CINXE.COM
GeriPal EP333 Dialysis vs Conservative Management
<!DOCTYPE html> <html lang="en"> <head> <meta charset="utf-8"> <meta http-equiv="X-UA-Compatible" content="IE=edge"> <link rel="shortcut icon" href="https://static.grain.com/images/favicon.png"> <meta name="viewport" content="width=device-width, initial-scale=1.0"> <meta name="theme-color" content="#000000"> <meta name="grain:native:protocol" content="grain"> <meta name="grain:frontend:hash" content="ef848caa1860e553433f42be2c98754dd93b8668"> <meta name="grain:frontend:deploy_timestamp" content="1732309167"> <title>GeriPal EP333 Dialysis vs Conservative Management</title> <meta name="robots" content="noindex, nofollow"> <meta name="grain:status" content="ok"> <link rel="canonical" href="https://grain.com/share/recording/ecfc6a3c-71f6-4141-b925-4236e6caf162/B0ZfPLzqJNRLdGJUsdjAzHftTPGwWExzmtdxs3DX"> <meta property="og:url" content="https://grain.com/share/recording/ecfc6a3c-71f6-4141-b925-4236e6caf162/B0ZfPLzqJNRLdGJUsdjAzHftTPGwWExzmtdxs3DX"> <meta property="og:type" content="video.other"> <meta property="og:title" content="GeriPal EP333 Dialysis vs Conservative Management"> <meta property="og:site_name" content="Grain"> <meta property="og:locale" content="en"> <meta name="twitter:site" content="@GrainHQ"> <meta name="twitter:card" content="player"> <meta name="twitter:player" content="https://grain.com/_/embed/recording/ecfc6a3c-71f6-4141-b925-4236e6caf162/B0ZfPLzqJNRLdGJUsdjAzHftTPGwWExzmtdxs3DX"> <meta name="twitter:player:width" content="576"> <meta name="twitter:player:height" content="364"> <link rel="alternate" type="application/json+oembed" title="GeriPal EP333 Dialysis vs Conservative Management" href="https://grain.com/_/api/oembed?url=https%3A%2F%2Fgrain.com%2Fshare%2Frecording%2Fecfc6a3c-71f6-4141-b925-4236e6caf162%2FB0ZfPLzqJNRLdGJUsdjAzHftTPGwWExzmtdxs3DX&format=json"> <meta name="grain:recording:locked" , content="no"> <meta name="grain:recording:can_copy" , content="yes"> <meta name="grain:registration:copy_query_string" , content="post_registration=g3QAAAADdwZhY3Rpb253DmNvcHlfcmVjb3JkaW5ndwxyZWNvcmRpbmdfaWRtAAAAJGVjZmM2YTNjLTcxZjYtNDE0MS1iOTI1LTQyMzZlNmNhZjE2MncLbGlua19zZWNyZXRtAAAAKEIwWmZQTHpxSk5STGRHSlVzZGpBekhmdFRQR3dXRXh6bXRkeHMzRFg"> <meta name="grain:recording:trimmed" , content="no"> <meta property="og:image" content="https://media.grain.com/public_thumbnails/recordings/ZWNmYzZhM2MtNzFmNi00MTQxLWI5MjUtNDIzNmU2Y2FmMTYyOkIwWmZQTHpxSk5STGRHSlVzZGpBekhmdFRQR3dXRXh6bXRkeHMzRFg="> <meta name="grain:recording:id" content="ecfc6a3c-71f6-4141-b925-4236e6caf162"> <meta name="grain:recording:json" content="{"id":"ecfc6a3c-71f6-4141-b925-4236e6caf162","owner":{"name":"Tim Stuck"},"state":"PROCESSED","title":"GeriPal EP333 Dialysis vs Conservative Management","duration":2826520,"url":"https://grain.com/share/recording/ecfc6a3c-71f6-4141-b925-4236e6caf162/B0ZfPLzqJNRLdGJUsdjAzHftTPGwWExzmtdxs3DX","locked":false,"views":4,"persons":[],"participants":[],"transcript":{"data":{"results":[[1040,"This",1176],[1176,"episode",1504],[1504,"of",1600],[1600,"the",1720],[1720,"Jerry",1976],[1976,"Paul",2240],[2265,"podcast",2769],[2857,"is",3105],[3145,"CME",3521],[3593,"eligible.",4209],[4337,"To",4577],[4601,"claim",4857],[4921,"credit,",5377],[5481,"please",5745],[5785,"go",5937],[5961,"to",6217],[6281,"the",6505],[6545,"CME",6993],[7089,"tab",7361],[7393,"on",7537],[7561,"jerrypal.org",9045],[9785,"welcome",10329],[10417,"to",10569],[10577,"the",10673],[10689,"Jerry",10961],[10993,"Pal",11201],[11233,"Podcast.",11481],[11513,"This",11609],[11617,"is",11689],[11697,"Eric",11841],[11873,"Gueira.",12409],[12457,"This",12569],[12577,"is",12697],[12721,"Alex",13049],[13097,"Smith.",13745],[13905,"And,",14177],[14201,"Alex,",14601],[14673,"I",14857],[14881,"am",15089],[15137,"very",15345],[15385,"excited",15665],[15705,"today",16025],[16105,"because",16465],[16545,"there",16737],[16761,"was",16921],[16953,"an",17289],[17377,"awesome",17969],[18097,"article",18433],[18489,"on",18681],[18713,"Annals",19433],[19609,"on",20017],[20081,"conservative",20593],[20649,"management",21009],[21097,"versus",21473],[21529,"dialysis.",22417],[22521,"Kind",22713],[22729,"of",23289],[23457,"how",23713],[23729,"we",23953],[24009,"think",24177],[24201,"about",24385],[24425,"that.",24673],[24729,"This",24873],[24889,"is",25017],[25041,"a",25177],[25201,"topic",25425],[25465,"I",25689],[25737,"love",25993],[26049,"to",26217],[26241,"talk",26401],[26433,"about.",26745],[26825,"So",27281],[27393,"we",27617],[27641,"got",27777],[27801,"a",27913],[27929,"lot",28105],[28145,"to",28321],[28353,"cover.",28713],[28809,"Who",29041],[29073,"do",29217],[29241,"we",29401],[29433,"have",29601],[29633,"with",29777],[29801,"us",29961],[29993,"today?",30233],[30289,"Got",30529],[30577,"a",30737],[30761,"lot",31017],[31081,"to",31281],[31313,"cover.",31781],[31913,"Delighted",32277],[32301,"to",32437],[32461,"welcome",32709],[32757,"Susan",33125],[33165,"Wong,",33517],[33541,"who's",33693],[33709,"a",33789],[33797,"nephrologist",34709],[34797,"and",34973],[34989,"she's",35181],[35213,"associate",35629],[35677,"professor",36005],[36045,"of",36173],[36189,"medicine",36485],[36525,"at",36629],[36637,"the",36757],[36781,"University",37085],[37165,"of",37405],[37445,"Washington,",38085],[38205,"though",38437],[38461,"she's",38877],[38941,"joining",39389],[39437,"us",39813],[39909,"from",40189],[40237,"Leeds,",40733],[40789,"England,",41069],[41117,"where",41277],[41301,"she",41461],[41493,"is",41637],[41661,"a",41821],[41853,"distinguished",42421],[42453,"Fulbright",43085],[43165,"scholar.",43765],[43885,"Susan,",44621],[44733,"welcome",45157],[45221,"to",45349],[45357,"the",45453],[45469,"Jerry",45741],[45773,"Powell",46045],[46085,"Podcast.",46597],[46701,"Thank",46893],[46909,"you",47037],[47061,"for",47245],[47285,"having",47461],[47493,"me.",48093],[48269,"And",48533],[48549,"we're",48717],[48741,"delighted",49037],[49061,"to",49197],[49221,"welcome",49493],[49549,"Maria",50189],[50317,"Marquez",50989],[51037,"Rath,",51453],[51509,"who",51653],[51669,"is",51773],[51789,"a",51869],[51877,"biostatistician",52845],[52885,"and",53061],[53093,"director",53309],[53357,"of",53469],[53477,"the",53597],[53621,"Biostatistics",54493],[54549,"Corps",54845],[54885,"at",55157],[55221,"Stanford",55685],[55765,"in",55933],[55949,"the",56077],[56101,"division",56325],[56365,"of",56541],[56573,"nephrology.",57785],[58125,"Maria,",58837],[58941,"welcome",59205],[59245,"to",59373],[59389,"Jerry",59677],[59701,"Pal.",60461],[60653,"Thank",60933],[60949,"you",61077],[61101,"for",61285],[61325,"having",61525],[61565,"me.",62125],[62285,"And",62557],[62581,"we're",62805],[62845,"delighted",63245],[63285,"to",63437],[63461,"welcome",63733],[63789,"Manju",64453],[64509,"Karela",65037],[65061,"Tamura,",65669],[65717,"who",65853],[65869,"is",66117],[66181,"a",66333],[66349,"nephrologist",67109],[67157,"and",67365],[67405,"professor",67701],[67733,"of",67877],[67901,"medicine",68269],[68317,"at",68573],[68629,"Stanford.",69397],[69581,"Munju,",70309],[70357,"welcome",70589],[70637,"to",70797],[70821,"Jerry",71181],[71213,"Powell.",71957],[72141,"Thank",72437],[72461,"you,",72621],[72653,"Alex",73005],[73045,"and",73197],[73221,"Eric,",73825],[74125,"Nice",74437],[74461,"to",74573],[74589,"be",74741],[74773,"here.",75345],[75645,"So",75933],[75949,"we",76077],[76101,"got",76237],[76261,"a",76373],[76389,"lot",76541],[76573,"to",76717],[76741,"cover.",76973],[77029,"Again,",77197],[77221,"we're",77357],[77381,"going",77469],[77477,"to",77549],[77557,"be",77629],[77637,"talking",77733],[77749,"about",77901],[77933,"conservative",78397],[78461,"management",78829],[78917,"versus",79269],[79317,"dialysis",79885],[79925,"in",80101],[80133,"older",80421],[80453,"adults.",80805],[80845,"But",81045],[81085,"before",81405],[81485,"we",81749],[81797,"do,",82461],[82653,"Susan,",83413],[83509,"I",83669],[83677,"think",83869],[83917,"all",84053],[84069,"the",84173],[84189,"way",84317],[84341,"from",84573],[84629,"Leeds,",85599],[85797,"we",86059],[86067,"have",86163],[86179,"a",86283],[86299,"song",86547],[86611,"request.",87099],[87187,"Yes,",87499],[87547,"maybe",87851],[87883,"appropriate",88299],[88347,"because",88795],[88915,"it's",89163],[89179,"a",89283],[89299,"British",89627],[89691,"band.",90291],[90443,"Let",90707],[90731,"It",90939],[90987,"Be",91243],[91299,"from",91467],[91491,"the",91627],[91651,"Beatles.",92335],[92915,"Why",93275],[93315,"did",93515],[93555,"you",93779],[93827,"choose",94147],[94211,"Let",94363],[94379,"It",94603],[94659,"Be?",95255],[96155,"To",96659],[96747,"reflect",97495],[98115,"continuing",99083],[99259,"medical",99739],[99827,"management",100267],[100371,"versus",100811],[100883,"starting",101155],[101195,"dialysis,",102215],[102515,"which",102827],[102851,"is",103011],[103043,"what",103547],[103691,"Maria's",104267],[104291,"wonderful",104643],[104699,"paper",105179],[105307,"goes",105659],[105707,"through.",106295],[106635,"Great,",107451],[107643,"Alex.",108535],[110955,"When",111315],[111355,"I",111531],[111563,"find",111851],[111923,"myself",112611],[112763,"in",113195],[113275,"times",113635],[113715,"of",114027],[114091,"trouble",114683],[114819,"Mother",115331],[115403,"Mary",116443],[116539,"comes",116819],[116867,"to",117027],[117051,"me",117615],[118335,"Speaking",119087],[119231,"words",119663],[119719,"of",119935],[119975,"wisdom",120755],[121215,"Let",121527],[121551,"it",121735],[121775,"be",122355],[125135,"and",125519],[125567,"in",125799],[125847,"my",126103],[126159,"hour",126591],[126703,"of",126999],[127047,"darkness",127835],[128135,"she",128519],[128567,"is",128871],[128943,"standing",129519],[129607,"right",130215],[130375,"in",130647],[130671,"front",130879],[130927,"of",131087],[131111,"me",131675],[132375,"Speaking",133103],[133239,"words",133727],[133791,"of",133991],[134023,"wisdom",134795],[135255,"Let",135591],[135623,"it",135791],[135823,"be",136395],[138575,"Let",138911],[138943,"it",139183],[139239,"be",139835],[140335,"Let",140647],[140671,"it",140855],[140895,"be",141475],[142135,"Let",142447],[142471,"it",142655],[142695,"be",143303],[143479,"yeah,",143959],[144047,"Let",144295],[144335,"it",144607],[144671,"be",145275],[146535,"Whisper",147199],[147287,"words",147895],[147975,"of",148191],[148223,"wisdom",148995],[149515,"Let",149827],[149851,"it",150011],[150043,"be.",150615],[154755,"Wow.",155535],[155915,"That",156275],[156315,"was",156611],[156683,"impressive.",157615],[158555,"We",158867],[158891,"will",159147],[159211,"see",159411],[159443,"at",159587],[159611,"the",159771],[159803,"end",159923],[159939,"of",160043],[160059,"the",160235],[160275,"podcast",161075],[161235,"if",161891],[162043,"let",162307],[162331,"it",162491],[162523,"be",162691],[162723,"is",162891],[162923,"the",163259],[163347,"appropriate,",164295],[166155,"appropriate",166811],[166883,"message",167171],[167203,"we'll",167619],[167627,"be",167795],[167835,"talking",168067],[168091,"about",168323],[168379,"with",168643],[168699,"conservative",169299],[169387,"management.",170015],[172555,"Well,",173295],[173795,"I",174059],[174067,"got.",174283],[174339,"I",174483],[174499,"got",174819],[174907,"a",175155],[175195,"lot",175491],[175563,"to",175771],[175803,"cover",176115],[176195,"because",176483],[176539,"I'm.",176859],[176907,"I'm",177155],[177195,"really",177371],[177403,"interested",177859],[177947,"in",178147],[178171,"this",178427],[178491,"topic,",178867],[178931,"especially",179227],[179291,"around",179611],[179683,"older",180011],[180043,"adults,",180419],[180467,"because",180819],[180907,"on",181059],[181067,"the",181271],[181323,"inpatient",181735],[181775,"side,",182071],[182143,"we",182375],[182415,"see",182591],[182623,"this",182767],[182791,"all",182879],[182887,"the",182983],[182999,"time.",183199],[183247,"So,",183407],[183431,"for",183591],[183623,"example,",184383],[184559,"you",184823],[184839,"know,",185231],[185343,"we",185567],[185591,"see",185775],[185815,"somebody",186183],[186239,"coming",186479],[186527,"in",186807],[186871,"from",187359],[187487,"the",187751],[187783,"nursing.",188287],[188391,"A",188631],[188663,"nursing",188999],[189047,"home.",189447],[189551,"Maybe",189943],[189999,"they",190263],[190319,"have,",190799],[190927,"you",191119],[191127,"know,",191343],[191399,"advanced",191911],[191943,"ckd,",192535],[192615,"not",192807],[192831,"yet",192991],[193023,"on",193215],[193255,"dialysis.",194195],[195375,"Their",195759],[195807,"function's",196351],[196383,"kind",196503],[196519,"of",196695],[196735,"decreasing.",197515],[197895,"Maybe",198359],[198407,"they're",198655],[198695,"having",198991],[199063,"some",199343],[199399,"issues",199663],[199719,"with",199959],[200007,"cognition.",200495],[200575,"And",200743],[200759,"the",200887],[200911,"question",201119],[201167,"always",201471],[201543,"is,",201823],[201879,"hey,",202279],[202367,"what",202567],[202591,"if",202727],[202751,"we",202959],[203007,"like",203527],[203671,"started",204071],[204143,"dialysis,",204807],[204871,"will",205047],[205071,"any",205279],[205327,"of",205463],[205479,"that",205703],[205759,"improve?",206355],[206975,"And",207263],[207279,"man,",207431],[207463,"it",207583],[207599,"feels",207847],[207871,"like",208175],[208255,"every",208519],[208567,"year",208799],[208847,"those",209079],[209127,"GFR",209711],[209783,"numbers",210231],[210303,"just",210559],[210607,"keep",210791],[210823,"on",210991],[211023,"ticking",211383],[211439,"higher",211655],[211695,"and",211847],[211871,"higher",212103],[212159,"when",212351],[212383,"we're",212639],[212687,"starting",212951],[212983,"to",213211],[213263,"dialysis.",214175],[214635,"No",214947],[214971,"longer",215315],[215355,"in",215507],[215531,"the",215907],[216011,"less",216275],[216315,"than",216515],[216555,"10s,",216910],[216989,"but",217304],[217383,"maybe",217699],[217778,"15s",218094],[218173,"or",218488],[218567,"16s",218923],[218979,"because",219243],[219299,"we're",219571],[219603,"having",219819],[219867,"these",220455],[221195,"quasi",221955],[222035