcomes that matter most to patients is vital. To support the shift towards value-based health care in atrial fibrillation (AF), the International Consortium for Health Outcomes Measurement (ICHOM) assembled an international Working Group (WG) of 30 volunteers, including health professionals and patient representatives to develop a standardized minimum set of outcomes for benchmarking care delivery in clinical settings. Methods and results Using an online-modified Delphi process, outcomes important to patients and health professionals were selected and categorized into (i) long-term consequences of disease outcomes, (ii) complications of treatment outcomes, and (iii) patient-reported outcomes. The WG identified demographic and clinical variables for use as case-mix risk adjusters. These included baseline demographics, comorbidities, cognitive function, date of diagnosis, disease duration, medications prescribed and AF procedures, as well as smoking, body mass index (BMI), alcohol intake, and physical activity. Where appropriate, and for ease of implementation, standardization of outcomes and case-mix variables was achieved using ICD codes. The standard set underwent an open review process in which over 80% of patients surveyed agreed with the outcomes captured by the standard set. Conclusion Implementation of these consensus recommendations could help institutions to monitor, compare and improve the quality and delivery of chronic AF care. Their consistent definition and collection, using ICD codes where applicable, could also broaden the implementation of more patient-centric clinical outcomes research in AF.
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Affiliation(s)
- William H Seligman
- International Consortium for Health Outcomes Measurement, Hamilton House, London WC1H 9BB, UK
| | - Zofia Das-Gupta
- International Consortium for Health Outcomes Measurement, Hamilton House, London WC1H 9BB, UK
| | - Adedayo O Jobi-Odeneye
- International Consortium for Health Outcomes Measurement, Hamilton House, London WC1H 9BB, UK
| | - Elena Arbelo
- Hospital Clínic, Universitat de Barcelona, Carrer de Villarroel, 170, 08036 Barcelona, Spain.,IDIBAPS, Institut d'Investigacio, August Pi I Sunyer, Rossello, 149-153, 08036 Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Av. Monforte de Lemos, 3-5. Pabellon 11. Planta 0 28029 Madrid, Spain
| | - Amitava Banerjee
- Institute of Health Informatics, University College London, 222 Euston Road, London NW1 2DA, UK
| | - Andreas Bollmann
- Department of Electrophysiology, Heart Center Leipzig, University of Leipzig, Strumpellstrabe 39, 04289 Leipzig, Germany.,Leipzig Heart Institute, Russenstrabe 69A, 04289 Leipzig, Germany.,Leipzig Heart Digital, Russenstrabe 69A, 04289 Leipzig, Germany
| | | | - Daniel A Cehic
- GenesisCare, Buildings 1&11, The Mill, 41-43 Bourke Road, Alexandria, NSW 2015, Australia
| | - Ramon Corbalan
- Cardiovascular Division, Pontificia Universidad Catolica de Chile, Av Libertador Bernardo O'Higgins 340, Santiago, Region Metropolitana, Chile
| | | | - Gopi Dandamudi
- CHI Franciscan, 2709 Hemlock Street, Bremerton, WA 98310, USA
| | - Prabhakaran Dorairaj
- Public Health Foundation of India, Unit No 316, 3rd Floor, Rectangle -1 Building, Plot No D-4, District Centre Saket, New Delhi-110017, India
| | - Matthew Fay
- University of Warwick Medical School, The University of Warwick, Coventry CV4 7AL, UK.,Affinity Care, Westcliffe Road, Shipley, BD18 3EE, UK
| | - Isabelle C Van Gelder
- University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, Netherlands
| | - Shinya Goto
- Tokai University, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan
| | | | | | - Jeff S Healey
- Population Health Research Institute, McMaster University, 237 Barton Street East, Hamilton, Ontario, ON L8L 2X2, Canada
| | - Jeroen M Hendriks
- Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, North Terrace, Adelaide SA 5000, Australia
| | - Mellanie True Hills
- StopAfib.org, American Foundation for Women's Health, PO Box 541, Greenwood, TX 76246, USA
| | - F D Richard Hobbs
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Oxford OX2 6GG, UK
| | - Menno V Huisman
- Department of Thrombosis and Hemostasis, Leiden University Medical Center, Akbinusdreef 2, 2333 ZA Leiden, Netherlands
| | - Kate E Koplan
- The Southeast Permanente Medical Group, Kaiser Permanente Georgia, 9, 3495 Piedmont Rd NE, Atlanta, GA 30305, USA
| | - Deirdre A Lane
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Faculty of Health and Life Sciences, University of Liverpool, Brownlow Hill, Liverpool L69 3BX, UK
| | - William R Lewis
- MetroHealth System, Case Western Reserve University, 2500 MetroHealth Drive, Cleveland, OH 44109, USA
| | - Trudie Lobban
- Arrhythmia Alliance & AF Association, Unit 6B, Essex House, Cromwell Business Park, Chipping Norton, OX7 5SR, UK
