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审核状态: Project audit state: |
通过审核 Successful |
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注册号: Registration number: |
ChiCTR2600126109 |
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最近更新日期: Date of Last Refreshed on: |
2026-06-03 17:21:00 |
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注册时间: Date of Registration: |
2026-06-03 00:00:00 |
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注册号状态: |
预注册 |
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Registration Status: |
Prospective registration |
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注册题目: |
透析前社会适应性指数(SAI)与腹膜透析患者技术退出和预后风险的关系研究 |
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Public title: |
The study on the relationship between the pre-dialysis Social Adaptability Index (SAI) and the risk of technique failure and prognosis in peritoneal dialysis patients. |
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注册题目简写: |
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English Acronym: |
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研究课题的正式科学名称: |
透析前社会适应性指数(SAI)与腹膜透析患者技术退出和预后风险的关系研究 |
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Scientific title: |
The study on the relationship between the pre-dialysis Social Adaptability Index (SAI) and the risk of technique failure and prognosis in peritoneal dialysis patients. |
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研究课题代号(代码): Study subject ID: |
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在二级注册机构或其它机构的注册号: The registration number of the Partner Registry or other register: |
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申请注册联系人: |
李申恒 |
研究负责人: |
李申恒 |
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Applicant: |
Shenheng Li |
Study leader: |
Shenheng Li |
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申请注册联系人电话: Applicant telephone: |
+86 136 3210 1662 |
研究负责人电话:
Study leader's |
+86 20 6278 2305 |
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申请注册联系人传真 : Applicant Fax: |
研究负责人传真: Study leader's fax: |
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申请注册联系人电子邮件: Applicant E-mail: |
947734814@qq.com |
研究负责人电子邮件: Study leader's E-mail: |
947734814@qq.com |
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申请单位网址(自愿提供): Applicant website(voluntary supply): |
研究负责人网址(自愿提供): Study leader's website(voluntary supply): |
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申请注册联系人通讯地址: |
广东省广州市工业大道中253号 |
研究负责人通讯地址: |
广州市海珠区工业大道中253号 |
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Applicant address: |
No. 253, Gongye Dadao Zhong, Guangzhou, Guangdong Province, China |
Study leader's address: |
No. 253, Industrial Avenue, Haizhu District, Guangzhou |
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申请注册联系人邮政编码: Applicant postcode: |
研究负责人邮政编码: Study leader's postcode: |
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申请人所在单位: |
南方医科大学珠江医院 |
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Applicant's institution: |
Zhujiang Hospital of Southern Medical University |
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研究负责人所在单位: |
南方医科大学珠江医院 |
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Affiliation of the Leader: |
Zhujiang Hospital of Southern Medical University |
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是否获伦理委员会批准: |
是 |
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Approved by ethic committee: |
Yes |
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伦理委员会批件文号: Approved No. of ethic committee: |
2025-KY-340-01 |
伦理委员会批件附件: Approved file of Ethical Committee: |