,"uremic",222571],[222643,"symptoms.",223011],[223043,"So",223379],[223467,"I",223643],[223659,"wonder",223811],[223843,"if",223939],[223947,"I",224043],[224059,"could",224163],[224179,"turn",224307],[224331,"to",224491],[224523,"either",224755],[224795,"of",224947],[224971,"our",225131],[225163,"nephrologists.",226243],[226379,"Is",226627],[226651,"what",226811],[226843,"I'm",227051],[227083,"seeing",227451],[227523,"real?",227851],[227923,"Are",228083],[228099,"we",228275],[228315,"seeing",228627],[228691,"people",228963],[229019,"like",229667],[229851,"more",230195],[230235,"older",230531],[230563,"adults,",230979],[231027,"more",231235],[231275,"nursing",231531],[231563,"home",231755],[231795,"patients",232123],[232179,"starting",232499],[232547,"dialysis,",233495],[234075,"and",234411],[234443,"even",234635],[234675,"at",234827],[234851,"a",234963],[234979,"higher",235203],[235259,"gfr?",236135],[236955,"You",237243],[237259,"want",237339],[237347,"me",237443],[237459,"to",237563],[237579,"take",237707],[237731,"this,",237867],[237891,"Susan?",238655],[239805,"What",240117],[240141,"you're",240405],[240445,"describing,",240997],[241061,"Eric,",241581],[241693,"was",242037],[242101,"probably",242861],[243053,"what",243405],[243445,"we",243741],[243813,"saw",244501],[244693,"starting",245125],[245165,"about",245485],[245565,"in",245733],[245749,"the",245925],[245965,"2000s.",246797],[246861,"There",247037],[247061,"was",247461],[247573,"definitely",248705],[249085,"this",249565],[249645,"idea",250389],[250517,"in",250781],[250813,"nephrology",252053],[252229,"of",252829],[252957,"what",253221],[253253,"we",253421],[253453,"called",253741],[253813,"healthy",254213],[254269,"start",254557],[254621,"dialysis,",255665],[256285,"which",256573],[256589,"is",256741],[256773,"this",256989],[257037,"idea",257389],[257437,"that",257621],[257653,"we",257845],[257885,"should",258181],[258253,"start",258557],[258621,"dialysis",259429],[259517,"before",259981],[260093,"someone",260509],[260597,"develops",261445],[261605,"really",261973],[262029,"florid",262469],[262517,"uremic",263053],[263149,"symptoms.",264105],[264925,"By",265285],[265325,"doing",265597],[265661,"so,",265957],[266021,"we",266221],[266253,"might",266565],[266645,"prevent",267305],[267765,"the",268101],[268133,"mortality",268845],[268925,"associated",269461],[269533,"with",269741],[269773,"kidney",270117],[270181,"failure.",270825],[272025,"There",272361],[272393,"was",272681],[272753,"definitely",273649],[273817,"a",274145],[274185,"practice",274593],[274649,"shift",274977],[275041,"towards",275425],[275505,"starting",275913],[275969,"dialysis",276633],[276689,"at",276905],[276945,"higher",277217],[277281,"levels",277577],[277601,"of",277761],[277793,"EGFR",278473],[278529,"and",278745],[278785,"with",278985],[279025,"less",279249],[279297,"severe",279777],[279841,"symptoms.",280725],[281745,"I",282057],[282081,"would",282385],[282465,"say",282705],[282745,"that",283041],[283113,"that",283725],[284065,"practice",284921],[285073,"has",285361],[285393,"now",285561],[285593,"shifted",286073],[286129,"back",286321],[286353,"the",286497],[286521,"other",286777],[286841,"way",287089],[287137,"now",287321],[287353,"that",287521],[287553,"we",287769],[287817,"have",288097],[288161,"some",288769],[288937,"randomized",289681],[289753,"trial",290121],[290193,"evidence",290649],[290737,"that",290985],[291025,"suggests",291665],[291705,"that",292025],[292105,"that",292513],[292609,"actually",293129],[293257,"probably",293865],[293985,"does",294289],[294337,"not",294617],[294681,"benefit",295161],[295233,"patients.",295925],[296585,"I",296873],[296889,"think",297017],[297041,"the",297201],[297233,"tide",297497],[297561,"is",297809],[297857,"turning,",298305],[298385,"but.",299051],[299233,"May",299527],[299551,"not",299639],[299647,"be",299959],[300047,"actually",300367],[300431,"happening",300711],[300743,"in",300935],[300975,"real",301151],[301183,"life.",301375],[301415,"Or",301567],[301591,"do",301703],[301719,"we",301919],[301967,"just",302175],[302215,"have",302391],[302423,"the",302783],[302879,"evidence",303383],[303479,"that",303687],[303711,"it",303823],[303839,"doesn't",304159],[304207,"help",304795],[305375,"but",306167],[306351,"dialysis",307039],[307087,"centers",307415],[307455,"are",307631],[307663,"still",308143],[308279,"dial.",308955],[309735,"I",310047],[310071,"think",310255],[310295,"the",310495],[310535,"tide",310823],[310879,"is",311095],[311135,"shifting,",311879],[312007,"but",312675],[313095,"probably",313695],[313775,"not",314015],[314055,"enough",314635],[315215,"just",315551],[315583,"to",315727],[315751,"throw",316007],[316071,"some",316367],[316431,"statistics",317175],[317255,"out",317495],[317535,"there",317783],[317839,"for",318079],[318127,"you.",318719],[318887,"About",319359],[319447,"half",319719],[319767,"of",319999],[320047,"patients",320647],[320751,"who",320967],[320991,"are",321175],[321215,"over",321391],[321423,"the",321591],[321623,"age",321767],[321791,"of",321999],[322047,"65",322401],[322480,"start",322796],[322874,"dialysis",323190],[323269,"with",323584],[323663,"a",323978],[324057,"GFR",324372],[324451,"of",324767],[324845,"over",325161],[325240,"9,",325595],[325775,"which",326139],[326187,"is",326683],[326819,"sort",327067],[327091,"of",327227],[327251,"the",327435],[327475,"level",327771],[327843,"below",328171],[328243,"which",328547],[328611,"we",329291],[329483,"have",329835],[329875,"clinical",330243],[330299,"trial",330643],[330699,"evidence",331259],[331387,"for",331939],[332067,"suggesting",332627],[332651,"that",332811],[332843,"there",333035],[333075,"may",333371],[333443,"not",333795],[333875,"be",334067],[334091,"a",334227],[334251,"benefit",334723],[334779,"to",335019],[335067,"starting",335707],[335851,"at",336107],[336131,"that",336291],[336323,"level",336467],[336491,"of",336627],[336651,"gfr.",337075],[337115,"So",337291],[337323,"we're",337555],[337595,"still",337867],[337931,"seeing",338615],[339035,"about",339467],[339531,"half",339755],[339795,"of",339947],[339971,"the",340155],[340195,"older",340579],[340627,"population",341091],[341203,"starts",341571],[341603,"at",341747],[341771,"that",341931],[341963,"level",342155],[342195,"of",342347],[342371,"gfr.",343215],[343595,"And",343931],[343963,"I",344083],[344099,"think",344251],[344283,"the",344475],[344515,"question",344811],[344883,"for",345067],[345091,"our",345323],[345379,"field",345787],[345891,"is,",346535],[346955,"is",347291],[347323,"that",347587],[347651,"because",348139],[348267,"the",348579],[348627,"estimates",349131],[349163,"that",349307],[349331,"we",349443],[349459,"have",349659],[349707,"of",349915],[349955,"GFR",350819],[350987,"based",351243],[351259,"on",351435],[351475,"creatinine",352575],[353825,"provide",354565],[355225,"misrepresentation",356393],[356449,"or",356665],[356705,"an",356905],[356945,"inaccurate",357513],[357569,"representation",358257],[358321,"of",358569],[358617,"someone's",359001],[359033,"kidney",359329],[359377,"function.",360041],[360193,"Or",360553],[360609,"is",360777],[360801,"it",360985],[361025,"just",361297],[361361,"this",361705],[361785,"lingering",362425],[362545,"practice",363129],[363217,"of",363705],[363825,"starting",364233],[364289,"dialysis",365285],[365825,"early",366565],[367025,"before",367793],[367969,"really",368305],[368345,"severe",368769],[368817,"complications",369497],[369601,"develop?",370297],[370481,"Or",370969],[371057,"having",371353],[371409,"watched",371697],[371721,"that",371881],[371913,"John",372153],[372209,"Oliver",372625],[372705,"episode",373605],[374545,"about",374929],[374977,"DaVita,",375937],[376081,"we",376313],[376329,"will",376481],[376513,"have",376657],[376681,"a",376793],[376809,"link.",376961],[376993,"To",377113],[377129,"it",377281],[377313,"in",377433],[377449,"our",377625],[377665,"show.",377889],[377937,"Notes.",378241],[378313,"Is",378473],[378489,"it",378617],[378641,"because",378921],[378993,"of",379273],[379329,"tremendous",379889],[379977,"financial",380441],[380553,"incentives",381177],[381241,"to",381393],[381409,"get",381585],[381625,"people",381921],[381993,"on",382321],[382393,"dialysis",383089],[383137,"and",383273],[383289,"into",383489],[383537,"dialysis",384129],[384177,"centers?",384845],[385485,"Well,",385893],[385949,"I",386093],[386109,"think",386261],[386293,"that's",386477],[386501,"always",386757],[386821,"a",387069],[387117,"worry",387589],[387677,"of",387877],[387901,"whether",388037],[388061,"or",388131],[388133,"not",388337],[388391,"financial",388725],[388805,"incentives",389665],[390845,"play",391205],[391245,"into",391541],[391613,"decisions.",392149],[392197,"I",392333],[392349,"think",392525],[392565,"if",392669],[392677,"you",392797],[392821,"asked",392981],[393013,"any",393181],[393213,"nephrologist,",393925],[393965,"they",394093],[394109,"would",394357],[394421,"deny",394741],[394773,"it,",394941],[394973,"and",395213],[395269,"I",395389],[395397,"think",395517],[395541,"they",395725],[395765,"truly",396069],[396117,"believe",396349],[396397,"it.",397037],[397221,"But",397517],[397541,"there's",397845],[397885,"been",398085],[398125,"really",398349],[398397,"compelling",398941],[399013,"data",399461],[399573,"to",399869],[399917,"suggest",400173],[400229,"that,",400825],[401125,"you",401437],[401461,"know,",401837],[401941,"your",402253],[402309,"financial",402645],[402725,"model",403069],[403117,"does",403781],[403973,"have",404325],[404365,"some",404589],[404637,"influence",404965],[405005,"and",405229],[405277,"Manju",405717],[405741,"did",405877],[405901,"an",406037],[406061,"amazing",406477],[406541,"study",406765],[406805,"on",406957],[406981,"this",407213],[407269,"looking",407461],[407493,"at",408065],[408525,"different",408909],[408957,"populations.",410025],[410325,"Let",410589],[410597,"me",411125],[411285,"back.",411653],[411709,"Actually,",411901],[411933,"Manju,",412277],[412301,"you",412413],[412429,"probably",412605],[412645,"could",412989],[413077,"talk",413277],[413301,"about",413485],[413525,"yourself,",414265],[414565,"but",414853],[414869,"I",414997],[415021,"cite",415261],[415293,"it",415461],[415493,"all",415613],[415629,"the",415733],[415749,"time",416321],[416493,"of",416849],[416897,"veterans",417345],[417425,"who",417953],[418089,"are",418409],[418457,"equally",418865],[418945,"eligible",419385],[419425,"to",419553],[419569,"get",419697],[419721,"their",419881],[419913,"care",420105],[420145,"and",420321],[420353,"Medicare",420841],[420913,"fee",421161],[421193,"for",421409],[421457,"service",422045],[422345,"system",422801],[422873,"versus",423185],[423225,"the",423425],[423465,"va",424105],[424265,"and",424537],[424561,"that",424793],[424849,"patients",425281],[425353,"who",425801],[425913,"get",426185],[426225,"their",426449],[426497,"care",426801],[426873,"in",427105],[427145,"Medicare",427729],[427817,"are",428041],[428073,"more",428313],[428369,"likely",428609],[428657,"to",428865],[428905,"start",429129],[429177,"dialysis.",430165],[430465,"And",430873],[430929,"patient",431233],[431289,"subgroups",431929],[431977,"who",432377],[432481,"I",432673],[432689,"think",432841],[432873,"were",433089],[433137,"most",433393],[433449,"worried",433785],[433825,"about",434313],[434449,"their",434793],[434849,"prognosis",435345],[435385,"on",435537],[435561,"dialysis",436065],[436105,"or",436281],[436313,"getting",436601],[436673,"started",437337],[437521,"are",437817],[437841,"more",438025],[438065,"likely",438241],[438273,"to",438441],[438473,"get",438689],[438737,"started",439281],[439433,"in",439769],[439817,"Medicare",440441],[440553,"if",440753],[440769,"they",440873],[440889,"get",440993],[441009,"their",441137],[441161,"care",441297],[441321,"in",441457],[441481,"Medicare",441873],[441929,"than",442097],[442121,"if",442257],[442281,"they",442417],[442441,"get",442577],[442601,"their",442761],[442793,"care",443365],[443785,"in",444073],[444089,"the",444241],[444273,"VA.",444641],[444713,"So",445113],[445209,"patients",445529],[445577,"who",445689],[445697,"are",445817],[445841,"over",445977],[446001,"the",446137],[446161,"age",446297],[446321,"of",446553],[446609,"80,",446945],[447025,"patients",447289],[447337,"with",447497],[447521,"metastatic",448113],[448209,"cancer,",448753],[448849,"all",449057],[449081,"the",449217],[449241,"folks",449401],[449433,"that",449577],[449601,"we",449713],[449729,"get,",449929],[449977,"we're",450225],[450265,"really",450465],[450505,"worried",450785],[450825,"about.",451405],[451945,"And",452209],[452217,"then",452337],[452361,"there's",452577],[452601,"also",452929],[453017,"another",453385],[453465,"study",453801],[453873,"done",454057],[454081,"by",454241],[454273,"Margaret",454577],[454601,"Yu,",454777],[454801,"who's",455017],[455041,"also",455225],[455265,"at",455441],[455473,"Stanford",455857],[455921,"now,",456457],[456601,"who",456857],[456881,"looked",457097],[457121,"at",457401],[457473,"timing",457849],[457897,"of",458081],[458113,"dialysis",458713],[458769,"initiation.",459481],[459553,"Again,",460097],[460241,"veterans",460737],[460801,"who",460953],[460969,"are",461145],[461185,"equally",461513],[461569,"eligible",461969],[462017,"to",462153],[462169,"get",462297],[462321,"their",462481],[462513,"care",462681],[462713,"and",462881],[462913,"Medicare",463401],[463473,"or",463681],[463713,"in",463809],[463817,"the",463961],[463993,"va,",464645],[465185,"those",465521],[465553,"who",465697],[465721,"get",465857],[465881,"their",466041],[466073,"care",466241],[466273,"and",466417],[466441,"Medicare",466897],[466961,"start",467233],[467289,"dialysis",467913],[467969,"at",468113],[468129,"a",468233],[468249,"higher",468473],[468529,"GFR",469201],[469313,"than",469561],[469593,"if",469785],[469825,"they",470001],[470033,"were",470201],[470233,"getting",470401],[470433,"their",470601],[470633,"care",470801],[470833,"in",470929],[470937,"the",471057],[471081,"va.",471393],[471449,"So",471929],[472057,"there",472321],[472353,"seems",472665],[472705,"to",472833],[472849,"be",473025],[473