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Busy lives demand at-home dialysis

Rating

3 Star

Busy lives demand at-home dialysis

Our Review Summary

This story discusses in-home dialysis, an option for some patients with kidney failure. The article does not provide information on the risks of this form of dialysis, nor does it compare the cost of in-home dialysis with other forms of treatment. Transplantation is not mentioned, though it can be a viable long-term option for some patients, especially for the younger, active patients whom the article claims are “demanding” the home machines. Quality of life may be improved with in-home dialysis, but we only can extrapolate this from the anecdotal portion of the article (N=1). The article refers to in-home dialysis as “having been shown to be better for patient health”, but it is more the frequency of dialysis, not the type of machine that has been shown to reduce some of the complications of kidney disease. Additionally, physicians may be reluctant to advocate in-home dialysis as they want to carefully monitor kidney disease patients who often have other health conditions. The story provides no quantitative results of studies of in-home machines, nor is there a comparison with other forms of renal replacement therapy such as peritoneal dialysis or kidney transplants. Renal failure in diabetics is greater in people of lower socioecomonic status. This form of therapy is not yet approved by Medicare and the story makes no mention of payment by managed care companies. Without Medicare or insurance coverage, home dialysis may be cost prohibitive for many, which would further increase health care disparities. This story appeared in the Globe’s business section, and, as seems to happen sometimes with health stories in a business section, it reads like an unbalanced promotion taken from a company news release in some ways. While investors may be interested that the company “says it has developed an economic model that will work,” people with kidney disease would appreciate more evidence-based fact.

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

Mention of cost and that it is not approved by Medicare. No mention

if it is approved by managed care.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

Information not balanced. Discounts potential risks.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

No mention of any clinical evidence

that in-home dialysis is superior to dialysis in the clinic. The claim that in-home machines are the only form of daily

treatment is implied. It is the frequency of the dialysis, not the type of device, that has shown to improve health in some

patients. In-home dialysis may be more convenient, but there is no mention of clinical studies or established guidelines

which would guide physicians to advocate for in-home machines over in-clinic dialysis. No mention of risks involved with

in-home dialysis, only that it may improve quality of life for patients.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

Mentions possible conflict of interest of the head of a noNPRofit foundation that receives

funding from companies in the dialysis industry

Does the story compare the new approach with existing alternatives?

Not Satisfactory

Mentions

hemodialysis in the clinic as other option, however, peritoneal dialysis (another home option) and transplantation not

mentioned. Downplays and pretty much omits any real discussion of the potential risks or side effects of home dialysis. No

controlled studies to determine if this is a viable, safe option for many dialysis patients.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

Mentions availability and that the NxStage model recently won FDA approval.

Does the story establish the true novelty of the approach?

Satisfactory

Mentions that this is not a

new treatment. It is just not widely adopted.

Total Score: 6 of 10 Satisfactory

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