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 on-going since 1996 and has yielded detailed data on more than 38,000 patients in over 900 dialysis facilities.

The DOPPS is coordinated by research scientists and staff of the Arbor Research and is supported by un-restricted  scientific grants.

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 75 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 I, II & III was supported by research grants from Amgen and Kirin Pharma, without restrictions on publications.

In each of the selected units, the Study Coordinator records a census of all patients undergoing treatment. About 20 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 10 years, several sets of clinical practice guidelines have been developed to help practitioners provide the best possible care to dialysis patients. Although such guidelines are useful, attaining recommended guideline levels for all patients remains challenging.

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.

DOPPS IV, launched early 2009 is supported by a Consortium with the following benefits: Maintains scientific independence by representing the community rather than individual sponsors, Further enhances external credibility, Promotes long-term study stability and Broadens sphere of input and impact.

DOPPS outcomes have been presented in many local, national and international meetings, just to mentioned the ones in 2008-2009:

• National Kidney Foundation Spring Clinical Meetings, Dallas, TX
• Asian Pacific Congress of Nephrology, Kuala Lumpur, Malaysia
• ERA-EDTA Congress, Stockholm, Sweden
• EDTNA/ERCA Congress, Prague, Czech Republic
• American Society of Nephrology, Philadelphia, PA
• World Congress of Nephrology. Milan, Italy.

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

DOPPSIII Participating Countries

Total  Units: 284 Patients: more than 7000.
DOPPS IV has the following objectives:

• 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.

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 Mahon, Jitka Pancirova (EDTNA/ERCA Presidents) David Ashwanden (DOPPS Project Manager 2005-2008) and Alessandra Zampieron (Executive Committee link) that has ended up with the DOPPS III completion and signature of a new contract for DOPPS IV with ARBOR Research.

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 update information on meetings, workshops and publications please visit: http://www.dopps.org/showPresentations.aspx

For more information about DOPPS, please visit www.dopps.org or contact Anna Marti i Monros, Project Manager.