Epidemiology research to foster improvement in chronic kidney disease care.
Epidemiology research to foster improvement in chronic kidney disease care.
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DOI：
10.1016/j.kint.2019.11.010
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发表时间：
2019-11
影响因子：
19.6
通讯作者：
Shengyuan Luo;M. Grams
中科院分区：
文献类型：
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作者：
Shengyuan Luo;M. Grams
随着互联电子健康记录、长期队列和高通量技术的日益普及，流行病学研究改善肾病患者护理的潜力比以往任何时候都大。在这篇综述中，我们重点介绍流行病学技术在识别、评估和解决慢性肾脏疾病方面的应用。我们讨论为指导方针提供信息、确定健康差异、评估疾病的遗传基础以及将组学数据（例如蛋白质组学、代谢组学和遗传学）与结果相关联的研究。我们描述了如何使用观察数据通过加强对高风险个体的识别和替代肾脏疾病结果的评估来促进随机对照试验的进行，以及如何解决随机对照试验不切实际或不可行的临床问题。最后，我们讨论了消费者对研究的参与，包括患者、政策制定者、付款人和医疗保健系统的参与，以及肾脏疾病流行病学研究在实施科学中的作用以及作为精准医疗数据和方法的关键来源。
With the increasing availability of linked electronic health records, long-running cohorts, and high-throughput technologies, the potential for epidemiology research to improve the care of patients with kidney disease is greater than ever before. In this review, we highlight the application of epidemiology techniques to identify, evaluate, and address chronic kidney disease. We discuss studies that inform guidelines, identify health disparities, evaluate the genetic basis of disease, and relate data on omics, such as proteomics, metabolomics, and genetics, to outcomes. We describe how observational data have been used to facilitate the conduct of randomized controlled trials through enhanced identification of high-risk individuals and the evaluation of surrogate kidney disease outcomes as well as to address clinical questions where randomized controlled trials are impractical or infeasible. Finally, we discuss consumer engagement in research, including that of patients, policymakers, payers, and health care system, and the role of kidney disease epidemiology research in implementation science and as a key source of data and methodology for precision medicine.