The DOPPS is a prospective cohort study of hemodialysis practices based on the collection of observational longitudinal data for a random sample of patients from a representative and random sample of units in 12 countries (Australia, Belgium, Canada, France, Germany, Japan, Italy, New Zealand, Spain, Sweden, the United Kingdom, and the United States).  The random selection of Dialysis Units reflects the country profile of dialysis patients and also the patients in each unit. Data collection for the study has been ongoing since 1996 and has yielded detailed data on more than 41.000 patients in over 500 distinct dialysis facilities.

DOPPS investigations focus on determining which dialysis practices are associated with the best patient outcomes, with the primary goal of improving patient longevity, quality of life, and other outcomes. With over 100 peer-reviewed publications in print or in press, the DOPPS continues to provide numerous important findings that are relevant for patients and practicing clinicians alike.   

The DOPPS is supported by scientific grants (as of October 2011) from Amgen (since 1996), Kyowa Hakko Kirin  (since 1999, in Japan), Genzyme (since 2009), Abbott (since 2009), and Baxter (since 2011) without restrictions on publications.

In each of the selected units, the Study Coordinator records a census of all patients undergoing treatment. 20-40 of the patients are then selected for follow up with all aspects of their treatment being recorded on a regular basis. The data includes details of medication, access and dialysis given. At regular intervals the patients are asked to complete their own assessment of the treatment they have received and of their state of health. The Medical Directors, too, complete regular reports on the patients under observation. All this data is collated and consolidated by Arbor Research for study and analysis. Some of the findings of such analysis can be seen on the Arbor Research web site.

The impact of DOPPS in the Renal community has been steadily growing since its set up back in 1996, Over the past 16 years, several sets of clinical practice guidelines have been developed to help practitioners provide the best possible care to dialysis patients.

Another important tool offered by DOPPS to the Nephrology Community is the DOPPS Practice Monitor (DPM) features contemporary trends in US dialysis practices, facility services offered, and achievement of performance measures. Users may browse the DPM results by clinical topic or facility characteristics, or download slides at  www.DOPPS.org/DPM.

DOPPS also develop a series of individual DOPPS Country Reports to provide information at the individual country level regarding the attainment of guidelines and their potential impact on outcomes. These country reports suggest the practices that appear to have the greatest impact upon patient longevity and forecast how guideline achievement could possibly improve HD patient longevity in each DOPPS country.

In addition DOPPS Facilities receive the Facility Feedback Reports (FFR) for DOPPS 4, initial release in October 2010, including: feedback modules, with facility and country specific DOPPS research findings on:

• Mineral Bone Disease (calcium, phosphorus, PTH, vitamin D).
• Quality of Life (KDQOL SF-36 measures, kidney disease burden)
• Vascular Access (access use, rates of prior access use, hospitalization).

Additional content areas for FFR modules include:

• Clinical outcomes (mortality, hospitalization)
• Quality of Life – (related to Facility Care)
• Laboratory Values
• Demographics and Comorbidities.

In 2009 DOPPS  launched its Annual Report and since then has been published annually.
The DOPPS Annual Report is a comprehensive collection of descriptive statistics spanning more than a decade of longitudinal DOPPS data collection. Calculated for multiple, representative cross-sectional cohorts, each Annual Report portrays country-specific results and illustrates trends over several practice areas.

DOPPS outcomes have been presented in many local, national and international meetings,  and since 2008 invite to:

As mentioned DOPPS IV was launched early 2009 with the following objectives and presence and country distribution around the world:

• Provide for the uninterrupted continuation of longitudinal data collection from a large, international cohort of representative dialysis subjects and facilities in 12 countries.
• Facilitate generation of hypotheses regarding the relationship between traditional and non-traditional  risk factors and clinical outcomes.
• Identify preferred and successful practice patterns and treatment strategies.
• Assess the impact of changes in health policy, regulatory oversight, clinical practice guidelines, and reimbursement quality, economics and delivery of care and intermediate and clinical outcomes.

DOPPS IV Participating Countries

Another important tool offered by DOPPS to the Nephrology Community is the DOPPS Practice Monitor (DPM) features contemporary trends in US dialysis practices, facility services offered, and achievement of performance measures. Users may browse the DPM results by clinical topic or facility characteristics, or download slides at  www.DOPPS.org/DPM.   

DECEMBER 2011 CLOSE DOPPS 4 OFFICIAL LOUNCH DOPPS 5.

DOPPS 5 some steps forwards from DOPPS 4.

‘Seamless’ Transition from DOPPS 4 to 5:  The goal is to have essentially no lag between phases. This will allows to follow trends in care without interruption and, analytically, to follow patients for much longer (e.g., to study longer‐term survivors).

Data on Home Dialysis modalities:  Adding home dialysis (PD and home hemo) patients to the census, i.e., collecting basic demographic data on all dialysis patients, not just in-center HD patients. This will allows to readily expand to study home dialysis (via ancillary studies outside of core DOPPS).

AR is happy to report that they’re pursuing funding support for P‐DOPPS, a proposed international study of PD practices and outcomes. P‐DOPPS would be aligned closely with DOPPS and take advantage of DOPPS infrastructure but would be funded independently. P‐DOPPS  have already been discussed with several Country Investigators in countries where PD is common and look forward to developing the project further.

EDTNA/ERCA and DOPPS.

EDTNA/ERCA started involved with DOPPS back in 2005, with phase III,  since then we´ve been able to build a strong and fruitful relationship under the leadership of Althea Manhon, Jitka Pancirova, Anastasia Laskari (EDTNA/ERCA Presidents) David Ashwanden, Anna Marti  (DOPPS Project Manager 2005-2008, 2009-    ) and Alesandra Zampieron (EDTNA/ERCA Treasurer and Executive Committee link) that ended up with the DOPPS III completion and signature of DOPPS IV and just recently DOPPS 5 contracts with ARBOR Research. Since 2009 and as a result of the excellent collaboration EDTNA/ERCA has a sit on the DOPPS Steering Committee.

In Europe, the task of facilitating and coordinating the data collection is managed by EDTNA/ERCA volunteers. In each participating country  (Germany,  Italy, Spain, Sweden, Belgium & United Kingdom) there is an EDTNA/ERCA Clinical Research Associate who is responsible for liaising with and supporting the staff at the dialysis units. In each participating dialysis unit there is a Study Coordinator who is responsible for the actual data collection. The Study Coordinators work closely with the Medical Directors of their units who in turn liaise with the Country Investigator who is the leader of the research project in the country.

As mentioned for EDTNA/ERCA working with ARBOR Research and being part of DOPPS it’s a great experience.

For more information about DOPPS, please visit www.dopps.org  were you´ll find:

• Slides from peer-reviewed publications for downloading, slides  include goals, methods, results, etc.
• Meeting  study details, organizational information.
• External links, other resources,

or contact Anna Marti i Monros,  Project Manager.