查看附件View |
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批准本研究的伦理委员会名称: |
南方医科大学珠江医院医学伦理委员会 |
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Name of the ethic committee: |
Medical Ethics Committee of the Pearl River Hospital of Southern Medical University |
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伦理委员会批准日期: Date of approved by ethic committee: |
2025-09-15 00:00:00 | ||
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伦理委员会联系人: |
张婷婷 |
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Contact Name of the ethic committee: |
Zhang Tingting |
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伦理委员会联系地址: |
广州市海珠区工业大道中253号 |
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Contact Address of the ethic committee: |
No. 253, Industrial Avenue, Haizhu District, Guangzhou |
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伦理委员会联系人电话: Contact phone of the ethic committee: |
+86 20 6278 3254 |
伦理委员会联系人邮箱: Contact email of the ethic committee: |
zjyyllxs@126.com |
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研究实施负责(组长)单位: |
南方医科大学珠江医院 |
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Primary sponsor: |
Zhujiang Hospital of Southern Medical University |
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研究实施负责(组长)单位地址: |
广州市海珠区工业大道中253号 |
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Primary sponsor's address: |
No. 253, Industrial Avenue, Haizhu District, Guangzhou |
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试验主办单位(项目批准或申办者): Secondary sponsor: |
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经费或物资来源: |
自选课题(自筹) |
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Source(s) of funding: |
Self-selected Topic (Self-funded) |
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研究疾病: |
慢性肾脏病 |
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Target disease: |
Chronic kidney disease |
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研究疾病代码: |
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Target disease code: |
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研究类型: |
观察性研究 |
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Study type: |
Observational study |
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研究所处阶段: |
回顾性研究 | ||||||||||||||||||||||
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Study phase: |
Retrospective study |
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研究设计: |
队列研究 |
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Study design: |
Cohort study |
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研究目的: |
社会适应性指数(Social Adaptability Index, SAI)与慢性肾脏病、心血管疾病以及糖尿病的预后显著相关,也与肾移植患者的全因死亡和重返透析相关,但SAI对腹膜透析患者的技术生存和预后影响尚不清楚。 SAI是一个用于衡量个体社会经济地位的综合指标,它结合了教育水平、就业状态、婚姻状况、家庭收入和物质滥用等五个方面的因素进行评分,并且影响到多种疾病的预后。已有研究表明,在美国人群较低的SAI水平与肾移植后不良结局相关,但SAI在瑞士肾移植患者中的预测价值不高,这种差异可能源于瑞士的高福利医疗体系:全民强制医疗保险、较低的医疗自付比例以及均衡的社会资源分配,有效缓冲了社会经济劣势对健康结局的影响;SAI与糖尿病人群的死亡率相关,有助于识别有不良结局风险的个体[8];SAI是慢性肾脏病(CKD)患者生存率的强预测指标,其综合特性优于传统人口学分类。较低的SAI水平通常与不良的生活方式相关联,例如吸烟、酗酒、不健康的饮食习惯和缺乏运动等,而社会环境因素对腹膜透析患者预后和心血管并发症有不容忽视的影响。 SAI对预后的影响可能随疾病进展阶段而变化。针对CKD患者的NHANES III数据分析表明,SAI与患者生存率呈“剂量依赖性”关联,每增加1分可降低12%的死亡风险。然而,在终末期肾病(ESRD)患者中,SAI的预测效力可能因治疗方式(如透析或移植)而异。瑞士研究显示,接受活体供肾移植患者的SAI显著高于死亡供体受者(9.4 vs. 7.0分),提示SAI可能通过影响供体选择间接改善预后。 有研究表明,社会经济与环境因素对腹膜透析患者的技术存活和预后存在较大的影响。教育水平影响腹膜透析患者的抉择,从而影响技术退出率; 婚姻状况则显著影响腹膜透析患者的技术生存和预后,已婚患者的社会支持可能增强治疗依从性,而单身或离异者因心理压力更易中断治疗; 就业状态和收入情况则与是否 合并基础疾病相关,而基础疾病与合并症则会显著增加腹膜透析患者的不良预后;物质滥用如吸烟为腹膜透析后内源性腹膜炎的最强独立危险因素,从而影响腹膜透析患者的技术退出和预后。基于以上研究发现,我们进一步推测,SAI作为评估患者社会适应能力的以上5个方面的综合指标,可能与腹膜透析患者的技术生存和预后风险相关。 当前腹膜透析患者预后指标多聚焦于生物医学指标(如残余肾功能、白蛋白、炎症指标等),SAI作为一种组合式的新的社会学预测指标,可与生物医学指标形成互补。研究发现,CKD患者中低SAI与高炎症指标(如C反应蛋白)的协同作用可能加剧心血管并发症;而在瑞士的一项移植患者的研究中,SAI与年龄、合并症等生物因素的交互作用需进一步评价。 项目组团队通过前期研究发现,时间平均的血清钾水平及其波动与腹膜透析患者5年生存率相关,时间平均血清钾用于于评估腹膜透析患者低钾血症的不良预后是可靠和全面;项目组团队的另一项有关腹膜透析预后的研究发现,较低的白蛋白球蛋白比值与腹膜透析患者较高的心血管死亡率和全因死亡率相关,白蛋白球蛋白比值可能是识别有心血管疾病和全因死亡率风险的腹膜透析患者的有用指标。基于项目组之前的研究成果的基础,项目组将有能力完成透析前社会适应性指数与腹膜透析患者技术退出和预后风险的关系研究。 本项目探讨透析前SAI与中国南方人群腹膜透析患者技术生存和预后的关系,进一步阐明SAI对腹膜透析患者技术退出和预后的风险关系,将进一步促进肾脏科医护以及腹膜透析患者更加重视社会经济因素对腹膜透析治疗技术的影响,从而采取针对性社会预防措施减少腹膜透析患者技术退出,改善腹膜透析患者预后。 |
