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Guidelines for Using SRTR Program-Specific Reporting Tools in Patient Care and Policy

This document outlines the use of SRTR (Scientific Registry of Transplant Recipients) program-specific reporting tools, detailing their complementary roles in policymaking and patient care. It covers various aspects such as data sources, reporting formats for diverse audiences, analysis methods for incomplete data, and adjusting outcomes based on risk factors. Additionally, it reviews the advantages of using SRTR data over self-reported data, timelines for reports, and specific criteria for evaluating center performance. This guide is essential for improving transplant outcomes through informed decision-making.

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Guidelines for Using SRTR Program-Specific Reporting Tools in Patient Care and Policy

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Presentation Transcript

  1. About these Slides

  2. Slide Use Guidelines

  3. The SRTR Program-Specific Reporting Tools: Key Points

  4. Outline

  5. SRTR and OPTN: complementary roles

  6. SRTR Products and Responsibilities Inferential Analyses to Support Policymaking and Patient Care

  7. SRTR Data Sources

  8. SRTR Information Flow

  9. Program-Specific Reporting Different Formats for Different Audiences

  10. Different Audiences, Different Questions: Different Statistics and Interpretations

  11. Advantages to the User:SRTR vs Self-Reported Data

  12. Program-Specific Report Contents

  13. Program-Specific Report Tables

  14. Timeline for Program-Specific Reports

  15. Choosing Cohorts for Analysis

  16. Why Don’t We Have 1-Year Survival for Last Month’s Transplants?

  17. Incomplete Data and Lost to Follow-UpSolution 1: Censored Data Methods

  18. Calculating Survival Using Incomplete Follow-Up

  19. Incomplete Data and Lost to Follow-UpSolution 2: Extra Ascertainment

  20. Implications of Extra Ascertainment for Survival Analyses

  21. Adjusted Outcomes

  22. Different outcomes might arisebecause of:

  23. Why Compare to Expected?

  24. Survival Rate vs Death Rate vs Death CountDelta or Ratio

  25. “Expected Deaths” Calculation Accounts for Survival Time

  26. Risk Adjustment

  27. Choosing Model Variables

  28. Model Review

  29. Examples of Factors Used for Risk Adjustment

  30. Documentation of Risk-Adjustment Models

  31. Interpreting Model Coefficients

  32. Example: Adjusting for Age

  33. Risk Adjustment Example: Expanded Criteria Kidney Donors

  34. Expected Values and the Effects of Excluding ECD

  35. How Many Kidney Programs Have Better Outcomes for ECD than for SCD?

  36. The Importance of AdjustmentCenter SizeLength of Follow-UpCase Mix

  37. No Adjustment

  38. Adjustment: Account for Center Size

  39. Adjustment: Account for Center Size

  40. Center X Transplants More Older Recipients Than National Average

  41. Adjustment: Account for Case Mix

  42. Adjustment: Metric and Confounding Factors

  43. Adjustment: Random Variation

  44. How Should Survival Be Evaluated?

  45. These Criteria Affect Large and Small Centers Differently

  46. Many Facilities Have More Observed Than Expected Deaths

  47. Important: More Than Three Excess Deaths

  48. Actionable: More Than 50% Excess Deaths

  49. Significant: Excess Deaths Are Unlikely Due to Chance

  50. Center Z Performance over Time and MPSC Flagging Boundaries

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