| | - Benjamin A Steinberg
- Division of Cardiovascular Medicine, University of Utah Health Sciences Center, 50 N Medical Dr, Salt Lake City, UT 84132, USA
| | - Christopher J McLeod
- Department of Cardiovascular Medicine, Mayo Clinic, 4500 San Pablo Rd S, Jacksonville, FL 32224, USA
| | | | - Adam Timmis
- Barts and The London School of Medicine and Dentistry, Garrod Building, Turner Street, Whitechapel, London E1 2AD, UK.,Department of Interventional Cardiology, Barts Heart Centre, W Smithfield, London EC1A 7BE, UK
| | - Guo Yutao
- Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, China
| | - A John Camm
- Department of Clinical Cardiology, St George's University of London, Blackshaw Road, Tooting, London SW17 0QT, UK
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Verberne WR, Das-Gupta Z, Allegretti AS, Bart HAJ, van Biesen W, García-García G, Gibbons E, Parra E, Hemmelder MH, Jager KJ, Ketteler M, Roberts C, Al Rohani M, Salt MJ, Stopper A, Terkivatan T, Tuttle KR, Yang CW, Wheeler DC, Bos WJW. Development of an International Standard Set of Value-Based Outcome Measures for Patients With Chronic Kidney Disease: A Report of the International Consortium for Health Outcomes Measurement (ICHOM) CKD Working Group. Am J Kidney Dis 2018; 73:372-384. [PMID: 30579710 DOI: 10.1053/j.ajkd.2018.10.007] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 10/14/2018] [Indexed: 12/14/2022]
Abstract
Value-based health care is increasingly promoted as a strategy for improving care quality by benchmarking outcomes that matter to patients relative to the cost of obtaining those outcomes. To support the shift toward value-based health care in chronic kidney disease (CKD), the International Consortium for Health Outcomes Measurement (ICHOM) assembled an international working group of health professionals and patient representatives to develop a standardized minimum set of patient-centered outcomes targeted for clinical use. The considered outcomes and patient-reported outcome measures were generated from systematic literature reviews. Feedback was sought from patients and health professionals. Patients with very high-risk CKD (stages G3a/A3 and G3b/A2-G5, including dialysis, kidney transplantation, and conservative care) were selected as the target population. Using an online modified Delphi process, outcomes important to all patients were selected, such as survival and hospitalization, and to treatment-specific subgroups, such as vascular access survival and kidney allograft survival. Patient-reported outcome measures were included to capture domains of health-related quality of life, which were rated as the most important outcomes by patients. Demographic and clinical variables were identified to be used as case-mix adjusters. Use of these consensus recommendations could enable institutions to monitor, compare, and improve the quality of their CKD care.
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Affiliation(s)
| | - Zofia Das-Gupta
- International Consortium for Health Outcomes Measurement, London, United Kingdom
| | | | - Hans A J Bart
- patient representative, Dutch Kidney Patients Association (NVN), Bussum, the Netherlands
| | - Wim van Biesen
- Renal Division, Ghent University Hospital, Ghent, Belgium
| | - Guillermo García-García
- University of Guadalajara Health Sciences Center, Hospital Civil de Guadalajara "Fray Antonio Alcalde," Guadalajara, Jalisco, Mexico
| | - Elizabeth Gibbons
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom (EG)
| | - Eduardo Parra
- Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Marc H Hemmelder
- Dutch Renal Registry (Renine), Nefrovisie, Utrecht; Medical Center Leeuwarden, Leeuwarden
| | - Kitty J Jager
- ERA-EDTA Registry, Amsterdam UMC, University of Amsterdam, Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Markus Ketteler
- Klinikum Coburg, Coburg, Germany; University of Split School of Medicine, Split, Croatia
| | - Charlotte Roberts
- International Consortium for Health Outcomes Measurement, London, United Kingdom
| | | | - Matthew J Salt
- International Consortium for Health Outcomes Measurement, London, United Kingdom
| | - Andrea Stopper
- European Renal Care Providers Association, Brussels, Belgium
| | | | - Katherine R Tuttle
- Providence Medical Research Center, Providence Health Care Kidney Research Institute, Nephrology Division and Institute for Translational Health Sciences, University of Washington, Spokane, WA
| | - Chih-Wei Yang
- Chang Gung Memorial Hospital, Linkou; Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - David C Wheeler
- Centre for Nephrology, University College London, London, United Kingdom
| | - Willem Jan W Bos
- St Antonius Hospital, Nieuwegein; Leiden University Medical Center, Leiden, the Netherlands
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