065,"signal",473481],[473553,"but",474165],[475045,"think",475381],[475413,"these",475629],[475677,"just",475861],[475893,"kind",476013],[476029,"of",476109],[476117,"are",476405],[476485,"food",476701],[476733,"for",476925],[476965,"thought",477405],[477525,"right",477733],[477749,"now.",477901],[477933,"But",478269],[478357,"we",478557],[478581,"couldn't",478821],[478853,"say",479069],[479117,"proof",479389],[479437,"or",479837],[479941,"causal.",480705],[481125,"And",481413],[481429,"my",481605],[481645,"understanding",482085],[482125,"is",482277],[482301,"that",482485],[482525,"the",482749],[482797,"policy",483173],[483269,"and",483477],[483501,"reimbursement",484109],[484157,"rates",484421],[484453,"have",484621],[484653,"shifted",485141],[485213,"to",485469],[485517,"encourage",486285],[486405,"less",486781],[486853,"facility",487365],[487445,"dialysis",488125],[488205,"and",488421],[488453,"more",489025],[489325,"dialysis",489989],[490037,"at",490197],[490221,"home.",490405],[490445,"For",490621],[490653,"example,",491205],[491325,"with",491557],[491581,"peritoneal",492045],[492085,"dialysis",492733],[492829,"and",493157],[493221,"conservative",493701],[493773,"management.",494317],[494461,"Is",494717],[494741,"that",494925],[494965,"fair",495141],[495173,"to",495293],[495309,"say?",495865],[496645,"Yeah.",497157],[497221,"Both",497397],[497421,"Susan",497781],[497813,"and",497933],[497949,"I",498149],[498197,"practice",498509],[498557,"in",498693],[498709,"the",498837],[498861,"va,",499237],[499301,"so",499477],[499501,"we're",499813],[499869,"a",500013],[500029,"little",500205],[500245,"bit",500445],[500485,"shielded,",501197],[501301,"I",501517],[501541,"think",501773],[501829,"from",502285],[502405,"sort",502653],[502669,"of",502989],[503077,"the",503301],[503333,"true",503565],[503605,"practice",503997],[504061,"change",504309],[504357,"that's",504685],[504725,"happening",505117],[505181,"outside",505453],[505509,"of",505629],[505637,"the",505757],[505781,"va.",506069],[506117,"But",506253],[506269,"you're",506461],[506493,"right,",507065],[508745,"there",509129],[509177,"has",509385],[509425,"been",509577],[509601,"a",509713],[509729,"shift",509969],[510017,"in",510273],[510329,"policy",510925],[511625,"to",512033],[512089,"incentivize",513241],[513433,"patients",513929],[513977,"and",514185],[514225,"providers",514705],[514745,"to",514945],[514985,"choose",515337],[515401,"home",515673],[515729,"therapies.",516525],[516945,"To",517257],[517281,"what",517489],[517537,"extent",518025],[518105,"it's",518593],[518689,"incentivizing",519641],[519713,"conservative",520353],[520449,"management,",520897],[521001,"I",521217],[521241,"would",521473],[521529,"say",521697],[521721,"it's",521945],[521985,"probably",522345],[522425,"negligible.",523033],[523129,"But",523481],[523553,"maybe",524257],[524441,"that's",524841],[524873,"just",525113],[525169,"my",525481],[525553,"own",526165],[526785,"VA",527297],[527361,"centric",527801],[527873,"view.",528485],[528985,"Well,",529513],[529609,"the",529841],[529873,"devil's",530305],[530345,"advocate.",530921],[530993,"So",531177],[531201,"you",531409],[531457,"have,",531809],[531897,"I",532025],[532025,"mean",532209],[532257,"versus",533009],[533177,"a",533457],[533481,"younger,",533849],[533897,"healthier",534297],[534361,"person",534965],[535305,"with",535713],[535769,"worsening",536217],[536281,"ckd.",536793],[536849,"That's",537017],[537041,"their",537249],[537297,"main",537481],[537513,"thing.",537705],[537745,"They're",537977],[538001,"having",538185],[538225,"some",538425],[538465,"functional",538769],[538817,"decline.",539345],[539465,"I",539697],[539721,"feel",539881],[539913,"like",540081],[540113,"that's",540329],[540377,"different",540585],[540625,"than",541257],[541441,"the",541737],[541761,"older",542041],[542073,"adult",542377],[542441,"with",542593],[542609,"multimorbidity.",543857],[544001,"A",544233],[544249,"lot",544377],[544401,"of",544537],[544561,"things",544697],[544721,"may",544881],[544913,"be",545057],[545081,"contributing",545481],[545513,"to",545633],[545649,"their",545801],[545833,"functional",546193],[546249,"decline.",546641],[546713,"A",546873],[546889,"lot",546993],[547009,"of",547113],[547129,"things",547281],[547313,"may",547457],[547481,"be",547617],[547641,"contributing",548449],[548617,"to",549089],[549177,"these",549425],[549465,"symptoms",549817],[549841,"that",549977],[550001,"we",550137],[550161,"may",550345],[550385,"be",550561],[550593,"defining",550921],[550953,"as",551217],[551281,"uremic",551889],[551977,"symptoms,",552401],[552433,"but",552577],[552601,"they",552761],[552793,"also",553009],[553057,"could",553241],[553273,"just",553489],[553537,"be",553817],[553881,"non",554105],[554145,"uremic",554585],[554665,"symptoms",555041],[555073,"from",555241],[555273,"all",555441],[555473,"these",555617],[555641,"other",555825],[555865,"comorbidities.",556805],[557105,"I",557393],[557409,"think",557609],[557657,"that",557841],[557873,"is",558065],[558105,"a",558329],[558377,"big",558705],[558785,"challenge",559225],[559305,"of",559473],[559489,"what",559593],[559609,"we",559713],[559729,"know.",559953],[560009,"If",560153],[560169,"we",560321],[560353,"see",560521],[560553,"somebody's",560977],[561001,"functional",561465],[561545,"status",561913],[561969,"declining,",562765],[563065,"like",563449],[563497,"how",563657],[563681,"much",563865],[563905,"of",564081],[564113,"that",564281],[564313,"is",564505],[564545,"from",564913],[565009,"their",565289],[565337,"CKD",565873],[565929,"and",566097],[566121,"how",566257],[566281,"Much",566465],[566505,"of",566657],[566681,"that",566841],[566873,"would",567017],[567041,"be",567225],[567265,"reversed",568033],[568169,"from",568849],[569017,"dialysis.",570121],[570273,"Isn't",570705],[570745,"that",570921],[570953,"a",571073],[571089,"big",571289],[571337,"challenge",571577],[571601,"in",571737],[571761,"older",572001],[572033,"adults?",572765],[573105,"Yeah,",573505],[573545,"Eric,",573977],[574081,"you're",574765],[575065,"giving",575425],[575465,"me",575641],[575673,"this",575865],[575905,"great",576201],[576273,"segue",577045],[577385,"into",578009],[578137,"how",578449],[578497,"I",578681],[578713,"got",579193],[579329,"interested",579801],[579833,"in",579977],[580001,"this",580209],[580257,"area",580537],[580601,"in",580753],[580769,"the",580921],[580953,"first",581193],[581249,"place.",581845],[582305,"So",582857],[582961,"that",583177],[583201,"was",583433],[583489,"exactly",584485],[584825,"the",585185],[585225,"dilemma",585697],[585761,"that",586009],[586057,"I",586385],[586465,"saw",586753],[586809,"when",587001],[587033,"I",587153],[587169,"was",587321],[587353,"a",587497],[587521,"trainee",588073],[588169,"in",588377],[588401,"nephrology.",589113],[589169,"And",589313],[589329,"we",589481],[589513,"would",589681],[589713,"see",589881],[589913,"the",590105],[590145,"patients",590489],[590537,"that",590697],[590721,"you",590929],[590977,"described",591409],[591457,"at",591641],[591673,"the",591889],[591937,"start",592217],[592281,"of",592481],[592513,"the",592705],[592745,"podcast,",593619],[593817,"older",594295],[594335,"adults",594775],[594815,"with",594991],[595023,"functional",595415],[595495,"decline,",595959],[596047,"cognitive",596511],[596583,"impairment,",597475],[598175,"and",598679],[598767,"kidney",599335],[599455,"failure",599927],[599991,"or",600167],[600191,"advanced",600703],[600759,"ckd.",601715],[602055,"And",602367],[602391,"the",602527],[602551,"question",602735],[602775,"is,",602999],[603047,"is",603159],[603167,"this",603335],[603375,"uremia",603999],[604047,"or",604231],[604263,"is",604431],[604463,"this",604823],[604919,"something",605295],[605375,"else?",605639],[605687,"Is",605823],[605839,"it",605991],[606023,"delirium",606631],[606703,"from",606959],[607007,"something",607287],[607351,"else?",607743],[607839,"And",608335],[608455,"is",608759],[608807,"dialysis",609647],[609751,"the",609991],[610023,"right",610479],[610607,"treatment",611127],[611191,"in",611391],[611423,"this",611927],[612071,"situation?",612795],[613495,"I",613783],[613799,"felt",613991],[614023,"like",614239],[614287,"more",614495],[614535,"often",614783],[614839,"than",615055],[615095,"not,",615583],[615719,"we",616039],[616087,"erred",616391],[616423,"towards",616743],[616799,"dialysis",617559],[617647,"because",617871],[617903,"there",618047],[618071,"it",618183],[618199,"is.",618375],[618415,"It's",618591],[618623,"right",618791],[618823,"there.",619039],[619087,"It's",619319],[619367,"easy.",620035],[621815,"That",622103],[622119,"was",622223],[622239,"the",622367],[622391,"lingering",622791],[622863,"question",623167],[623231,"I",623431],[623463,"had",623703],[623759,"was,",624047],[624111,"well,",624479],[624567,"what",624791],[624823,"is",624967],[624991,"it",625271],[625343,"actually",625695],[625775,"doing?",626395],[627255,"The",627591],[627623,"first",627815],[627855,"question",628223],[628319,"I",628575],[628615,"got",628863],[628919,"started",629135],[629175,"with",629399],[629447,"is,",629727],[629791,"what",629991],[630023,"does",630143],[630159,"it",630287],[630311,"do",630447],[630471,"to",630679],[630727,"cognitive",631111],[631183,"function?",631655],[631735,"It",632355],[633215,"got",633575],[633615,"bigger",633911],[633943,"and",634087],[634111,"bigger",634335],[634375,"from",634551],[634583,"there.",634823],[634879,"Well,",635383],[635519,"not",635743],[635759,"just",635935],[635975,"cognitive",636367],[636431,"function.",636783],[636839,"What",637007],[637031,"is",637599],[637767,"actually",638191],[638263,"dialysis?",639315],[639735,"How",640023],[640039,"is",640167],[640191,"it",640375],[640415,"benefiting",640831],[640903,"patients?",641635],[642815,"What",643151],[643183,"did",643279],[643287,"it",643407],[643431,"do",643567],[643591,"to",643775],[643815,"cognitive",644119],[644167,"function?",644915],[645815,"That's",646207],[646231,"a",646463],[646519,"really",646975],[647095,"difficult",647623],[647719,"question",648071],[648143,"to",648375],[648415,"answer,",648815],[648895,"but",649135],[649175,"it's",649551],[649623,"probably.",650315],[651125,"We're",651525],[651565,"probably",652141],[652293,"mixing",652805],[652845,"up",653141],[653213,"two",653421],[653453,"or",653621],[653653,"three",654013],[654109,"different",654485],[654565,"conditions",655045],[655125,"here.",655461],[655533,"There's",655917],[655981,"definitely",656885],[657045,"uremic",657645],[657725,"encephalopathy,",659185],[659485,"and",659821],[659853,"dialysis",660581],[660653,"does",660933],[660989,"improve",661301],[661373,"uremic",661821],[661893,"encephalopathy.",662829],[662877,"But",663037],[663061,"the",663221],[663253,"truth",663421],[663453,"is",663765],[663845,"that",664133],[664189,"most",664381],[664413,"of",664533],[664549,"us",664749],[664797,"don't",664997],[665021,"see",665181],[665213,"uremic",665621],[665693,"encephalopathy",666621],[666693,"anymore",667093],[667149,"because",667389],[667437,"we",667669],[667717,"start",667949],[667997,"dialysis",669077],[669261,"before",669821],[669933,"anybody",670573],[670669,"actually",671021],[671093,"develops",671421],[671453,"uremic",671861],[671933,"encephalopathy,",672933],[672989,"except",673485],[673565,"maybe",673877],[673901,"in",674013],[674029,"the",674157],[674181,"acute",674525],[674605,"setting.",675265],[675845,"But",676157],[676181,"then",676341],[676373,"there",676541],[676573,"are",676837],[676901,"all",677077],[677101,"of",677237],[677261,"these",677421],[677453,"older",677765],[677805,"patients",678141],[678213,"who",678493],[678549,"have",678909],[678997,"microvascular",679877],[679941,"brain",680253],[680309,"disease,",680629],[680677,"which",680837],[680861,"you",681021],[681053,"guys",681245],[681285,"could",681485],[681525,"talk",681701],[681733,"about",682021],[682093,"better",682277],[682301,"than,",682493],[682539,"than",682697],[682721,"we",682953],[683009,"can.",683609],[683777,"And",684105],[684145,"dialysis,",684753],[684809,"at",684953],[684969,"least",685193],[685249,"hemodialysis",686433],[686529,"probably",687097],[687201,"harms",687689],[687777,"that.",688409],[688577,"There's",689113],[689169,"evidence",689561],[689633,"that",689841],[689873,"suggests",690361],[690393,"that",690537],[690561,"there's",690873],[690929,"cognitive",691433],[691529,"decline",691985],[692065,"and",692281],[692313,"an",692505],[692545,"increased",692921],[692953,"incidence",693297],[693361,"of",693537],[693561,"dementia",694489],[694657,"after",695081],[695153,"patients",695537],[695601,"start",695849],[695897,"hemodialysis.",696769],[696817,"And",696977],[697001,"that's",697209],[697257,"corroborated",698025],[698065,"by",698313],[698369,"some",698897],[699041,"magnetic",699649],[699697,"resonance",700113],[700169,"imaging",700617],[700681,"studies",701017],[701081,"as",701257],[701281,"well.",701845],[702385,"It's",703025],[703145,"a",703401],[703433,"mixed",703977],[704081,"bag,",704393],[704449,"and",704617],[704641,"it",704801],[704833,"probably",705241],[705313,"depends",705681],[705713,"on",705881],[705913,"what",706081],[706113,"the",706329],[706377,"underlying",706921],[706993,"cause",707257],[707281,"of",707489],[707537,"cognitive",707961],[708033,"dysfunction",708609],[708657,"is.",709245],[710495,"I",710831],[710863,"also",711055],[711095,"have",711247],[711271,"to",711431],[711463,"ask,",711703],[711759,"because",712359],[712527,"we",712831],[712863,"will",713007],[713031,"have",713143],[713159,"a",713263],[713279,"link",713407],[713431,"to",713543],[713559,"this",713711],[713743,"article.",714007],[714071,"One",714223],[714239,"of",714343],[714359,"my",714511],[714543,"favorite",714815],[714855,"articles.",715615],[715775,"I",716095],[716135,"talk",716287],[716311,"about",716471],[716503,"it",716623],[716639,"all.",716791],[716823,"This",716919],[716927,"is",717335],[717455,"my",717711],[717743,"favorite",717975],[718015,"article,",718263],[718319,"Susan,",718671],[718703,"that",718847],[718871,"I",719007],[719031,"talk",719191],[719223