Late referral

                             Early referral

                               Survival (months)


           ...
Late referral

                             Early referral

                              Survival (months)


            ...
Initiation of dialysis for late referrals

                             Late referral

                             Early ...
Survival time off
      dialysis gained by                             Initiation of dialysis for late referrals
      the...
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Lead Time Bias

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This demonstrates lead time bias. I do not know if lead time bias is responsible for the prolonged survival with early referral to nephrology I just know that it needs to be accounted for and most literature ignores this source of error.

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  • Lead Time Bias

    1. 1. Late referral Early referral Survival (months) Initiation of dialysis Conclusion: early referral has a large effect on the survival on dialysis Wednesday, March 11, 2009
    2. 2. Late referral Early referral Survival (months) GFR of 10 mL/min Wednesday, March 11, 2009
    3. 3. Initiation of dialysis for late referrals Late referral Early referral Survival (months) Initiation of dialysis for early referrals GFR of 10 mL/min Wednesday, March 11, 2009
    4. 4. Survival time off dialysis gained by Initiation of dialysis for late referrals the late initiation of dialysis Late referral Early referral Survival (months) Initiation of dialysis for early referrals GFR of 10 mL/min New conclusion: early referral results in earlier initiation of dialysis and prolonged survival on dialysis but does not change patient survival. Wednesday, March 11, 2009
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