1. Nat. Rev. Nephrol. doi:10.1038/nrneph.2017.170
Figure 1 Framework for a platform-adaptive clinical trial for the prevention of perioperative AKI
Figure 1 | Framework for a platform-adaptive clinical trial for the prevention of perioperative AKI. Risk stratification occurs in the preoperative period using real-time, intelligent engine processing of clinical data from electronic health records and medical devices. Patients then undergo sequential and adaptive random assignment to multiple intervention or standard-care groups. The first sequence involves intraoperative interventions aimed at preventing immediate postoperative renal stress (determined using real-time analytics and biomarkers). Following surgery, patients are risk stratified based on markers of renal stress and, again, adaptively assigned to risk groups, which are randomly assigned to interventions or standard care with the aim of preventing acute kidney injury (AKI) and achieving renal recovery. Colour of patients indicates risk of AKI, ranging from green (lowest risk) to red (highest risk).
Bihorac, A. & Hobson, C. E. (2017) Precision perioperative care protects the kidneys
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