,"about",719463],[719519,"of",719687],[719711,"Monjuz",720655],[720815,"is",721111],[721143,"a",721239],[721247,"New",721391],[721423,"England",721663],[721719,"Journal",722007],[722071,"article",722343],[722399,"that",722591],[722623,"came",722815],[722855,"out",723435],[723775,"2009.",724877],[725122,"2009,",726102],[726347,"yeah,",727327],[727572,"2009.",728675],[729335,"Looking",729791],[729863,"at",730431],[730583,"what",731231],[731383,"happens",732135],[732255,"to",732583],[732639,"older",733015],[733055,"adults",733983],[734159,"in",734543],[734599,"nursing",735007],[735071,"homes",735795],[736125,"when",736437],[736461,"they",736645],[736685,"initiate",737189],[737277,"dialysis.",738133],[738229,"What",738581],[738653,"happens",739005],[739045,"to",739197],[739221,"their",739429],[739477,"function?",740269],[740437,"How",740693],[740709,"many",740861],[740893,"of",741037],[741061,"them",741173],[741189,"are",741317],[741341,"alive",741589],[741637,"and",741773],[741789,"dead",741997],[742021,"at",742157],[742181,"one",742317],[742341,"year?",742525],[742565,"How",742693],[742709,"many",742837],[742861,"of",743021],[743053,"them",743293],[743349,"have",743661],[743733,"improved",744349],[744397,"function",744765],[744805,"at",745005],[745045,"one",745245],[745285,"year?",745893],[746069,"Would",746333],[746349,"you",746477],[746501,"mind",746661],[746693,"just",746885],[746925,"describing",747341],[747373,"what",747517],[747541,"you",747677],[747701,"did",747813],[747829,"in",747957],[747981,"that",748141],[748173,"article?",748797],[748981,"Just",749349],[749397,"briefly,",750105],[750525,"thanks",750877],[750901,"for",751037],[751061,"giving",751197],[751221,"me",751357],[751381,"an",751541],[751573,"opportunity",752173],[752229,"to",752637],[752741,"go",752981],[753013,"back",753181],[753213,"to",753357],[753381,"that.",753945],[754885,"Sorry",755261],[755293,"if",755413],[755429,"you",755557],[755581,"have",755669],[755677,"to",756085],[756205,"go",756485],[756525,"way",756773],[756829,"back.",757429],[757597,"No,",757973],[758029,"no",758173],[758189,"worries.",758741],[758893,"I'll",759221],[759253,"share",759469],[759517,"maybe",759789],[759837,"a",759997],[760021,"small",760277],[760341,"personal",760685],[760765,"anecdote",761421],[761493,"before",761749],[761797,"I",761933],[761949,"tell",762077],[762101,"you",762237],[762261,"about",762757],[762901,"the",763277],[763341,"story.",763945],[764855,"I",765595],[766495,"was",766975],[767055,"while",767295],[767335,"we",767487],[767511,"were",767983],[768119,"waiting",768527],[768591,"to",768767],[768791,"hear",768975],[769015,"back",769191],[769223,"from",769391],[769423,"the",769615],[769655,"New",769807],[769831,"England",770079],[770127,"Journal",770455],[770535,"about",770847],[770911,"this",771159],[771207,"paper,",771795],[772215,"I",772551],[772583,"was",772847],[772911,"nine",773135],[773175,"months",773423],[773479,"pregnant",774195],[774695,"and",775487],[775671,"actually",776303],[776439,"I",776687],[776711,"went",776871],[776903,"into",777167],[777231,"labor",777719],[777807,"about",778199],[778287,"30",778535],[778575,"minutes",778919],[778967,"after",779247],[779311,"I",779535],[779575,"got",780015],[780135,"the",780463],[780519,"email",780999],[781127,"that",781463],[781519,"said",781855],[781935,"that",782415],[782535,"our",782815],[782855,"paper",783151],[783223,"had",783383],[783399,"been",783575],[783615,"accepted.",784475],[784975,"And",785715],[786055,"so",786367],[786391,"when",786695],[786775,"my",786991],[787023,"co",787239],[787287,"authors",787607],[787631,"were",787839],[787887,"emailing",788231],[788263,"me",788455],[788495,"and",788671],[788703,"I",788823],[788839,"was",788967],[788991,"of",789127],[789151,"course",789359],[789407,"oblivious",790275],[790875,"because",791211],[791243,"I",791411],[791443,"was",791971],[792123,"in",792363],[792379,"the",792507],[792531,"maternity",792979],[793027,"ward",793355],[793395,"by",793523],[793539,"then.",793739],[793787,"So",793947],[793971,"by",794107],[794131,"the",794267],[794291,"time",794523],[794579,"I",794795],[794835,"finally",795179],[795227,"got",795483],[795539,"a",795731],[795763,"chance",796051],[796123,"to",796331],[796363,"respond",796747],[796811,"to",797011],[797043,"them,",797615],[798075,"I",798411],[798443,"said,",798683],[798739,"well,",799147],[799251,"it's",799467],[799491,"the",799651],[799683,"second",799899],[799947,"best",800155],[800195,"thing",800347],[800371,"that's",800635],[800675,"happened",800907],[800931,"to",801043],[801059,"me",801259],[801307,"today,",801895],[805275,"so",805851],[805963,"it",806163],[806179,"will",806403],[806459,"always",806747],[806811,"be",806987],[807011,"linked",807331],[807363,"to",807531],[807563,"my",807779],[807827,"daughter",808455],[809795,"who's",810187],[810211,"named",810427],[810451,"England.",810819],[810867,"No,",811027],[811051,"I'm",811307],[811371,"kidding.",811827],[811931,"I",812099],[812107,"was",812227],[812251,"going",812315],[812315,"to",812379],[812387,"say",812483],[812499,"who's",812643],[812659,"named",812851],[812883,"Midjum.",813695],[814155,"Midjum.",814795],[814835,"That's",815067],[815091,"a",815251],[815283,"really",815547],[815611,"interesting",816415],[816715,"first",817099],[817147,"name.",817735],[818435,"Yeah.",819215],[819675,"Going",820035],[820075,"back",820203],[820219,"to",820347],[820371,"your",820627],[820691,"question,",821227],[821371,"what",821699],[821747,"we",822027],[822091,"did",822695],[823075,"was",823531],[823603,"we",823883],[823939,"had",824563],[824739,"an",825123],[825179,"opportunity",826175],[826595,"through",827291],[827443,"one",827683],[827699,"of",827827],[827851,"my",828011],[828043,"mentors,",828363],[828419,"Glenn",828651],[828683,"Church,",829243],[829339,"who",829571],[829603,"had",829843],[829899,"access",830187],[830251,"to",830475],[830515,"the",830763],[830819,"US",831107],[831171,"Renal",831563],[831619,"Data",831883],[831939,"System,",832227],[832291,"which,",832467],[832491,"as",832915],[833035,"I",833243],[833259,"think",833411],[833443,"all",833563],[833579,"of",833707],[833731,"you",833891],[833923,"know,",834091],[834123,"is",834315],[834355,"this",834555],[834595,"registry",835283],[835379,"of",835947],[836091,"patients",836459],[836507,"in",836619],[836627,"the",836747],[836771,"US",837051],[837123,"who",837307],[837331,"are",837539],[837587,"treated",838043],[838099,"with",838339],[838387,"dialysis",839019],[839067,"or",839371],[839443,"transplant",840295],[840835,"that",841219],[841267,"had",841475],[841515,"been",841715],[841755,"linked",842187],[842251,"to",842643],[842739,"a",843019],[843067,"registry",843731],[843843,"called",844115],[844155,"the",844307],[844331,"Minimum",844723],[844779,"Data",845019],[845067,"Set,",845299],[845347,"which",845579],[845627,"I",845763],[845779,"think",845955],[845995,"you",846171],[846203,"guys",846419],[846467,"know",846627],[846651,"and",846811],[846843,"probably",847059],[847107,"most",847267],[847291,"of",847403],[847419,"your",847595],[847635,"listeners",848051],[848083,"know,",848251],[848283,"is",848451],[848483,"this",848651],[848683,"registry",849463],[849619,"of",849911],[849943,"patients",850239],[850287,"in",850495],[850535,"nursing",850863],[850919,"homes.",851635],[852295,"By",852871],[852983,"linking",853519],[853567,"the",853775],[853815,"two,",854375],[854535,"we",854879],[854927,"had",855111],[855143,"an",855359],[855407,"opportunity",856383],[856519,"to",857195],[857655,"trace",858087],[858151,"out",858375],[858415,"the",858639],[858687,"trajectory",859231],[859303,"of",859583],[859639,"patients",860355],[860935,"functional",861671],[861783,"status",862555],[862855,"relative",863391],[863463,"to",863671],[863703,"when",863919],[863967,"they",864199],[864247,"started",864527],[864591,"dialysis.",865635],[866735,"I",867047],[867071,"remember",867367],[867431,"when",867631],[867663,"I",867831],[867863,"was",868391],[868543,"first",868927],[868991,"just",869595],[870255,"exploring",870975],[871015,"the",871239],[871287,"data",871519],[871567,"and",871751],[871783,"looking",871999],[872047,"at",872231],[872263,"it,",872527],[872591,"I",872743],[872759,"was",873247],[873391,"seeing",873783],[873839,"this",874103],[874159,"dramatic",875309],[875487,"drop",875953],[876009,"and",876129],[876137,"I",876233],[876249,"was",876809],[876977,"showing",877401],[877433,"it",877601],[877633,"to",877801],[877833,"people",878073],[878129,"and",878297],[878321,"I",878409],[878417,"was",878561],[878593,"like,",878929],[879017,"what",879217],[879241,"do",879353],[879369,"you",879569],[879617,"think",879825],[879865,"about",880161],[880233,"this?",880585],[880665,"This",880905],[880945,"looks",881513],[881649,"really",882017],[882081,"surprising",882425],[882465,"to",882593],[882609,"me.",883145],[883305,"Drop",883665],[883705,"in",884001],[884073,"function",884617],[884721,"when",884961],[884993,"dialysis",885465],[885505,"was",885657],[885681,"initiated.",886041],[886073,"So",886193],[886209,"you",886313],[886329,"saw",886505],[886545,"function",886913],[886969,"before",887257],[887321,"and",887545],[887585,"after",887833],[887889,"dialysis",888465],[888505,"and",888633],[888649,"what",888729],[888737,"you",888833],[888849,"were",888977],[889001,"seeing",889161],[889193,"was",889361],[889393,"this",889585],[889625,"drop?",890245],[890585,"Yeah,",890937],[890961,"there",891097],[891121,"was",891281],[891313,"a",891481],[891513,"dramatic",892073],[892129,"drop.",892409],[892457,"So",892689],[892737,"people,",893065],[893145,"it",893765],[894745,"starts",895201],[895233,"to",895425],[895465,"decline",896165],[896745,"a",897009],[897017,"couple",897225],[897265,"of",897441],[897473,"months",897713],[897769,"before",898129],[898217,"they",898465],[898505,"start",898705],[898745,"dialysis,",899417],[899481,"which",899681],[899713,"I",899833],[899849,"think",900217],[900321,"resonates",900849],[900897,"with",901153],[901209,"Mike.",901713],[901849,"Clinical",902605],[902905,"experience.",903645],[903985,"But",904321],[904353,"then",904689],[904777,"after",905121],[905193,"starting",905593],[905649,"dialysis,",906609],[906737,"they",907025],[907065,"don't",907305],[907345,"recover.",907849],[907937,"Most",908233],[908289,"patients",908641],[908713,"don't",908961],[908993,"recover.",909385],[909465,"And",909657],[909681,"I",909817],[909841,"think",910049],[910097,"that's",910609],[910737,"what",911025],[911065,"was",911313],[911369,"so",911657],[911721,"surprising",912177],[912241,"to",912465],[912505,"people",912801],[912873,"because",913485],[913865,"our",914489],[914617,"clinical",915445],[915985,"instinct",916569],[916617,"is",916801],[916833,"to",917025],[917065,"intervene",917601],[917673,"when",917857],[917881,"we",918065],[918105,"see",918329],[918377,"someone",918681],[918753,"declining",919337],[919401,"with",919601],[919633,"the",919825],[919865,"hope",920113],[920169,"that",920433],[920489,"we",920729],[920777,"will",921345],[921505,"prevent",922185],[922345,"that",923097],[923281,"dramatic",923977],[924041,"decline",924457],[924521,"in",924745],[924785,"function",925153],[925209,"and",925425],[925465,"rescue",925825],[925865,"them",926065],[926105,"from",926329],[926377,"that.",927023],[927209,"And",927483],[927499,"we",927603],[927619,"weren't",927875],[927915,"seeing",928243],[928299,"that.",928779],[928907,"And",929171],[929203,"I",929347],[929371,"think",929935],[930275,"that's",930739],[930787,"probably",931299],[931387,"why",931755],[931835,"the",932075],[932115,"paper",932363],[932419,"made",932611],[932643,"it",932787],[932811,"into",933019],[933067,"the",933251],[933283,"New",933451],[933483,"England",933739],[933787,"Journal",934019],[934067,"is.",934227],[934251,"So",934603],[934699,"it",934883],[934899,"went",935171],[935243,"counter",935571],[935603,"to",935795],[935835,"what",936083],[936139,"our",936451],[936523,"instincts,",937243],[937379,"which",937627],[937651,"was",937811],[937843,"to",938035],[938075,"intervene.",938571],[938643,"Yeah.",939043],[939139,"I",939419],[939467,"personally",939731],[939763,"loved",939947],[939971,"it",940107],[940131,"because",940387],[940451,"again,",940699],[940747,"you",940931],[940963,"saw",941131],[941163,"this",941331],[941363,"thing.",941987],[942171,"I",942443],[942459,"have",942611],[942643,"face",942811],[942843,"validity.",943459],[943587,"We",943827],[943851,"see",944035],[944075,"people,",944347],[944411,"they're",944627],[944651,"having",944835],[944875,"some",945051],[945083,"worsening",945483],[945539,"functional",945907],[945971,"decline.",946655],[946995,"Hey,",947403],[947459,"as",947675],[947715,"doctors,",947995],[948035,"we",948163],[948179,"got",948307],[948331,"a",948443],[948459,"fix",948635],[948675,"for",948803],[948819,"that.",948971],[949003,"We",949147],[949171,"got",949379],[949427,"dialysis.",950003],[950059,"Let's",950227],[950251,"do",950387],[950411,"dialysis",950851],[950883,"and",951075],[951115,"let's",951307],[951331,"see",951443],[951459,"if",951563],[951579,"their",951731],[951763,"function",952083],[952139,"improves.",952867],[953011,"What",953291],[953323,"I",953491],[953523,"remember",953763],[953819,"from",953987],[954011,"the",954171],[954203,"article",954775],[955115,"is",955523],[955579,"that",955795],[955835,"at",956059],[956107,"one",956339],[956387,"year,",956975],[957395,"nobody",958075],[958155,"improved,",959135],[959635,"but",960187],[960291,"some",960531],[960563,"people",960923],[961019,"maintained.",961667],[961731,"Not",961907],[961931,"a",962043],[962059,"lot,",962427],[962531,"but",962915],[962995,"most",963211],[963243,"people",963435],[963475,"either",963699],[963747,"had",963931],[963963,"a",964131],[964163,"decrease",964435],[964475,"in",964627],[964651,"functional",965003],[965059,"status",965331],[965363,"or",965507],[965531,"were",965667],[965691,"dead",966251],[966403,"at",966667],[966691,"one",966851],[966883,"year.",967455],[968115,"And",968427],[968451,"I'll",968627],[968651,"just",968859],[968907,"say",969115],[969155,"