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Outcomes Of Early Versus Late Nephrology Referral In Chronic Kidney Disease – A Systematic Review, Neil A. Smart Assoc. Prof.

Neil Smart

Background As late provision of specialist care, prior to starting dialysis therapy, is believed to be associated with increased morbidity and mortality, a systematic review was undertaken to evaluate clinical outcomes relating to early versus late referral of patients to nephrology services.

Methods: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE were searched up until September 2008 for studies of early versus late nephrology referral in adult (>18 years) patients with chronic kidney disease. Early referral was defined by the time period, at which patients were referred to a nephrologist.

Findings: No randomized, controlled trials were found. …

What Is The Number Needed To Treat When Exercise Training Heart Failure Patients?, Neil Smart

Neil Smart

Debate exists on the number needed to treat (NNT) to prevent one mortality with exercise training in heart failure patients. The primary aim of this work was to conduct a sensitivity analysis, removing outlying mortality data from a published meta-analysis of exercise training in heart failure patients. A sensitivity analysis was conducted by removing data from one randomized controlled trial that reported particularly high mortality rates and may be considered a data outlier. Annualized NNTs were subsequently calculated for mortality data from a meta-analysis of exercise training in heart failure patients. Sensitivity analysis showed that the mortality benefit reported by …