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  "path": "/t/a-longitudinal-renal-health-outcome-for-clinical-trials-in-acute-kidney-injury/28750#post_7",
  "publishedAt": "2026-05-19T21:54:38.000Z",
  "site": "https://discourse.datamethods.org",
  "tags": [
    "(described in the methodology of this paper)"
  ],
  "textContent": "Thanks some of this is beyond me I must confess…\n\nMuch of the intention of this post is because we lack the statistical grounding understand all the available methodologies however the scientific question is very much a pragmatic one - how do we understand if a randomised intervention effectively modifies kidney injury/kidney health in early phase studies when existing metrics fail to capture temporal elements of kidney health and are falsely dichotomised. Unfortunately we have no gold standard training data to calibrate such a metric - I don’t know the actual location to understand how to filter the GPS data. I have done some extensive mathematical modelling of glomerular filtration and creatinine kinetics (described in the methodology of this paper) however GFR itself is still just a physiological variable indicative of organ function - not directly paralleling structural injury or prognosis. We certainly do not have renal biopsy data in relation to world ICU examples. So we are forced to design a metric that incorporates our _gestalt_ of kidney health and then establish its utility and external meaning. What I really what to do is find something that is 1) feasible to collect and calculate 2) interpretable and meaningful to clinicians and patients 3) amenable to methodology targeting clinically meaningful estimands. This will be an inherently imperfect tool for clinical investigation but much better than what we currently have.\n\nThe definition of the states in our model will certainly incorporate our understanding of underlying physiology. The methodology we might adapt is (I understand) based on a Bayesian implementation of Markov Chain Monte Carlo Modelling. What I must confess I don’t understand is how we can use the modelling to determine the state definitions…",
  "title": "A Longitudinal Renal Health Outcome for Clinical Trials in Acute Kidney Injury?"
}