a",969283],[969299,"couple",969499],[969547,"meta",969939],[969987,"comments.",970603],[970779,"One",971115],[971155,"is",971735],[972115,"people",972571],[972643,"remember",973083],[973179,"figures.",973659],[973747,"Nobody",974179],[974227,"remembers",974635],[974675,"a",974851],[974883,"table.",975499],[975667,"The",976067],[976131,"figure",976571],[976643,"of",977091],[977203,"the",977763],[977899,"functional",978451],[978523,"status",978907],[978971,"decline",979651],[979803,"and",980067],[980091,"then",980635],[980795,"minimal",981347],[981411,"recovery",982375],[982675,"after",983415],[983715,"initiation",984435],[984475,"of",984627],[984651,"dialysis",985403],[985499,"is",985707],[985731,"just",985867],[985891,"a",986027],[986051,"figure",986251],[986283,"that's",986531],[986563,"seared",986843],[986899,"into",987115],[987155,"my",987331],[987363,"brain.",987915],[988075,"Mine",988427],[988451,"is",988587],[988611,"the",988795],[988835,"bar",989059],[989107,"chart",989419],[989467,"looking",989651],[989683,"at",989851],[989883,"3",990107],[990157,"months,",990356],[990406,"6",990606],[990655,"months,",990855],[990905,"9",991104],[991154,"months,",991354],[991403,"12",991603],[991653,"months.",991852],[991902,"Seeing",992102],[992151,"like",992351],[992401,"at",992600],[992650,"12",992875],[992955,"months.",993411],[993523,"Well,",993771],[993803,"that",994307],[994451,"figure",994875],[994915,"is",995043],[995059,"a",995187],[995211,"hat",995395],[995435,"tip",995715],[995755,"to",995931],[995963,"Chuck",996195],[996235,"McCulloch,",996811],[996843,"who",996963],[996979,"is",997131],[997163,"still",997307],[997331,"at",997467],[997491,"UCSF.",998499],[998667,"Without",999067],[999131,"his",999331],[999363,"help,",999531],[999563,"I",999683],[999699,"wouldn't",999931],[999963,"have",1000107],[1000131,"been",1000243],[1000259,"able",1000411],[1000443,"to",1000611],[1000643,"make",1000811],[1000843,"that.",1001415],[1002955,"That",1003243],[1003259,"was",1003435],[1003475,"awesome.",1003867],[1003931,"I",1004107],[1004131,"love",1004291],[1004323,"this",1004467],[1004491,"entire",1004731],[1004763,"paper",1005027],[1005091,"because",1005387],[1005451,"I",1005603],[1005619,"do",1005771],[1005803,"think",1006163],[1006259,"it",1006563],[1006619,"started",1007213],[1007379,"making",1007753],[1007809,"me",1008097],[1008161,"question",1008765],[1009225,"what",1009657],[1009721,"is",1010041],[1010113,"the",1010369],[1010417,"role",1010697],[1010761,"of",1010985],[1011025,"dialysis",1011857],[1011961,"as",1012201],[1012233,"far",1012449],[1012497,"as",1012849],[1012937,"making",1013233],[1013289,"people's",1013681],[1013713,"function",1014009],[1014057,"improve,",1014361],[1014433,"helping",1014657],[1014681,"with",1014865],[1014905,"their",1015129],[1015177,"symptoms,",1015609],[1015657,"their",1015865],[1015905,"quality",1016201],[1016233,"of",1016425],[1016465,"life,",1017045],[1017545,"and",1017929],[1017977,"starting",1018241],[1018273,"to",1018441],[1018473,"question",1018809],[1018897,"some",1019097],[1019121,"of",1019281],[1019313,"this",1019505],[1019545,"stuff.",1020125],[1020905,"So",1021193],[1021209,"I",1021313],[1021329,"guess",1021481],[1021513,"the",1021657],[1021681,"other",1021865],[1021905,"question",1022057],[1022081,"is",1022385],[1022465,"what",1022633],[1022649,"do",1022753],[1022769,"we",1022969],[1023017,"know",1023225],[1023265,"about,",1023825],[1023985,"if",1024425],[1024505,"we",1024769],[1024817,"think",1025001],[1025033,"about",1025441],[1025553,"other",1025897],[1025961,"things",1026161],[1026193,"that",1026361],[1026393,"we",1026561],[1026593,"use",1026737],[1026761,"it",1026873],[1026889,"for?",1027089],[1027137,"And",1027273],[1027289,"I",1027369],[1027377,"think,",1027521],[1027553,"Susan,",1027905],[1027945,"I'm",1028073],[1028089,"going",1028169],[1028177,"to",1028273],[1028289,"turn",1028393],[1028409,"to",1028513],[1028529,"you",1028681],[1028713,"on",1028857],[1028881,"this",1029017],[1029041,"one.",1029605],[1029945,"What",1030233],[1030249,"do",1030353],[1030369,"we",1030497],[1030521,"know",1030657],[1030681,"around",1031245],[1031745,"quality",1032201],[1032233,"of",1032647],[1032761,"life?",1033299],[1033427,"Because",1033739],[1033787,"you've,",1034163],[1034219,"you",1034411],[1034443,"also",1034803],[1034899,"did",1035131],[1035163,"a,",1035691],[1035843,"you",1036083],[1036099,"did",1036227],[1036251,"a",1036411],[1036443,"study",1036659],[1036707,"looking",1036891],[1036923,"at",1037067],[1037091,"this,",1037299],[1037347,"right?",1037935],[1038555,"I",1038843],[1038859,"guess",1039011],[1039043,"where",1039187],[1039211,"I",1039323],[1039339,"would",1039611],[1039683,"kind",1039867],[1039891,"of",1040291],[1040403,"piggyback",1040955],[1040995,"from",1041363],[1041459,"Manju's",1042171],[1042203,"work",1042371],[1042403,"here",1042595],[1042635,"is",1042787],[1042811,"that",1042947],[1042971,"I",1043083],[1043099,"think",1043419],[1043507,"she,",1044211],[1044403,"as",1044683],[1044699,"well",1044827],[1044851,"as",1045083],[1045139,"others,",1045735],[1046035,"started",1046515],[1046595,"to",1047099],[1047227,"gather",1047643],[1047699,"the",1047915],[1047955,"evidence",1048643],[1048819,"that",1049535],[1049835,"to",1050123],[1050139,"at",1050267],[1050291,"least",1050691],[1050803,"bring",1051455],[1052155,"us",1052515],[1052555,"to",1052731],[1052763,"take",1053075],[1053155,"pause",1053627],[1053691,"about",1054011],[1054083,"how",1054363],[1054419,"beneficial",1054915],[1054955,"dialysis",1055611],[1055683,"really",1055963],[1056019,"was",1056379],[1056467,"for",1056691],[1056723,"older",1057123],[1057179,"patients",1057699],[1057827,"with",1058067],[1058091,"multimorbidity",1058931],[1058963,"and",1059107],[1059131,"frailty.",1059763],[1059859,"And",1060043],[1060059,"I",1060139],[1060147,"think",1060387],[1060451,"that",1061055],[1061355,"myth",1061867],[1061931,"first",1062227],[1062291,"had",1062467],[1062491,"to",1062627],[1062651,"be",1062835],[1062875,"debunked",1063691],[1063843,"before",1064359],[1064467,"people",1064783],[1064839,"could",1065007],[1065031,"be",1065239],[1065287,"open",1065591],[1065663,"to",1065847],[1065871,"the",1066079],[1066127,"idea",1066415],[1066455,"of,",1066799],[1066887,"well,",1067447],[1067591,"is",1067847],[1067871,"there",1068127],[1068191,"something",1068535],[1068615,"else?",1068999],[1069087,"Is",1069263],[1069279,"there",1069455],[1069495,"something",1069719],[1069767,"else",1069999],[1070047,"we",1070303],[1070359,"can",1070599],[1070647,"offer,",1070975],[1071055,"we",1071271],[1071303,"should",1071567],[1071631,"offer?",1072235],[1072855,"And",1073167],[1073191,"I",1073303],[1073319,"think",1073519],[1073567,"that",1074039],[1074167,"needing",1074551],[1074583,"to",1074727],[1074751,"build",1074911],[1074943,"that",1075111],[1075143,"evidence",1075463],[1075519,"was",1075951],[1076063,"so",1076311],[1076343,"important",1076655],[1076735,"to",1076927],[1076951,"set",1077111],[1077143,"the",1077311],[1077343,"stage",1077695],[1077775,"to",1078063],[1078119,"be",1078287],[1078311,"able",1078471],[1078503,"to",1078695],[1078735,"even",1079315],[1079615,"publish",1080135],[1080215,"studies",1080875],[1081735,"that",1082023],[1082039,"would",1082167],[1082191,"even",1082423],[1082479,"counter",1082775],[1082815,"the",1082991],[1083023,"idea",1083279],[1083327,"that",1083559],[1083607,"actually",1084055],[1084175,"you",1084431],[1084463,"could",1084631],[1084663,"maintain",1084967],[1085031,"people",1085327],[1085391,"fairly",1085783],[1085839,"well",1086295],[1086415,"by",1086719],[1086767,"continuing",1087359],[1087447,"medical",1087791],[1087863,"management",1088215],[1088295,"or",1088487],[1088511,"even",1088695],[1088735,"adding",1088999],[1089047,"kidney",1089359],[1089407,"supportive",1089831],[1089863,"care",1090439],[1090607,"in",1090887],[1090911,"a",1091023],[1091039,"bigger",1091231],[1091263,"bucket.",1091565],[1091615,"We",1091777],[1091801,"call",1091961],[1091993,"this,",1092233],[1092289,"you",1092409],[1092417,"know,",1092585],[1092625,"conservative",1093049],[1093097,"kidney",1093433],[1093489,"management.",1094085],[1094745,"So",1095485],[1095785,"in",1096121],[1096153,"terms",1096321],[1096353,"of",1096497],[1096521,"what",1096705],[1096745,"we",1096969],[1097017,"know",1097201],[1097233,"about",1097473],[1097529,"conservative",1097969],[1098017,"kidney",1098377],[1098441,"management,",1098881],[1098993,"I",1099169],[1099177,"would",1099273],[1099289,"say",1099441],[1099473,"in",1099569],[1099577,"the",1099673],[1099689,"U.S.",1099961],[1100033,"we,",1100457],[1100561,"we",1100825],[1100865,"don't,",1101441],[1101593,"we",1101881],[1101913,"don't",1102145],[1102185,"do",1102337],[1102361,"it",1102593],[1102649,"well.",1103225],[1103385,"And",1103873],[1103969,"so",1104657],[1104841,"it's",1105161],[1105193,"almost",1105385],[1105425,"like",1105577],[1105601,"a",1105761],[1105793,"lost",1106033],[1106089,"art.",1106305],[1106345,"You",1106449],[1106457,"know,",1106577],[1106601,"before",1106809],[1106857,"dialysis",1107457],[1107521,"was",1107745],[1107785,"invented,",1108321],[1108393,"ev,",1108721],[1108793,"you",1108929],[1108937,"know,",1109153],[1109209,"everybody",1109689],[1109737,"was",1109921],[1109953,"doing",1110145],[1110185,"their",1110385],[1110425,"very",1110649],[1110697,"best",1110953],[1111009,"at",1111177],[1111201,"conservative",1111545],[1111585,"kidney",1111905],[1111945,"management.",1112169],[1112217,"And",1112329],[1112337,"then",1112409],[1112417,"once",1112585],[1112625,"dialysis",1113297],[1113361,"came",1113537],[1113561,"about",1113841],[1113913,"in",1114073],[1114089,"the",1114217],[1114241,"1970s,",1115321],[1115473,"it's",1115737],[1115761,"a",1115921],[1115953,"practice",1116289],[1116337,"that's",1116721],[1116793,"kind",1116953],[1116969,"of",1117403],[1117529,"all",1117767],[1117791,"but",1117975],[1118015,"disappeared,",1119151],[1119343,"and",1119671],[1119703,"yet",1120275],[1120855,"we've",1121343],[1121399,"developed",1121855],[1121895,"so",1122023],[1122039,"many",1122287],[1122351,"more",1122743],[1122839,"services,",1123475],[1123895,"we",1124183],[1124199,"have",1124303],[1124319,"so",1124423],[1124439,"many",1124567],[1124591,"more",1124775],[1124815,"medications,",1125595],[1126295,"we",1126631],[1126663,"know",1126831],[1126863,"so",1126983],[1126999,"much",1127175],[1127215,"more",1127391],[1127423,"about",1127615],[1127655,"the",1127807],[1127831,"illness",1128119],[1128167,"that",1128351],[1128383,"we",1128575],[1128615,"could",1128887],[1128951,"provide",1129391],[1129503,"better",1129895],[1129975,"support",1130239],[1130287,"to",1130471],[1130503,"patients.",1130783],[1130839,"But",1131199],[1131287,"this",1131535],[1131575,"infrastructure",1132475],[1133215,"hasn't",1133631],[1133663,"been",1133831],[1133863,"built.",1134475],[1135175,"Most",1135511],[1135543,"of",1135687],[1135711,"what",1135871],[1135903,"we",1136071],[1136103,"know",1136271],[1136303,"about",1136543],[1136599,"conservative",1136975],[1137015,"kidney",1137359],[1137407,"management",1137711],[1137783,"comes",1137991],[1138023,"from",1138167],[1138191,"other",1138447],[1138511,"countries,",1138831],[1138903,"the",1139111],[1139143,"UK",1139551],[1139663,"being",1140271],[1140423,"one",1140687],[1140711,"of",1140823],[1140839,"the",1140967],[1140991,"most",1141223],[1141279,"prolific",1142071],[1142263,"countries",1142759],[1142847,"in",1143023],[1143039,"terms",1143167],[1143191,"of",1143519],[1143607,"producing",1144079],[1144127,"research",1144383],[1144439,"on",1144583],[1144599,"this.",1145117],[1145271,"And",1145489],[1145497,"so",1145641],[1145673,"what",1145865],[1145905,"they've",1146201],[1146233,"been",1146401],[1146433,"showing",1146753],[1146809,"here",1147025],[1147065,"is",1147241],[1147273,"that",1147873],[1148049,"when",1148337],[1148361,"you",1148521],[1148553,"have",1148721],[1148753,"an",1148945],[1148985,"established",1149785],[1149945,"conservative",1150489],[1150537,"kidney",1150825],[1150865,"management",1151209],[1151297,"pathway,",1152045],[1152345,"you",1152705],[1152745,"can",1153089],[1153177,"maintain",1153753],[1153889,"patients",1154577],[1154721,"for",1155049],[1155097,"quite",1155329],[1155377,"some",1155537],[1155561,"time,",1156033],[1156169,"for",1156465],[1156505,"several",1156777],[1156841,"years,",1157137],[1157201,"even",1157665],[1157785,"after",1158113],[1158169,"they've",1158441],[1158473,"made",1158617],[1158641,"the",1158825],[1158865,"decision",1159209],[1159297,"to",1159497],[1159521,"forego",1159881],[1159953,"dialysis,",1160965],[1161265,"and",1161601],[1161633,"that",1161825],[1161865,"they've",1162257],[1162321,"seen",1162881],[1163033,"pretty",1163417],[1163481,"comparable",1164313],[1164489,"survival",1165017],[1165081,"rates",1165545],[1165625,"between",1165937],[1166001,"those",1166201],[1166233,"who",1166353],[1166369,"are",1166497],[1166521,"conservatively",1167217],[1167281,"managed",1167689],[1167737,"and",1167897],[1167921,"those",1168105],[1168145,"who",1168725],[1169025,"receive",1169449],[1169497,"dialysis.",1170089],[1170137,"So",1170273],[1170289,"it's",1170441],[1170473,"been",1170593],[1170609,"a",1170737],[1170761,"real",1170945],[1170985,"inspiration,",1171885],[1172185,"I",1172473],[1172489,"think,",1172689],[1172737,"for",1173113],[1173209,"many",1173845],[1174185,"clinicians",1174929],[1175017,"and",1175241],[1175273,"researchers",1175745],[1175785,"in",1175913],[1175929,"the",1176033],[1176049,"US",1176297],[1176361,"to",1176513],[1176529,"figure",1176697],[1176721,"out,",1176937],[1176991,"well,",1177493],[1177629,"how",1177973],[1178029,"can",1178245],[1178285,"we",1178557],[1178621,"do",1178869],[1178917,"this",1179437],[1179581,"better",1180053],[1180149,"in",1180333],[1180349,"the",1180477],[1180501,"US",1180997],[1181141,"and",1181469],[1181517,"to",1181701],[1181733,"make",1182021],[1182093,"kidney",1182453],[1182509,"management",1182797],[1182861,"an",1183061],[1183093,"option",1183365],[1183405,"for",1183629],[1183677,"patients?",1184305