Publication Spotlight: Dr. Schold

Read the below interview with Jesse Schold, PhD, MStat, MEd, Department of Quantitative health Sciences, Cleveland Clinic and author of Failure to Advance Access to Kidney Transplantation over Two Decades in the United States.

What question did your study aim to answer?

Our primary aims were to evaluate rates of patients placed on the kidney transplant waiting list over the past two decades in the United States. In addition, we sought to understand whether rates of waitlist placement had changed over time among groups with historically lower rates.

What inspired you to conduct this study?

Considerable efforts, resources, and research have tried to identify barriers to transplant among patients with end-stage kidney disease in the United States. Our motivation for the study was to evaluate how the culmination of these efforts has led to significant changes in this important process of care for this population.

Which USRDS datasets did you use to conduct your study?

We used the USRDS core research files, including the patient, medevid, waitlist, and transplant files.

Using plain language, please summarize your study conclusions in two or three points.

Despite broad recognition of barriers to transplant and substantial efforts to improve access to transplant, rates of placement on the transplant waiting list have not improved over a two-decade period in the United States. In addition, marked disparities in access to the waiting list among patients have remained stagnant over the same period. Cumulatively, results suggest that more prominent efforts may be needed to improve access to transplant and attenuate disparities in care in this population.

Please share a specific insight about working with USRDS data that you learned during the completion of this study.

There are unlimited numbers of important research questions to address with these data to inform healthcare policy, clinical care, and the research community. Other extensions of this research and the ability to merge these data with other epidemiologic data would provide additional important insights.