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Objectives of Study: |
This project explores the association between pre-dialysis SAI and technique survival and prognosis in a Southern Chinese PD patient population, further elucidating the risk relationship between SAI and technique failure and outcomes. The findings will encourage nephrologists, healthcare providers, and PD patients to place greater emphasis on the impact of socioeconomic factors on PD treatment, enabling targeted social interventions to reduce technique failure and improve patient prognosis. |
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药物成份或治疗方案详述: |
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Description for medicine or protocol of treatment in detail: |
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纳入标准: |
1.年龄18-75岁; 2.确诊终末期肾病(ESRD)并接受规律腹膜透析治疗(CAPD 或APD)>=3个月; 3.初始透析方式为腹膜透析且规律随访>=3个月; |
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Inclusion criteria |
1.Age 18-75 years old; 2.Diagnosis of end-stage renal disease (ESRD) and receiving regular peritoneal dialysis treatment (CAPD or APD) for >= 3 months; 3.Initial dialysis modality was peritoneal dialysis with regular follow-up for >=3 months; |
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排除标准: |
1.合并恶性肿瘤; |
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Exclusion criteria: |
1.Malignant tumor; |
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研究实施时间: Study execute time: |
从 From 2025-06-01 00:00:00至 To 2027-06-30 00:00:00 |
征募观察对象时间: Recruiting time: |
从 From 2026-06-03 00:00:00 至 To 2027-06-30 00:00:00 |
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干预措施: Interventions: |
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研究实施地点: Countries of recruitment and research settings: |
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测量指标: Outcomes: |
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采集人体标本:
Collecting sample(s)
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征募研究对象情况: Recruiting status: |
尚未开始 Not yet recruiting |
年龄范围: Participant age: |
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性别: |
男女均可 |
Gender: |
Both |
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随机方法(请说明由何人用什么方法产生随机序列): |
无 |
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Randomization Procedure (please state who generates the random number sequence and by what method): |
None |
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是否公开试验完成后的统计结果: Calculated Results after the Study Completed public access: |
不公开/Private |
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盲法: |
无 |
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Blinding: |
None |
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是否共享原始数据: IPD sharing |
是Yes |
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共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址): |
1.共享原则 遵循FAIR原则,首要前提是确保患者隐私,数据经过去标识化处理。2.公开日期 2027年下半年(与项目结题及论文发表时间同步)。3.国家生物信息中心 China National center for Bioinformation (https://ngdc.cncb.ac.cn/gsub/)。 |
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The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url): |