],[1184685,"And",1185141],[1185213,"I",1185445],[1185485,"apologize",1185877],[1185901,"if",1185989],[1185997,"I'm",1186181],[1186213,"driving",1186909],[1187077,"the",1187405],[1187445,"conversation",1188069],[1188157,"to",1188597],[1188701,"this",1189157],[1189261,"Annals",1189677],[1189741,"paper,",1190013],[1190069,"but",1190665],[1192285,"what",1192573],[1192589,"I",1192813],[1192869,"really",1193109],[1193157,"liked",1193477],[1193501,"about",1193661],[1193693,"this",1193861],[1193893,"paper.",1194133],[1194189,"So",1194785],[1195445,"we've",1195837],[1195861,"been",1196021],[1196053,"talking",1196285],[1196325,"about",1196549],[1196597,"for",1196733],[1196749,"some.",1196949],[1196997,"Or",1197205],[1197245,"I've",1197501],[1197533,"been",1197677],[1197701,"talking",1197877],[1197901,"about",1198061],[1198093,"it",1198213],[1198229,"for",1198357],[1198381,"some",1198493],[1198509,"time,",1198685],[1198725,"like,",1198925],[1198965,"look",1199069],[1199077,"at",1199173],[1199189,"what",1199317],[1199341,"they're",1199589],[1199637,"doing",1199989],[1200077,"around",1200301],[1200333,"the",1200501],[1200533,"world,",1200773],[1200829,"this",1200997],[1201021,"conservative",1201397],[1201421,"kidney",1201749],[1201797,"management.",1202437],[1202621,"We",1202893],[1202909,"should",1203085],[1203125,"really",1203277],[1203301,"look",1203461],[1203493,"into",1203661],[1203693,"it.",1204161],[1204293,"And",1204537],[1204561,"there's",1204809],[1204857,"always",1205329],[1205457,"these.",1206125],[1206465,"There's",1206841],[1206873,"a",1206969],[1206977,"lot",1207073],[1207089,"of",1207241],[1207273,"skeptics",1207713],[1207769,"out",1207913],[1207929,"there.",1208153],[1208209,"They",1208401],[1208433,"say,",1208601],[1208633,"well,",1208849],[1208897,"you",1209009],[1209017,"know,",1209137],[1209161,"it",1209225],[1209225,"was",1209385],[1209425,"done",1209601],[1209633,"in",1209777],[1209801,"another",1210177],[1210281,"country.",1210617],[1210681,"Is",1210833],[1210849,"it",1211049],[1211097,"generalizable",1211793],[1211849,"to",1211993],[1212009,"the",1212137],[1212161,"U.S.",1212753],[1212929,"they",1213241],[1213273,"have",1213465],[1213505,"dedicated",1214025],[1214105,"programs",1214585],[1214625,"that",1214753],[1214769,"have",1214897],[1214921,"been",1215057],[1215081,"in",1215241],[1215273,"existence",1215713],[1215769,"for",1215937],[1215961,"a",1216073],[1216089,"couple",1216289],[1216337,"of",1216545],[1216585,"decades.",1217321],[1217473,"We",1217761],[1217793,"don't",1218009],[1218057,"have",1218241],[1218273,"that",1218489],[1218537,"here.",1219177],[1219361,"You",1219633],[1219649,"know,",1219993],[1220089,"can",1220297],[1220321,"we.",1220601],[1220673,"You",1220833],[1220849,"know,",1221025],[1221065,"none",1221193],[1221209,"of",1221313],[1221329,"these",1221505],[1221545,"studies",1221785],[1221825,"are",1221953],[1221969,"random.",1222529],[1222657,"None",1222889],[1222897,"of",1222993],[1223009,"the",1223137],[1223161,"studies",1223409],[1223457,"are",1223617],[1223641,"randomized.",1224281],[1224353,"They're",1224577],[1224601,"all",1224809],[1224857,"observational",1225513],[1225609,"studies.",1226285],[1226625,"You",1226913],[1226929,"know,",1227485],[1228265,"how",1228721],[1228793,"trustworthy",1229681],[1229793,"is",1230065],[1230105,"this",1230353],[1230409,"data?",1230937],[1231081,"And",1231433],[1231489,"so,",1231873],[1231969,"you",1232129],[1232137,"know,",1232281],[1232313,"Manju",1232713],[1232729,"and",1232809],[1232817,"Maria's",1233305],[1233345,"paper,",1233977],[1234161,"it",1234481],[1234513,"really",1235107],[1235281,"addresses",1235983],[1236039,"many",1236231],[1236263,"of",1236383],[1236399,"the",1236551],[1236583,"points",1236751],[1236783,"of",1236951],[1236983,"skepticism",1237951],[1238143,"that",1238519],[1238567,"people",1238871],[1238943,"have",1239555],[1240015,"about",1240423],[1240479,"all",1240647],[1240671,"of",1240783],[1240799,"the",1240951],[1240983,"data",1241175],[1241215,"that's",1241471],[1241503,"been",1241671],[1241703,"published",1241959],[1242007,"in",1242167],[1242191,"other",1242423],[1242479,"countries.",1242815],[1242895,"Well,",1243183],[1243239,"let's",1243447],[1243471,"get",1243631],[1243663,"to",1243807],[1243831,"that",1244039],[1244087,"then.",1244391],[1244463,"Let's",1244647],[1244671,"get",1244831],[1244863,"to",1245435],[1245895,"Maria",1246455],[1246535,"first",1246847],[1246911,"author",1247207],[1247271,"Anil's",1247791],[1247823,"paper.",1248255],[1248375,"I",1248703],[1248759,"absolutely",1249151],[1249183,"love",1249351],[1249383,"this",1249575],[1249615,"paper,",1250031],[1250143,"got",1250391],[1250423,"a",1250543],[1250559,"lot",1250711],[1250743,"to",1250959],[1251007,"talk",1251215],[1251255,"about",1251575],[1251655,"because",1252275],[1252655,"it",1252943],[1252959,"has",1253159],[1253207,"this",1253487],[1253551,"interesting",1254287],[1254431,"study",1254831],[1254903,"design.",1255471],[1255623,"But",1255887],[1255911,"before",1256119],[1256167,"we",1256375],[1256415,"do,",1256855],[1256975,"what",1257231],[1257263,"got",1257431],[1257463,"you",1257727],[1257791,"interested",1258191],[1258223,"in",1258535],[1258615,"doing",1258951],[1259023,"this",1259423],[1259519,"particular",1259919],[1260007,"paper?",1260635],[1261145,"Again,",1261481],[1261513,"it's",1261745],[1261785,"very",1262033],[1262089,"interesting",1262473],[1262529,"because",1262817],[1262881,"it",1263105],[1263145,"came",1263725],[1264105,"working",1264441],[1264473,"with",1264641],[1264673,"Manju.",1265273],[1265329,"So",1265925],[1266385,"I've",1266753],[1266769,"been",1266921],[1266953,"at",1267121],[1267153,"the",1267393],[1267449,"Division",1267785],[1267825,"of",1268001],[1268033,"Nephrology",1268689],[1268737,"for",1268921],[1268953,"a",1269073],[1269089,"few",1269289],[1269337,"years",1269713],[1269809,"now.",1270185],[1270265,"And",1270505],[1270545,"so",1270937],[1271041,"I'm",1271385],[1271425,"getting",1271673],[1271729,"deeper",1272041],[1272073,"and",1272217],[1272241,"deeper",1272545],[1272585,"into",1273193],[1273369,"pretending",1274001],[1274033,"to",1274153],[1274169,"be",1274273],[1274289,"a",1274369],[1274377,"nephrologist,",1275257],[1275361,"even",1275577],[1275601,"though",1275761],[1275793,"I'm",1276041],[1276073,"a",1276217],[1276241,"statistician.",1277285],[1278385,"But",1278721],[1278753,"I",1278897],[1278921,"do",1279129],[1279177,"like",1279409],[1279457,"to",1279713],[1279769,"dive",1280145],[1280185,"into",1280577],[1280681,"the",1280945],[1280985,"science",1281409],[1281497,"and",1281769],[1281817,"learn",1282249],[1282337,"and",1282801],[1282913,"understand.",1283565],[1285105,"And",1285393],[1285409,"I",1285513],[1285529,"want",1285657],[1285681,"to",1285889],[1285937,"understand",1286265],[1286345,"not",1286561],[1286593,"only",1286809],[1286857,"from",1287065],[1287105,"the",1287305],[1287345,"point",1287521],[1287553,"of",1287697],[1287721,"view",1288049],[1288137,"of",1288529],[1288617,"the",1288889],[1288937,"doctors",1289401],[1289473,"that",1289681],[1289713,"I",1289929],[1289977,"work",1290209],[1290257,"with,",1290873],[1291049,"but",1291385],[1291425,"also",1292005],[1292305,"the",1292689],[1292737,"patients",1293273],[1293369,"that",1293697],[1293761,"ultimately",1294565],[1295185,"we",1295545],[1295585,"can",1296145],[1296305,"provide",1296745],[1296825,"some",1297113],[1297169,"help.",1297769],[1297937,"And",1298577],[1298721,"even",1298977],[1299001,"though",1299161],[1299193,"I'm",1299449],[1299497,"not",1299921],[1300033,"a",1300329],[1300377,"medical",1300753],[1300849,"doctor,",1301645],[1302185,"I",1302497],[1302521,"feel",1302705],[1302745,"like",1303161],[1303273,"I",1303497],[1303521,"can",1303729],[1303777,"help",1304201],[1304313,"in",1304537],[1304561,"a",1304697],[1304721,"way",1305289],[1305457,"if",1305785],[1305825,"I",1306025],[1306065,"can",1306457],[1306561,"show",1307205],[1307505,"with",1307985],[1308065,"data,",1308401],[1308473,"with",1308729],[1308777,"statistics,",1309721],[1309873,"some",1310137],[1310161,"of",1310321],[1310353,"these",1310569],[1310617,"things",1310849],[1310897,"that",1311081],[1311113,"are",1311353],[1311409,"questionable",1312325],[1312625,"to",1312961],[1312993,"confirm.",1313805],[1314825,"And",1315161],[1315193,"this",1315361],[1315393,"idea,",1315729],[1315777,"like,",1315985],[1316025,"so",1316201],[1316233,"far,",1316473],[1316529,"this",1316769],[1316817,"paper",1317097],[1317161,"of",1317409],[1317457,"combining",1318129],[1318217,"survival",1319057],[1319241,"and",1319849],[1319977,"home",1320385],[1320465,"time",1321065],[1321225,"actually",1321641],[1321713,"came",1321969],[1322017,"from",1322605],[1323025,"personal",1323553],[1323649,"experience",1324145],[1324265,"with",1324545],[1324585,"my",1324785],[1324825,"dad,",1325405],[1326065,"not",1326737],[1326881,"because",1327209],[1327257,"of",1327465],[1327505,"dialysis,",1328353],[1328449,"but",1328921],[1329033,"his",1329377],[1329441,"surgeon",1330297],[1330481,"wanted",1330921],[1330953,"to",1331121],[1331153,"do",1331273],[1331289,"an",1331417],[1331441,"amputation.",1332365],[1332745,"And",1333513],[1333689,"my",1334073],[1334129,"dad",1334585],[1334665,"was",1334977],[1335041,"really",1335505],[1335625,"afraid",1336297],[1336401,"of",1336665],[1336705,"that",1336977],[1337041,"and",1337265],[1337305,"not",1337529],[1337577,"wanting",1337905],[1337945,"to",1338097],[1338121,"do",1338233],[1338249,"it.",1338805],[1339505,"And",1340245],[1340625,"I",1340937],[1340961,"went",1341121],[1341153,"into",1341345],[1341385,"the",1341561],[1341593,"literature",1342065],[1342145,"and",1342337],[1342361,"I",1342497],[1342521,"couldn't",1342873],[1342929,"find",1343313],[1343409,"anything",1344017],[1344121,"that",1344433],[1344489,"explained",1345441],[1345633,"really",1346105],[1346185,"what",1346569],[1346657,"happens.",1347257],[1347361,"All",1347601],[1347633,"of",1347753],[1347769,"the",1347945],[1347985,"papers",1348473],[1348529,"are",1348793],[1348849,"always",1349209],[1349297,"about",1349713],[1349809,"survival.",1350605],[1351305,"And",1351929],[1352057,"in",1352321],[1352353,"the",1352497],[1352521,"case",1352705],[1352745,"of.",1352897],[1352921,"My",1353105],[1353145,"dad",1353369],[1353417,"was",1353649],[1353697,"like,",1353881],[1353913,"he",1354105],[1354145,"really.",1354741],[1354913,"He",1355293],[1355349,"hated",1355709],[1355757,"being",1355965],[1356005,"in",1356133],[1356149,"the",1356325],[1356365,"hospital,",1356637],[1356701,"but",1356853],[1356869,"he",1356949],[1356957,"was",1357173],[1357229,"getting",1357541],[1357613,"all",1357797],[1357821,"of",1357981],[1358013,"these",1358205],[1358245,"infections",1359245],[1359405,"that",1359701],[1359733,"basically",1359989],[1360037,"were",1360197],[1360221,"putting",1360485],[1360525,"him",1360725],[1360765,"in",1360893],[1360909,"the",1361085],[1361125,"hospital",1361541],[1361653,"all",1361877],[1361901,"the",1362037],[1362061,"time.",1362341],[1362413,"It",1362621],[1362653,"started",1362917],[1362981,"like",1363301],[1363373,"every",1363653],[1363709,"month,",1364045],[1364125,"and",1364293],[1364309,"then,",1364533],[1364589,"like,",1364925],[1365005,"was.",1365509],[1365637,"He",1365877],[1365901,"would",1366085],[1366125,"go",1366325],[1366365,"home,",1366757],[1366861,"and",1367077],[1367101,"then",1367357],[1367421,"three",1367645],[1367685,"weeks",1367861],[1367893,"later",1368109],[1368157,"he",1368293],[1368309,"would",1368437],[1368461,"be",1368597],[1368621,"back",1368781],[1368813,"in",1368933],[1368949,"the",1369149],[1369197,"hospital.",1369525],[1369605,"And",1369749],[1369757,"then",1370305],[1371245,"this",1371557],[1371581,"kept",1371757],[1371781,"on",1371941],[1371973,"going",1372213],[1372269,"back",1372437],[1372461,"and",1372621],[1372653,"forth.",1372909],[1372957,"And",1373117],[1373141,"then,",1373541],[1373653,"like",1373877],[1373901,"I",1374013],[1374029,"said,",1374205],[1374245,"like,",1374397],[1374421,"okay,",1374597],[1374621,"is",1374733],[1374749,"there",1374997],[1375061,"anything",1375389],[1375437,"that",1375645],[1375685,"actually",1376197],[1376341,"can",1376645],[1376685,"tell",1376861],[1376893,"me",1377085],[1377125,"whether",1377757],[1377941,"it's",1378373],[1378429,"going",1378573],[1378589,"to",1378693],[1378709,"be",1378861],[1378893,"beneficial",1379429],[1379477,"in",1379661],[1379693,"terms",1379861],[1379893,"of",1380133],[1380189,"home",1380453],[1380509,"time,",1380773],[1380829,"the",1381021],[1381053,"time",1381221],[1381253,"that",1381421],[1381453,"he's",1381765],[1381805,"going",1381933],[1381949,"to",1382053],[1382069,"be",1382197],[1382221,"spending",1382485],[1382525,"at",1382701],[1382733,"home,",1382973],[1383029,"which",1383173],[1383189,"is",1383317],[1383341,"what",1383525],[1383565,"he",1383765],[1383805,"really",1384053],[1384109,"wants.",1384785],[1385195,"And",1385483],[1385499,"then",1385675],[1385715,"from",1385915],[1385955,"there,",1386203],[1386259,"that's",1386491],[1386523,"when",1386907],[1387011,"talking",1387331],[1387363,"with",1387555],[1387595,"Manju",1388091],[1388123,"and",1388723],[1388899,"the",1389187],[1389211,"other",1389443],[1389499,"doctors",1389819],[1389867,"that",1390027],[1390051,"I",1390211],[1390243,"work",1390435],[1390475,"with,",1390795],[1390875,"then",1391427],[1391571,"we",1391851],[1391883,"said,",1392051],[1392083,"why",1392203],[1392219,"don't",1392467],[1392491,"we",1392651],[1392683,"do",1392827],[1392851,"this?",1393415],[1393995,"In",1394379],[1394427,"particular,",1394851],[1394963,"looking",1395259],[1395307,"at",1395587],[1395651,"dialysis",1396411],[1396483,"patients",1397135],[1397755,"versus",1398627],[1398811,"those",1399131],[1399163,"who",1399235],[1399235,"are",1399347],[1399371,"getting",1399531],[1399563,"dialysis",1399971],[1400003,"versus",1400331],[1400403,"those",1400587],[1400611,"who",1400699],[1400707,"are",1400803],[1400819,"getting",1400995],[1401035,"conservative",1401491],[1401563,"management,",1402175],[1402515,"how",1402827