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Hemodialysis Arteriovenous Access Cosmesis Scale (AVACS): A new measure for vascular access.

Publication ,  Journal Article
Yuo, TH; Kim, CY; Rajan, DK; Niyyar, VD; Murea, M; Dillavou, ED; Bream, PR; Dinwiddie, LC; Hohmann, SE; Woo, K; Vachharajani, T; Roberts, C ...
Published in: J Vasc Access
December 14, 2022

RATIONALE AND OBJECTIVE: This study aimed to develop a cosmesis scale to evaluate the cosmetic appearance of hemodialysis (HD) arteriovenous (AV) accesses from the perspective of the patient and clinician, which could be incorporated into clinical trials. STUDY DESIGN: Using a modified Delphi process, two AV access cosmesis scale (AVACS) components were developed in a four-round Delphi panel consisting of two surveys and two consensus meetings with two rounds of patient consultation. SETTING AND PARTICIPANTS: The Delphi panel consisted of 15 voting members including five interventional or general nephrologists, five vascular surgeons, three interventional radiologists, and two vascular access nurse coordinators. Four patients experienced with vascular access were involved in patient question development. ANALYTICAL APPROACH: For a component to be included in the AVACS, it had to meet the prespecified panel consensus agreement of ⩾70%. RESULTS: The clinician component of the AVACS includes nine questions on the following AV access features: scarring, skin discoloration, aneurysm/pseudoaneurysms and megafistula appearance. The patient component includes six questions about future vascular access decisions, interference with work or leisure activities, clothing choices, self-consciousness or attractiveness, emotional impact, and overall appearance. LIMITATIONS: Delphi panel methods are subjective by design, but with expert clinical opinion are used to develop classification systems and outcome measures. The developed scale requires further validation testing but is available for clinical trial use. CONCLUSIONS: While safety and efficacy are the primary concerns when evaluating AV access for HD, cosmesis is an important component of the ESKD patient experience. The AVACS has been designed to assess this important domain; it can be used to facilitate patient care and education about vascular access choice and maintenance. AVACS can also be used to inform future research on developing new techniques for AV access creation and maintenance, particularly as relates to AV access cosmesis.

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Published In

J Vasc Access

DOI

EISSN

1724-6032

Publication Date

December 14, 2022

Start / End Page

11297298221141499

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • 4205 Nursing
  • 3201 Cardiovascular medicine and haematology
  • 1102 Cardiorespiratory Medicine and Haematology
 

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Yuo, T. H., Kim, C. Y., Rajan, D. K., Niyyar, V. D., Murea, M., Dillavou, E. D., … Lok, C. E. (2022). Hemodialysis Arteriovenous Access Cosmesis Scale (AVACS): A new measure for vascular access. J Vasc Access, 11297298221141500. https://doi.org/10.1177/11297298221141499
Yuo, Theodore H., Charles Y. Kim, Dheeraj K. Rajan, Vandana D. Niyyar, Marianna Murea, Ellen D. Dillavou, Peter R. Bream, et al. “Hemodialysis Arteriovenous Access Cosmesis Scale (AVACS): A new measure for vascular access.J Vasc Access, December 14, 2022, 11297298221141500. https://doi.org/10.1177/11297298221141499.
Yuo TH, Kim CY, Rajan DK, Niyyar VD, Murea M, Dillavou ED, et al. Hemodialysis Arteriovenous Access Cosmesis Scale (AVACS): A new measure for vascular access. J Vasc Access. 2022 Dec 14;11297298221141500.
Yuo, Theodore H., et al. “Hemodialysis Arteriovenous Access Cosmesis Scale (AVACS): A new measure for vascular access.J Vasc Access, Dec. 2022, p. 11297298221141500. Pubmed, doi:10.1177/11297298221141499.
Yuo TH, Kim CY, Rajan DK, Niyyar VD, Murea M, Dillavou ED, Bream PR, Dinwiddie LC, Hohmann SE, Woo K, Vachharajani T, Roberts C, Gooden C, Wright GW, Hogan AJ, Ferko NC, Kahle E, Clynes D, Lok CE. Hemodialysis Arteriovenous Access Cosmesis Scale (AVACS): A new measure for vascular access. J Vasc Access. 2022 Dec 14;11297298221141500.

Published In

J Vasc Access

DOI

EISSN

1724-6032

Publication Date

December 14, 2022

Start / End Page

11297298221141499

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • 4205 Nursing
  • 3201 Cardiovascular medicine and haematology
  • 1102 Cardiorespiratory Medicine and Haematology