1. Sharing Principle Adhering to the FAIR principles, the primary prerequisite is ensuring patient privacy, with data undergoing de-identification processing. 2. Release Date Second half of 2027 (synchronized with project completion and paper publication). 3. Primary Sharing Platforms (https://figshare.com/) or (https://zenodo.org/). 4.China National center for Bioinformation (https://ngdc.cncb.ac.cn/gsub/). |
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数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC: |
一、 病例记录表(Case Report Form, CRF) CRF是专门为一项临床研究而设计的文件,用于记录方案要求向申办者报告的所有每位受试者的数据。在本回顾性研究中,CRF是数据提取的模板和载体。 CRF设计的主要模块与变量: A. 人口统计学与社会经济学基线数据 患者编号(唯一识别码,替代姓名) 性别、出生日期(或年龄)、身高、体重、BMI SAI评分各组分: 就业状况(失业/退休/在职) 教育水平(小学/初中/高中/大学及以上) 婚姻状况(未婚/离异或分居/已婚或同居) 物质滥用(吸烟史、饮酒史) 家庭年收入范围(<8万/8-15万/15-30万/>30万人民币) SAI总分(0-13分) B. 临床基线数据(透析开始时或入组时) 原发病诊断(如糖尿病肾病、高血压肾病等) 合并症(糖尿病、高血压、心血管疾病等,是/否) 残余肾功能(RRF)指标:尿量、估算肾小球滤过率(eGFR) 实验室指标:血清白蛋白、总胆固醇、血钠、血钾、血磷、超敏C反应蛋白(hs-CRP)等 C. 暴露与随访数据 腹膜透析开始日期 透析模式(CAPD/APD) 研究起点日期(符合入排标准、开始规律腹膜透析满3个月的日期) D. 结局事件数据 技术退出: 是否发生:是/否 退出日期 退出原因(腹膜炎/超滤衰竭/导管问题/患者意愿/等) 生存状态: 是否死亡:是/否 死亡日期 死亡原因(全因/心血管疾病/感染/其他) 研究终点日期:发生结局事件的日期或最后一次随访日期(删失数据) 转归(截至研究终点):持续腹膜透析/转为血液透析/死亡/肾移植/失访 E. 数据提取记录 数据提取员姓名 提取日期 数据复核员姓名 复核日期 疑问与解答记录 二、 电子数据采集与管理系统(Electronic Data Capture, EDC) 尽管是回顾性研究,但使用专业的EDC系统进行数据的录入、管理和清理,远比使用Excel等通用软件更为规范、安全和高效。项目申报书中提到了“珠江医院腹膜透析中心自建数据库”和“CTMS系统”,这表明他们有成熟的电子化平台作为支撑。 1. 系统名称与地址 系统名称: 腹膜透析治疗计划跟踪平台 & 腹膜透析操作指导记录系统(项目组自研软件,获软件著作权, likely用于日常临床数据记录)。 CTMS (Clinical Trial Management System) - 临床试验管理系统。 系统地址:珠江医院CTMS系统网址为 https://zjyygcp.wetrial.com/ (申报书内提供)。 2. 数据采集与管理流程 步骤一:数据提取与录入 数据源:研究者从医院的HIS(医院信息系统)、LIS(实验室信息系统)、EMR(电子病历系统) 以及自研的腹膜透析专科数据库中,根据CRF的要求查找和提取患者的原始临床数据。 双人录入与复核:由两名研究人员独立将提取的数据录入到EDC系统的电子CRF(eCRF)中。完成后,系统会自动比对两次录入的结果,任何不一致的地方都会触发“质疑”(Query),由第三名研究者核对原始病历进行裁定和修正。这是保证数据质量的核心环节。 步骤二:数据清理与质疑管理 系统逻辑校验:EDC系统内置逻辑校验规则(如年龄范围、数值合理性、必填项检查),自动标记异常值或遗漏项。 人工审核:项目组成员定期运行数据报告,检查变量的分布和一致性,发现潜在问题。 质疑管理:所有发现的问题都在CTMS系统内以“质疑”的形式发起、跟踪和闭环解决,全程留痕。 步骤三:数据锁定与导出 当所有数据清理完毕,质疑全部关闭后,由项目负责人和指导老师进行评估。 确认数据无误后,在系统中执行数据锁定操作。锁定后的数据将不能再修改,为最终的统计分析做好准备。 从EDC系统直接导出为统计分析软件(如SPSS, R, Stata)可读取的格式(如.csv, .xlsx)。 3. 数据安全与隐私保护 去标识化:所有数据在录入EDC时均使用患者编号,而非真实姓名和身份证号。 权限管理:CTMS/EDC系统设有严格的权限控制,不同角色的成员(学生、导师)只能访问和操作其授权范围内的功能与数据。 安全存储:数据存储在南方医科大学珠江医院的服务器上,受到医院信息中心的网络安全保护。 合规性:整个数据管理流程均通过南方医科大学珠江医院伦理委员会的审批,并符合《个人信息保护法》和《医疗卫生机构科学研究项目管理办法》的相关规定。 |
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Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture: |
1. Case Report Form (CRF) The CRF is a document specifically designed for a clinical study to record all data required by the protocol for each subject to be reported to the sponsor. In this retrospective study, the CRF serves as the template and carrier for data extraction. Key Modules and Variables in CRF Design: A. Demographic and Socioeconomic Baseline Data- Patient ID (unique identifier, replacing name) - Gender, date of birth (or age), height, weight, BMI - SAI score components: - Employment status (unemployed/retired/employed) - Education level (primary school/junior high school/high school/university or above) - Marital status (single/divorced or separated/married or cohabiting) - Substance use (smoking history, alcohol consumption history) - Annual household income range (<80k/80k-150k/150k-300k/>300k CNY) - Total SAI score (0-13 points) B. Clinical Baseline Data (at dialysis initiation or enrollment) - Primary disease diagnosis (e.g., diabetic nephropathy, hypertensive nephropathy) - Comorbidities (diabetes, hypertension, cardiovascular disease, etc.; yes/no) - Residual renal function (RRF) indicators: urine output, estimated glomerular filtration