Our latest study suggests that we may be diagnosing a LOT of people with acute kidney injury who don't actually have it.


Acute kidney injury (AKI) is a major killer in the US. At least, that's what the data shows. But a lot depends onhow you diagnose AKI. Our latest study suggests that natural variation in lab measurement of creatinine is leading to strikingly high false-diagnosis rates, and that the association we see between AKI and bad outcomes like mortality may be an artifact of the fact that sicker people get more blood draws. Take a look at our full paper here.

And if you want to run the simulation for yourself (and you have stata), you can get our code and relevant files here.

We performed a randomized trial to see if electronic alerts for AKI would improve patient outcomes... the results surprised us

The full paper is online, but the quick version is that alerts for AKI did not improve clinical outcomes for AKI patients.  Not a bit. What's worse, in at least one group of patients, the alerts increased the rate of renal consult and the rate of dialysis.  For me, this was a lesson in unintended consequences, and a reminder of why randomized trials are so important.

See the full story at The Lancet:

Automated, electronic alerts for acute kidney injury: a single-blind, parallel-group, randomised controlled trial - The Lancet.