Mondo has several different definitions, such as "very", or "big".
Lets keep this definition in mind as we examine the MONDO initiative launched by
Fresenius’s Renal Research Initiative. More details are available here.
RRI describes the MONDO initiative as follows: “the MONDO
(MONitoring Dialysis
Outcomes) initiative …encompasses multiple data bases from
around the world. MONDO’s goal is to gain a better understanding of the natural
history of chronic dialysis patients on a global scale.
So far, it seems that “RRI and its partners have collected
longitudinal per-patient data in 155,000 patients from 27 countries on five
continents (Asia, Europe, North America, South America, and Australia). In the
MONDO initiative, RRI collaborates with the following partners: Fresenius
Medical Care (FMC) Europe, FMC Asia Pacific, FMC Latin America, FMC Canada,
University of Maastricht (The Netherlands), University of California at Santa
Barbara, and the Kuratorium für Heimdialyse und Nierentransplantation (Germany).”
The goal is to study “temporal trends of surrogate outcome
indicators”; as well as “for the future development of predictive models, which
might aid the clinician in identifying patients at risk for adverse outcomes”.
MONDO also asks the question: “are US clinical practices or US dialysis
population characteristics different from those of the rest of the world?”
I am pretty certain that this initiative must be costing
several hundred thousand dollars each year. The question I would ask is this:
what is the most important question we need to answer in managing dialysis
patients?
Surely, the question should be "Is more dialysis better?" Shouldn’t a dialysis company of the global scale and deep pockets of Fresenius want to know the
answer to this question? Instead, it is spending money and resources on research that is unlikely to change clinical practice.
Mondo!
Why does this NOT surprise me? Considering all that I have been posting, for seven, or more years, well, that is why? Let's first start with providers being aware that more dialysis is better. Clearly, we all know there have been studies, as well as providers, themselves, stating they would not do traditional dialysis. That, in itself, should certainly state something to consumers of healthcare, legislators, CMS, etc.
ReplyDeleteForgive me for being so pessimistic, but don't we already have ENOUGH data collected, including patients themselves speaking out, to see that more dialysis is better ... that patient's lives improve... there is more quality, often less medications and dietary restrictions, etc.
Forgive me again, as I have to almost laugh when I read "The goal is to study............................................................which might aid the clinician in identifying patients at risk for adverse outcomes": I would like to know what type of adverse outcomes they refer to/ If we are speaking of adverse outcomes related to the actual process of the dialysis treatment, as far as I am concerned we might already have that information at hand. And, if we are looking at adverse outcomes from a treatment perspective, just take a good look at what the patients state after, or during a treatment. As far as population characteristics, don't we know enough about other countries at this time?
To see this money not go towards more education of patients, more education of staff, along with intense training, not cookie-cutter training, is appalling to me. There is always more to that which we read, than meets our eye-level. What are the other reasons for this. To determine outcomes the providers just need to take a long, hard look into what happens in their facilities and analyze such in order to determine what is best for the patients.
As before, I challenge these providers, at the top, who probably have no idea what happens to patients at the unit level to take a look at their inspection (survey) findings and start from there to improve care. Let's get back to the basics -- simple, but the only way to improve care. It still amazes me why providers don't move in the directly of 'more dialysis is better' When this does not happen, it sends a clear and certainly convincing message to consumer of healthcare...................................why do the providers not fight for more dialysis?
opinions of Roberta Mikles BA RN - Dialysis Patient Safety Advocate
www.qualitysafepatientcare.com
They are obviously studying deaths.
ReplyDeleteIn some European countries, that are still not the members of EC, FMC is doing that MONDO study in completely illegal way, since the patients do not know, simply not informed that they are participating the "scientific" study of death.
Bravo for FMC, counting deaths instead of postponing them.