],[1402851,"much",1403203],[1403299,"time",1403935],[1404275,"are",1404587],[1404611,"they",1404771],[1404803,"spending",1405235],[1405315,"alive,",1406175],[1406595,"and",1407243],[1407379,"not",1407651],[1407683,"just",1407875],[1407915,"alive,",1408331],[1408403,"but",1408587],[1408611,"also",1409083],[1409219,"just",1409683],[1409779,"those",1410035],[1410075,"days",1410251],[1410283,"that",1410403],[1410419,"they're",1410603],[1410619,"doing",1410795],[1410835,"dialysis",1411291],[1411323,"to,",1411539],[1411587,"like",1411771],[1411803,"the.",1412265],[1412395,"But",1413093],[1413269,"the",1413629],[1413677,"institutionalized",1414717],[1414781,"days,",1415269],[1415397,"if",1415589],[1415597,"you",1415717],[1415741,"will.",1415949],[1415997,"Yeah,",1416437],[1416541,"exactly.",1417373],[1417509,"We",1417781],[1417813,"knew,",1418093],[1418149,"because",1418413],[1418469,"I",1418613],[1418629,"don't",1418733],[1418749,"know",1418853],[1418869,"if",1419021],[1419053,"you",1419365],[1419445,"noticed,",1419861],[1419893,"we",1420061],[1420093,"have",1420717],[1420901,"a",1421221],[1421253,"paper",1421941],[1422133,"that",1422917],[1423101,"also,",1423565],[1423645,"I'm",1423965],[1424005,"first",1424205],[1424245,"off",1424493],[1424549,"with,",1424933],[1425029,"where",1425309],[1425357,"we",1425589],[1425637,"actually",1425917],[1425981,"look",1426181],[1426213,"at",1426333],[1426349,"what",1426573],[1426629,"happens",1426901],[1426933,"on",1427125],[1427165,"patients",1427429],[1427477,"on",1427661],[1427693,"dialysis",1428357],[1428421,"in",1428573],[1428589,"the",1428765],[1428805,"year",1429101],[1429173,"after",1429501],[1429573,"they",1429781],[1429813,"start",1430029],[1430077,"dialysis",1431045],[1431205,"and",1431501],[1431533,"a",1431629],[1431637,"little",1431805],[1431845,"bit",1432045],[1432085,"before.",1432429],[1432517,"And",1432789],[1432837,"we",1433045],[1433085,"have",1433309],[1433357,"these.",1433945],[1434605,"I'm",1434933],[1434949,"a",1435053],[1435069,"visual",1435397],[1435461,"person.",1435781],[1435853,"So",1436421],[1436573,"we",1436885],[1436925,"created",1437301],[1437333,"these",1437573],[1437629,"heat",1437909],[1437957,"maps",1438405],[1438485,"where",1438677],[1438701,"you",1438861],[1438893,"could",1439133],[1439189,"see",1439429],[1439477,"for",1439685],[1439725,"each",1439973],[1440029,"individual",1440709],[1440797,"what",1441117],[1441181,"actually",1441573],[1441669,"happened",1442037],[1442061,"in",1442197],[1442221,"the",1442381],[1442413,"days",1443013],[1443189,"and",1443429],[1443437,"you.",1443647],[1443701,"And",1443915],[1443955,"see",1444395],[1444515,"how",1444723],[1444739,"much",1444939],[1444987,"time",1445243],[1445299,"they",1445923],[1446099,"were",1446435],[1446475,"alive,",1446987],[1447091,"how",1447307],[1447331,"much",1447611],[1447683,"time",1448083],[1448179,"they",1448435],[1448475,"spent",1448755],[1448795,"in",1448923],[1448939,"the",1449115],[1449155,"hospital,",1449451],[1449523,"in",1449683],[1449699,"the",1449875],[1449915,"nursing",1450283],[1450339,"home",1450963],[1451139,"and",1451907],[1452091,"when",1452387],[1452411,"you",1452571],[1452603,"start",1452819],[1452867,"dialysis.",1453755],[1453875,"So",1454131],[1454163,"we",1454355],[1454395,"had",1454811],[1454923,"yellow",1455515],[1455595,"was",1456267],[1456451,"time",1456843],[1456899,"spent",1457371],[1457443,"in",1457651],[1457683,"a",1458139],[1458267,"hospital",1458771],[1458883,"or",1459535],[1459875,"in",1460211],[1460243,"the",1460507],[1460571,"nursing",1460939],[1460987,"home.",1461267],[1461331,"And",1461935],[1463315,"just",1463675],[1463715,"the",1463867],[1463891,"amount",1464099],[1464147,"of",1464355],[1464395,"time",1464595],[1464635,"that",1464811],[1464843,"these",1465059],[1465107,"patients",1465403],[1465459,"are",1465699],[1465747,"spending",1466275],[1466355,"in",1466571],[1466603,"an",1466747],[1466771,"institution",1467331],[1467403,"was",1467683],[1467739,"just",1468219],[1468347,"crazy",1468859],[1468907,"for",1469115],[1469155,"me.",1469735],[1470315,"But",1470603],[1470619,"then",1470771],[1470803,"there",1470923],[1470939,"was",1471091],[1471123,"always",1471339],[1471387,"the",1471571],[1471603,"question,",1471915],[1471995,"but,",1472403],[1472499,"okay,",1473259],[1473427,"what",1473779],[1473827,"happens",1474203],[1474259,"if",1474427],[1474451,"you",1474611],[1474643,"are",1474931],[1475003,"not",1475523],[1475659,"on",1475931],[1475963,"dialysis?",1477055],[1477995,"And",1478355],[1478395,"so",1478595],[1478635,"this",1478931],[1479003,"really",1479259],[1479307,"led",1479563],[1479619,"to",1479835],[1479875,"then",1480339],[1480467,"us",1480875],[1480955,"working",1481243],[1481299,"more",1481467],[1481491,"on",1481651],[1481683,"this",1481899],[1481947,"paper",1482179],[1482227,"and",1482387],[1482411,"trying",1482571],[1482603,"to",1482723],[1482739,"figure",1482931],[1482963,"that",1483107],[1483131,"out.",1483387],[1483451,"I",1483627],[1483651,"haven't",1483939],[1483987,"recreated",1484659],[1484707,"those",1485107],[1485211,"heat",1485531],[1485563,"maps,",1485947],[1486011,"which",1486187],[1486211,"I",1486347],[1486371,"still",1486579],[1486627,"hope",1486859],[1486907,"I",1487067],[1487091,"will",1487275],[1487315,"be",1487443],[1487459,"able",1487635],[1487675,"to",1487875],[1487915,"do.",1488571],[1488763,"But",1489379],[1489507,"at",1489747],[1489771,"least",1489955],[1489995,"we",1490147],[1490171,"were",1490355],[1490395,"able",1490571],[1490603,"to",1490795],[1490835,"put",1491083],[1491139,"the",1491451],[1491523,"statistics",1492083],[1492139,"together",1492427],[1492491,"and",1492691],[1492723,"really",1492963],[1493019,"compare",1493827],[1494011,"a",1494379],[1494427,"survival",1494899],[1494987,"and",1495235],[1495275,"home",1495547],[1495611,"time",1495883],[1495939,"in",1496107],[1496131,"this",1496435],[1496515,"Annals",1496979],[1497067,"paper.",1497771],[1497963,"Okay,",1498403],[1498459,"but",1498699],[1498747,"we're",1498907],[1498931,"going",1498995],[1498995,"to",1499059],[1499067,"do",1499163],[1499179,"a",1499307],[1499331,"little",1499467],[1499491,"bit",1499747],[1499811,"different",1500011],[1500043,"than",1500451],[1500563,"your",1500883],[1500939,"usual",1501459],[1501547,"like",1501771],[1501803,"journal",1502043],[1502099,"club.",1502315],[1502355,"We're",1502483],[1502499,"going",1502603],[1502619,"to",1502723],[1502739,"jump",1502891],[1502923,"to",1503091],[1503123,"results",1503555],[1503675,"and",1503883],[1503899,"then",1504003],[1504019,"I'm",1504187],[1504211,"going",1504299],[1504307,"to",1504403],[1504419,"go",1504547],[1504571,"back",1504707],[1504731,"to",1504891],[1504923,"methods.",1505635],[1505755,"What",1506107],[1506171,"did",1506395],[1506435,"you",1506707],[1506771,"find",1507375],[1508035,"in",1508371],[1508403,"this",1508619],[1508667,"Annals",1509051],[1509123,"paper?",1509739],[1509907,"Mendu,",1510515],[1510555,"why",1510707],[1510731,"don't",1510867],[1510891,"you",1511075],[1511115,"go?",1511483],[1511579,"You'll",1511963],[1512019,"do",1512163],[1512179,"a",1512283],[1512299,"better",1512499],[1512547,"job",1512779],[1512827,"than",1512987],[1513011,"me.",1513339],[1513427,"Yeah,",1514095],[1514715,"I",1515027],[1515051,"have",1515211],[1515243,"the",1515435],[1515475,"paper",1515795],[1515875,"here,",1516259],[1516347,"so",1516595],[1516635,"I'm",1516811],[1516843,"going",1516987],[1517011,"to",1517147],[1517171,"just",1517355],[1517395,"refer,",1517787],[1517851,"I'm",1518003],[1518019,"going",1518123],[1518139,"to",1518267],[1518291,"cheat",1518555],[1518595,"and",1518771],[1518803,"refer",1519059],[1519107,"back",1519243],[1519259,"to",1519435],[1519475,"it.",1520055],[1520795,"What",1521179],[1521227,"we",1521507],[1521571,"found",1521891],[1521963,"when",1522603],[1522779,"we",1523091],[1523123,"did",1523315],[1523355,"two",1523555],[1523595,"different",1523819],[1523867,"analyses",1524387],[1524451,"and",1524699],[1524747,"intention",1525171],[1525243,"to",1525451],[1525483,"treat",1525771],[1525843,"analysis",1526443],[1526499,"and",1526643],[1526659,"a",1526787],[1526811,"per",1527019],[1527067,"protocol",1527611],[1527683,"analysis.",1528535],[1528915,"In",1529227],[1529251,"the",1529435],[1529475,"intention",1529779],[1529827,"to",1529987],[1530011,"treat",1530219],[1530267,"analysis,",1530739],[1530787,"we're",1531083],[1531139,"comparing",1531627],[1531691,"people",1531963],[1532019,"who",1532355],[1532435,"started",1533125],[1533315,"dialysis",1534097],[1534161,"within",1534433],[1534489,"30",1534753],[1534809,"days",1535025],[1535065,"of",1535313],[1535369,"meeting",1535681],[1535753,"the",1536009],[1536057,"eligibility",1536729],[1536857,"criteria",1537465],[1537505,"for",1537681],[1537713,"this",1537905],[1537945,"hypothetical",1538577],[1538641,"trial",1539145],[1539265,"to",1539593],[1539649,"everyone",1539937],[1540001,"else.",1540537],[1540681,"So",1540985],[1541025,"that",1541201],[1541233,"includes",1541785],[1541865,"patients",1542233],[1542289,"who",1542505],[1542545,"did",1542745],[1542785,"later",1543057],[1543121,"go",1543273],[1543289,"on",1543441],[1543473,"to",1543617],[1543641,"start",1543825],[1543865,"dialysis",1544409],[1544457,"and",1544617],[1544641,"some",1544825],[1544865,"who",1545041],[1545073,"never",1545313],[1545369,"started",1545633],[1545689,"dialysis.",1546565],[1547345,"And",1547705],[1547745,"eligibility",1548185],[1548265,"was",1548721],[1548833,"older",1549177],[1549201,"than",1549433],[1549489,"65",1549955],[1550059,"and",1550474],[1550578,"a",1550993],[1551097,"GFR",1551512],[1551616,"less",1552031],[1552135,"than",1552550],[1552654,"12.",1553121],[1553233,"GFR.",1554045],[1554625,"That's",1554937],[1554961,"right.",1555145],[1555185,"Chronic",1555401],[1555433,"kidney",1555705],[1555745,"disease",1555985],[1556025,"and",1556153],[1556169,"a",1556249],[1556257,"GFR",1556601],[1556633,"less",1556825],[1556865,"than",1557017],[1557041,"12",1557513],[1557649,"and",1557969],[1558017,"people",1558297],[1558361,"who",1558729],[1558817,"had",1559017],[1559041,"not",1559201],[1559233,"been",1559401],[1559433,"referred",1559737],[1559761,"for",1559897],[1559921,"a",1560081],[1560113,"transplant",1560489],[1560537,"evaluation.",1561145],[1561265,"So",1561785],[1561905,"selecting",1562449],[1562497,"people",1562801],[1562873,"who",1563105],[1563145,"were",1563513],[1563609,"probably",1563961],[1564033,"not.",1564409],[1564497,"Eligible",1564929],[1564977,"for",1565137],[1565161,"a",1565321],[1565353,"transplant,",1566121],[1566273,"not",1566609],[1566657,"acute",1566969],[1567017,"kidney",1567329],[1567377,"injury.",1567737],[1567801,"These",1567929],[1567937,"are",1568057],[1568081,"people",1568217],[1568241,"with",1568425],[1568465,"chronic",1568657],[1568681,"kidney",1568841],[1568873,"and",1569017],[1569041,"that's",1569193],[1569209,"right.",1569409],[1569457,"Took",1569617],[1569641,"out",1569825],[1569865,"people",1570065],[1570105,"with",1570281],[1570313,"acute",1570561],[1570593,"kidney",1570865],[1570905,"injury.",1571545],[1571705,"And",1572241],[1572353,"so",1572649],[1572697,"in",1572905],[1572945,"that",1573217],[1573281,"comparison,",1574177],[1574361,"the",1574681],[1574713,"patients",1575009],[1575057,"who",1575265],[1575305,"started",1575553],[1575609,"dialysis",1576481],[1576593,"had",1577177],[1577321,"longer",1577809],[1577857,"survival",1578353],[1578449,"by",1578801],[1578873,"nine",1579177],[1579241,"days",1579825],[1579985,"but",1580305],[1580345,"spent",1580809],[1580897,"two",1581361],[1581473,"weeks",1581841],[1581913,"fewer",1582497],[1582601,"at",1582913],[1582969,"home.",1583565],[1583865,"Nine",1584273],[1584329,"days,",1585001],[1585193,"Nine",1585617],[1585681,"days.",1586285],[1588275,"That",1588539],[1588547,"wasn't",1588771],[1588803,"statistic.",1589495],[1590115,"Actually",1590499],[1590547,"nine",1590707],[1590731,"days.",1590867],[1590891,"Out",1590979],[1590987,"of",1591155],[1591195,"how",1591323],[1591339,"many",1591539],[1591587,"days,",1591915],[1591995,"like",1592211],[1592243,"how",1592339],[1592347,"long",1592467],[1592491,"did",1592579],[1592587,"they",1592659],[1592667,"spend?",1592835],[1592875,"Over",1593099],[1593147,"three",1593331],[1593363,"years.",1593603],[1593659,"Thank",1593803],[1593819,"you",1593923],[1593939,"for",1594091],[1594123,"reminding",1594403],[1594419,"me.",1594667],[1594731,"So",1594955],[1594995,"over",1595243],[1595299,"three",1595491],[1595523,"years",1595715],[1595755,"of",1595907],[1595931,"follow",1596067],[1596091,"up,",1596323],[1596379,"they",1596547],[1596571,"spent",1596843],[1596899,"nine",1597187],[1597251,"additional.",1597875],[1597995,"They",1598275],[1598315,"lived",1598571],[1598603,"longer",1598915],[1598955,"by",1599131],[1599163,"nine",1599403],[1599459,"additional",1599843],[1599899,"days",1600427],[1600571,"but",1600875],[1600915,"spent",1601195],[1601235,"two",1601435],[1601475,"weeks",1601795],[1601875,"less",1602163],[1602219,"at",1602387],[1602411,"home.",1602975],[1603595,"Then",1603955],[1603995,"we",1604195],[1604235,"did",1604459],[1604507,"what",1604715],[1604755,"we",1604955],[1604995,"called",1605315],[1605395,"the",1605635],[1605675,"per",1605899],[1605947,"protocol",1606483],[1606539,"analysis",1607123],[1607179,"which",1607347],[1607371,"is",1607627],[1607691,"comparing",1608339],[1608427,"people",1608723],[1608779,"who",1609091],[1609163,"started",1609443],[1609499,"dialysis",1610147],[1610211,"within",1610507],[1610571,"30",1610819],[1610867,"days",1611075],[1611115,"of",1611291],[1611323,"meeting",1611587],[1611651,"eligibility",1612535],[1613065,"to",1613449],[1613497,"those",1613849],[1613937,"who",1614353],[1614449,"never",1614825],[1614905,"started",1615193],[1615249,"dialysis.",1616129],[1616257,"Oh,",1616521],[1616553,"because",1616697],[1616721,"the",1616833],[1616849,"other",1617025],[1617065,"group",1617385],[1617465,"actually",1617729],[1617777,"could",1617985],[1618025,"have",1618201],[1618233,"started",1618425],[1618465,"dialysis",1619057],[1619121,