rate (eGFR) - Laboratory parameters: serum albumin, total cholesterol, sodium, potassium, phosphorus, high-sensitivity C-reactive protein ( CRP), etc. C. Exposure and Follow-up Data - Peritoneal dialysis start date - Dialysis modality (CAPD/APD) - Study start date (date meeting inclusion/exclusion criteria and completing 3 months of regular peritoneal dialysis) D. Outcome Event Data - Technique failure: - Occurrence: yes/no - Date of failure - Reason (peritonitis/ultrafiltration failure/catheter issue/patient preference/etc.) - Survival status: - Death: yes/no - Date of death - Cause of death (all-cause/cardiovascular disease/infection/other) - Study endpoint date: date of outcome event or last follow-up (censored data) - Outcome (at endpoint): ongoing peritoneal dialysis/switched to hemodialysis/death/kidney transplant/lost to follow-up E. Data Extraction Records- Data extractor name - Extraction date - Data reviewer name - Review date - Query and resolution log 2. Electronic Data Capture (EDC) System Despite being a retrospective study, using a professional EDC system for data entry, management, and cleaning is far more standardized, secure, and efficient than general software like Excel. The project proposal mentions the "Peritoneal Dialysis Center Database of Zhu jiang Hospital" and the "CTMS system," indicating a mature electronic platform as support. 1. System Name and Address - System name: - Peritoneal Dialysis Treatment Tracking Platform & Peritoneal Dialysis Operation Guidance Recording System (in-house software with copyright, likely used for routine clinical data recording). - CTMS (Clinical Trial Management System). - System URL:https://zjyygcp.wetrial.com/ (provided in the proposal). 2. Data Collection and Management Process - Step 1: Data Extraction and Entry - Data sources: Researchers extract raw clinical data from the hospital’s HIS (Hospital Information System), LIS (Laboratory Information System), EMR (Electronic Medical Record System), and the in-house peritoneal dialysis database based on CRF requirements. - **Dual entry and review: Two researchers independently enter extracted data into the EDC’s eCRF. The system automatically compares entries, flagging discrepancies as "queries" for resolution by a third reviewer. This is the core step for ensuring data quality. - Step 2: Data Cleaning and Query Management- System logic checks :The EDC has built-in validation rules (e.g., age range, value plausibility, mandatory fields) to flag outliers or missing data. - Manual review: The team runs periodic reports to check variable distributions and consistency. - Query management: All issues are tracked and resolved as "queries" in CTMS, with full audit trails. - Step 3: Data Locking and Export - After all queries are closed, the PI and supervisors evaluate the data. - Upon confirmation, data are locked in the system and exported to formats compatible with statistical software (e.g., .csv, .xlsx). 3. Data Security and Privacy Protection - De-identification: Data in EDC use patient IDs instead of real names or ID numbers. - Access control: CTMS/EDC enforces role-based permissions (e.g., students vs. supervisors). - Secure storage: Data are hosted on Zhu jiang Hospital servers with network protection. - Compliance: The process is approved by the hospital’s ethics committee and aligns with China’s Personal Information Protection Law and Healthcare Institution Research Project Management Regulations. |
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数据与安全监察委员会: Data and Safety Monitoring Committee: |
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