NephJC is ...well you know what NephJC is. We have run an occasional series on stats, helmed by Manasi Bapat. See all of them at this link, covering NNT, subgroup analysis, 2x2 factorial studies etc. We would try to accompany them with a study that we were discussing, but often the link would be tenuous and not much attention would go towards this standalone post.
Another related nephrology social media project was #DreamRCT. Arising from the fertile brains of Joel Topf and Jordan Weinstein, this was a fun project: Kickstarter meets Dragons Den meets the NIH. Recognizing the dismal state of RCTs in the nephrology world, first highlighted in (Strippoli et al, JASN, 2014) and recently reiterated (Chatzimanouil et al, JASN 2019), this social media project discussed many interesting trial ideas. Among them,
Can lowering uric acid help the kidneys? (See here http://pbfluids.com/2014/01/dreamrct-prove-the-uric-acid-ckd-connection-and-win-richard-johnson-a-nobel/ )
Modulating dialysate Magnesium in dialysis (https://www.medpage today.com/nephrology/dreamrct/53870)
Early or Late RRT in AKI https://www.medpagetoday.com/Nephrology/DreamRCT/53861
Placebo controlled trial for management of hypophosphatemia https://ukidney.com/news/nephrology-developments/entry/dream-rct-a-placebo-controlled-trial-of-hyperphosphatemia-management
You may have noticed that some of these trials have since transcended the dreams into reality. But this is not enough, we recognize ideas are important, but so is the ability to execute these ideas. Enter the ISN-ACT.
The ISN-ACT (Advancing Clinical Trials) is an International Society of Nephrology (ISN) initiative to encourage existing infrastructures within ISN to improve the global nephrology community’s participation in clinical trial research. The goals of ISN-ACT are to:
Facilitate collaboration by connecting people undertaking clinical trials and related studies in nephrology.
Provide a forum to discuss key scientific, operational, and analytical issues facing clinical trial researchers in kidney disease.
Increase the capacity to conduct high-quality clinical trials and studies in nephrology through ISN training and by connecting experienced and novice researchers.
Develop ISN led or supported activities that help standardize high-quality trial conduct in nephrology
The ISN-ACT produces a summary of clinical trials in nephrology published every month, which is distributed by email to ISN members and the collection can be accessed at the ISN online education platform (ISN Academy).
In addition to that, the workgroup has produced a toolkit, aimed at nephrologists and researchers from all parts of the globe to provide guidance for anyone wishing to start a clinical trial or participate as a trial site. This tool kit can be found here:
The #NephTrials initiative
We propose to join forces, to bring the social media expertise from the #NephJC community and the methods expertise from ISN-ACT.
The aim is to increase awareness about ongoing trials in nephrology, as well as to teach the wider nephrology community what it takes to design and conduct clinical trials, especially with respect to different trial designs. The hope is that this will ultimately increase trial participation.
Components:
A blogpost + visual abstract: written and created by volunteer NSMC intern
A tweetchat: frequency every 2-3 months, with the participation of one or more experts
Some of the topics we plan to discuss over the next few months:
Topics
To cluster or not to cluster
Non-inferior is good enough… isn't it?
Are RCTs only for experienced academic units?
Nephrology is great at big data, how can we use it to be great at RCTs?
Why don't all big trials use all-cause mortality as the outcome?
Can we test lots of treatments at once in a rare disease?
Will we ever clearly understand how diet affects health and kidney disease?
Mike Walsh, McMaster University, ISN-ACT
Roberto Pecoits Filho, Catholic University of Paraná State in Brazil, ISN Academy
Swapnil Hiremath, University of Ottawa, NephJC