News: Pre-existing kidney failure mortality models fail to be clinically applicable, new report suggests

The quality and clinical applicability of existing mortality prediction models for people with kidney failure was found to be “not suitable” for “inform[ing] clinical decision-making,” according to a new study published in JAMA Network Open.

The meta-study reviewed, identified and evaluated 50 studies occurring between January 1, 2004, and September 20, 2024, with more than 2.9 million kidney failure patients.

The authors of the study concluded that all pre-existing kidney failure models were “found to be at high risk of bias and to have applicability concerns for clinical practice, and none demonstrated promise in terms of clinical usability or incorporation into guidelines.”

The types of bias and concerns regarding clinical applicability found in the meta-analysis were as follows:

• Inadequate selection of study population (27 studies [54%])
• Shortcomings in methods of measurement of predictors (15 [30%]) and outcome (12 [24%])
• Flaws in the analysis strategy (50 [100%])
• Study participants (31 [62%]), predictors (17 [34%]), and outcome (five [10%]) did not fit the intended target clinical setting.

“According to this systematic review of 50 studies, published mortality prediction models for people with kidney failure were not found suitable to inform clinical decision-making,” the authors wrote in their conclusion. “We advocate for the use of existing guidelines and checklists to design, conduct, and report prediction modeling studies and the involvement of stakeholders in the study design to enhance model usability and clinical uptake.”

Editor’s note: To the read the JAMA article, click here.