"after",1619417],[1619481,"30",1619878],[1619966,"days",1620319],[1620407,"in",1620760],[1620849,"3",1621202],[1621290,"year,",1621643],[1621731,"9",1622129],[1622177,"day",1622385],[1622425,"difference",1622665],[1622705,"group.",1622977],[1623041,"Okay,",1623449],[1623537,"that's",1623713],[1623729,"right.",1623929],[1623977,"So",1624137],[1624161,"in",1624345],[1624385,"this",1624633],[1624689,"comparison,",1625489],[1625657,"not",1626009],[1626057,"necessarily",1626753],[1626809,"that",1627001],[1627033,"they",1627177],[1627201,"did",1627385],[1627425,"not",1627649],[1627697,"start",1627905],[1627945,"dialysis,",1628721],[1628793,"but",1629001],[1629033,"that",1629249],[1629297,"we",1629529],[1629577,"only",1629857],[1629921,"follow",1630265],[1630345,"them",1630705],[1630785,"when",1631313],[1631449,"they",1631793],[1631849,"are",1632113],[1632169,"on",1632385],[1632425,"dialysis",1633445],[1633745,"or",1634129],[1634177,"they",1634409],[1634457,"haven't",1634809],[1634857,"started",1635089],[1635137,"dialysis",1635777],[1635841,"yet.",1636445],[1636825,"Right.",1637257],[1637321,"So",1637545],[1637585,"it's",1637881],[1637953,"the",1638185],[1638225,"comparison.",1638705],[1638785,"There's",1639105],[1639145,"no",1639345],[1639385,"mixing",1640017],[1640121,"like",1640361],[1640393,"in",1640537],[1640561,"the",1640769],[1640817,"intention",1641169],[1641217,"to",1641401],[1641433,"treat",1641673],[1641729,"analysis.",1642755],[1642945,"Yeah.",1643511],[1643623,"If",1643895],[1643935,"they",1644111],[1644143,"don't",1644311],[1644343,"start",1644535],[1644575,"dialysis",1645175],[1645215,"at",1645367],[1645391,"the",1645527],[1645551,"beginning",1645831],[1645863,"of",1646031],[1646063,"the",1646255],[1646295,"trial,",1646879],[1647007,"we",1647295],[1647335,"follow",1647631],[1647703,"them",1647983],[1648039,"as",1648231],[1648263,"if",1648647],[1648751,"they",1648991],[1649023,"never",1649503],[1649639,"dialysis.",1650367],[1650431,"It's",1650607],[1650631,"just",1650839],[1650887,"like,",1651095],[1651135,"okay,",1651607],[1651711,"but",1651903],[1651919,"they",1652119],[1652167,"could",1652351],[1652383,"have.",1652671],[1652743,"They",1652927],[1652951,"could",1653087],[1653111,"have,",1653751],[1653943,"but",1654223],[1654239,"they're,",1654551],[1654623,"they're.",1654887],[1654911,"Now",1655335],[1655455,"the",1655687],[1655711,"analysis",1656319],[1656407,"is",1656655],[1656695,"saying",1657015],[1657095,"that",1657743],[1657919,"we",1658207],[1658231,"are,",1658559],[1658647,"this",1658823],[1658839,"is",1658943],[1658959,"our",1659159],[1659207,"intention,",1659543],[1659599,"that",1659743],[1659759,"they",1659863],[1659879,"were",1660031],[1660063,"not",1660207],[1660231,"going",1660319],[1660327,"to",1660399],[1660407,"do",1660479],[1660487,"it,",1660583],[1660599,"but",1660703],[1660719,"they",1660823],[1660839,"could",1660943],[1660959,"have",1661111],[1661143,"just",1661287],[1661311,"like",1661447],[1661471,"any",1661607],[1661631,"other",1661767],[1661791,"randomized",1662223],[1662279,"controlled",1662543],[1662559,"trial.",1662967],[1663071,"Exactly,",1663895],[1664015,"exactly,",1664607],[1664671,"exactly.",1665159],[1665247,"But",1665471],[1665503,"I",1665599],[1665607,"mean,",1665751],[1665783,"the",1665975],[1666015,"per",1666287],[1666351,"protocol,",1667303],[1667479,"right.",1668195],[1668545,"The",1668929],[1668977,"control",1669329],[1669417,"group",1669785],[1669865,"now",1670153],[1670209,"is",1670473],[1670529,"one",1670985],[1671105,"where",1671673],[1671809,"we",1672153],[1672209,"really",1672449],[1672497,"only",1672753],[1672809,"look",1673265],[1673385,"at",1673641],[1673673,"the",1673889],[1673937,"time",1674289],[1674377,"when",1674673],[1674729,"they",1674921],[1674953,"were",1675169],[1675217,"still",1675569],[1675657,"on",1676025],[1676105,"medical",1676537],[1676641,"management.",1677285],[1677865,"And",1678369],[1678457,"if",1678777],[1678841,"they",1679113],[1679169,"initiate",1679593],[1679649,"dialysis",1680425],[1680505,"afterwards,",1681153],[1681249,"that",1681577],[1681641,"time",1681889],[1681937,"is",1682169],[1682217,"not",1682473],[1682529,"included",1682985],[1683025,"in",1683153],[1683169,"the",1683321],[1683353,"analysis.",1684233],[1684409,"What",1684673],[1684689,"did",1684793],[1684809,"you",1684937],[1684961,"find?",1685361],[1685473,"Go",1685649],[1685657,"ahead,",1685753],[1685769,"Alex.",1686113],[1686169,"Just",1686601],[1686713,"to",1686961],[1686993,"clarify",1687425],[1687465,"for",1687617],[1687641,"our",1687753],[1687769,"listeners,",1688105],[1688145,"just",1688273],[1688289,"want",1688393],[1688409,"to",1688489],[1688497,"say",1688689],[1688737,"one",1688873],[1688889,"more",1689041],[1689073,"time",1689313],[1689369,"because",1689513],[1689529,"we're",1689673],[1689689,"getting",1689841],[1689873,"a",1689969],[1689977,"little",1690169],[1690217,"researchy",1690745],[1690785,"here",1690937],[1690961,"for",1691121],[1691153,"our",1691297],[1691321,"largely",1691665],[1691705,"clinical",1692017],[1692081,"audience.",1692765],[1694345,"Comes",1694705],[1694745,"from",1695281],[1695433,"like",1695721],[1695753,"a",1695921],[1695953,"time",1696145],[1696185,"when",1696745],[1696905,"you",1697153],[1697169,"know,",1697297],[1697321,"you're",1697625],[1697665,"on",1697817],[1697841,"the",1698025],[1698065,"protocol",1698609],[1698697,"and",1698873],[1698889,"the",1699041],[1699073,"protocols",1699817],[1699881,"here",1700177],[1700241,"are",1700465],[1700505,"either",1700729],[1700777,"you're",1701017],[1701041,"on",1701153],[1701169,"the",1701297],[1701321,"dialysis",1701889],[1701937,"protocol",1702457],[1702521,"or",1702697],[1702721,"you're",1702921],[1702953,"on",1703073],[1703089,"the",1703217],[1703241,"medical",1703569],[1703657,"management",1704073],[1704169,"protocol.",1704969],[1705137,"And",1705465],[1705505,"so",1705897],[1706001,"per",1706289],[1706337,"protocol",1706769],[1706817,"analysis",1707417],[1707481,"means",1707729],[1707777,"you",1708033],[1708089,"only",1708329],[1708377,"are",1708633],[1708689,"counted",1709041],[1709073,"in",1709241],[1709273,"this",1709465],[1709505,"study",1709921],[1710033,"for",1710257],[1710281,"the",1710417],[1710441,"time",1710625],[1710665,"that",1710817],[1710841,"you're",1711089],[1711137,"on",1711441],[1711513,"that",1711745],[1711785,"protocol",1712169],[1712217,"or",1712353],[1712369,"the",1712473],[1712489,"other",1712713],[1712769,"protocol,",1713129],[1713177,"the",1713313],[1713329,"dialysis",1713849],[1713897,"protocol",1714161],[1714193,"or",1714313],[1714329,"the",1714457],[1714481,"medical",1714737],[1714801,"management",1715097],[1715161,"protocol.",1715697],[1715801,"Okay,",1716337],[1716441,"continue.",1717085],[1717505,"And",1717817],[1717841,"what",1717977],[1718001,"did",1718161],[1718193,"you",1718361],[1718393,"find",1718561],[1718593,"in",1719025],[1719145,"per",1719617],[1719721,"protocol?",1720547],[1720721,"So",1721103],[1721159,"in",1721375],[1721415,"that",1721639],[1721687,"analysis,",1722223],[1722279,"we",1722519],[1722567,"found",1722991],[1723103,"that",1723759],[1723927,"the",1724255],[1724295,"patients",1724711],[1724783,"who",1725255],[1725375,"started",1725727],[1725791,"dialysis",1726471],[1726543,"live",1726823],[1726879,"longer,",1727303],[1727359,"by",1727599],[1727647,"77",1728495],[1728575,"days,",1729195],[1729815,"but",1730175],[1730215,"still",1730583],[1730679,"over",1730983],[1731039,"three",1731255],[1731295,"years,",1731875],[1732255,"but",1732639],[1732687,"still",1732967],[1733031,"spent",1733495],[1733575,"two",1733815],[1733855,"weeks",1734103],[1734159,"fewer",1734591],[1734663,"at",1734895],[1734935,"home.",1735471],[1735623,"So",1735887],[1735911,"kind",1735999],[1736007,"of",1736487],[1736631,"difference",1737135],[1737215,"between",1737647],[1737751,"the",1738395],[1738695,"intention",1739223],[1739279,"to",1739471],[1739503,"treat",1739743],[1739799,"analysis,",1740431],[1740503,"meaning",1740839],[1740887,"like",1741167],[1741231,"where",1741455],[1741495,"you",1741767],[1741831,"started",1742223],[1742319,"is",1742647],[1742711,"where",1742911],[1742943,"you're",1743215],[1743255,"counted",1743703],[1743759,"versus",1744055],[1744095,"the",1744247],[1744271,"per",1744479],[1744527,"protocol",1744983],[1745039,"analysis,",1745623],[1745679,"which",1745823],[1745839,"is",1746021],[1746063,"is",1746289],[1746337,"only",1746593],[1746649,"while",1746841],[1746873,"you're",1747097],[1747121,"in",1747281],[1747313,"that",1747529],[1747577,"group",1748073],[1748209,"in",1748457],[1748481,"which",1748689],[1748737,"we",1748921],[1748953,"assigned",1749257],[1749281,"you",1749417],[1749441,"at",1749553],[1749569,"the",1749697],[1749721,"beginning.",1750365],[1750665,"How",1750929],[1750937,"do",1751033],[1751049,"you",1751177],[1751201,"explain",1751505],[1751545,"the",1751745],[1751785,"difference?",1752405],[1752705,"Do",1752945],[1752945,"you",1753033],[1753049,"want",1753129],[1753137,"to",1753209],[1753217,"take",1753313],[1753329,"that,",1753457],[1753481,"Maria?",1754217],[1754401,"We'll",1754761],[1754793,"be",1755369],[1755537,"more",1755913],[1755969,"statistical",1756665],[1756745,"than",1757393],[1757569,"clinical,",1758169],[1758257,"I",1758481],[1758513,"think.",1758897],[1759001,"But",1759645],[1760505,"I",1760793],[1760809,"think",1760961],[1760993,"even",1761281],[1761353,"before",1761657],[1761721,"that,",1762325],[1762745,"for",1763105],[1763145,"me,",1763369],[1763417,"the",1763601],[1763633,"biggest",1763953],[1764009,"question",1764345],[1764425,"here",1764713],[1764769,"between",1765153],[1765249,"the",1765697],[1765801,"intention",1766209],[1766257,"to",1766417],[1766441,"treat",1766649],[1766697,"in",1766809],[1766817,"the",1766937],[1766961,"per",1767217],[1767281,"protocol",1767977],[1768081,"and",1768537],[1768641,"I'm",1769057],[1769121,"a",1769393],[1769449,"big",1769665],[1769705,"fan",1769929],[1769977,"of",1770137],[1770161,"the",1770297],[1770321,"intention",1770649],[1770697,"to",1770857],[1770881,"treat",1771089],[1771137,"analysis,",1772009],[1772097,"and",1772465],[1772545,"most",1772785],[1772825,"probably",1773105],[1773145,"you",1773273],[1773289,"will",1773441],[1773473,"have",1773617],[1773641,"even",1773825],[1773865,"other",1774065],[1774105,"statisticians",1774817],[1774881,"not",1775081],[1775113,"agreeing",1775465],[1775505,"with",1775657],[1775681,"me.",1776297],[1776481,"But",1777167],[1777321,"in",1777611],[1777643,"a",1777763],[1777779,"lot",1777883],[1777899,"of",1778099],[1778147,"things",1778331],[1778363,"that",1778555],[1778595,"we",1778795],[1778835,"do,",1779155],[1779235,"we",1779523],[1779579,"really",1779843],[1779899,"try",1780139],[1780187,"to",1780371],[1780403,"get",1780643],[1780699,"at",1781155],[1781275,"what",1781651],[1781723,"happens",1782123],[1782179,"in",1782323],[1782339,"the",1782515],[1782555,"real",1782803],[1782859,"world.",1783455],[1785195,"And",1785483],[1785499,"the",1785627],[1785651,"intention",1785963],[1786019,"to",1786187],[1786211,"treat",1786467],[1786531,"analysis",1787163],[1787219,"is",1787435],[1787475,"really",1788011],[1788163,"giving",1788547],[1788611,"us",1788859],[1788907,"that.",1789307],[1789411,"Because",1790055],[1791715,"from",1792099],[1792147,"what",1792331],[1792363,"I",1792531],[1792563,"learned",1792995],[1793115,"working",1793443],[1793499,"with",1793739],[1793787,"Manju",1794531],[1794603,"and",1794787],[1794811,"Susan",1795219],[1795267,"and",1795643],[1795739,"all",1795923],[1795939,"the",1796067],[1796091,"other",1796323],[1796379,"nephrologists",1797163],[1797219,"that",1797363],[1797379,"I",1797555],[1797595,"work",1797771],[1797803,"with,",1798043],[1798099,"it's",1798267],[1798291,"just",1798475],[1798515,"like",1799095],[1799475,"nothing",1799939],[1799987,"is",1800195],[1800235,"set",1800483],[1800539,"in",1800707],[1800731,"stone.",1801443],[1801619,"And",1801907],[1801931,"so",1802495],[1802835,"you",1803171],[1803203,"have",1803491],[1803563,"patience",1803971],[1804043,"and",1804563],[1804699,"the",1804971],[1805003,"patient",1805283],[1805339,"comes",1805531],[1805563,"to",1805707],[1805731,"you",1805867],[1805891,"and",1806003],[1806019,"you're",1806227],[1806251,"trying",1806387],[1806411,"to",1806547],[1806571,"make",1806707],[1806731,"a",1806891],[1806923,"decision",1807235],[1807315,"right",1807579],[1807627,"now,",1808237],[1808411,"like,",1808769],[1808817,"should",1809025],[1809065,"I",1809241],[1809273,"start",1809465],[1809505,"dialysis",1810169],[1810217,"or",1810425],[1810465,"not?",1811045],[1811385,"And",1811697],[1811721,"let's",1811873],[1811889,"say",1811993],[1812009,"you're",1812153],[1812169,"going",1812321],[1812353,"to",1812497],[1812521,"decide",1812977],[1813041,"like,",1813313],[1813369,"no,",1813633],[1813689,"actually",1814025],[1814105,"now,",1814345],[1814385,"I",1814489],[1814497,"don't",1814657],[1814681,"know.",1814865],[1814905,"I",1815033],[1815049,"do",1815153],[1815169,"not",1815321],[1815353,"want",1815497],[1815521,"to",1815657],[1815681,"start",1815889],[1815937,"dialysis.",1816801],[1816873,"But",1817081],[1817113,"I",1817281],[1817313,"hear",1817505],[1817545,"from",1817721],[1817753,"them",1817969],[1818017,"just",1818225],[1818265,"like,",1818441],[1818473,"yeah,",1819089],[1819257,"we",1819537],[1819561,"don't",1819785],[1819825,"really",1820073],[1820129,"plan",1820345],[1820385,"for",1820537],[1820561,"dialysis.",1821193],[1821249,"And",1821417],[1821441,"then",1821937],[1822081,"six",1822409],[1822457,"months",1822713],[1822769,"later,",1823177],[1823281,"they",1823545],[1823585,"decided",1824193],[1824329,"something",1824745],[1824825,"happens",1825145],[1825185,"and",1825337],[1825361,"they",1825497],[1825521,"decided",1825873],[1825929,"they",1826121],[1826153,"want",1826321],[1826353,"to",1826497],[1826521,"start",1826729],[1826777,"dialysis.",1827873],[1828049,"Right.",1828553],[1828649,"And",1829265],[1829425,"that's",1829753],[1829769,"what",1829969],[1830017,"happens.",1830305],[1830345,"That's",1830561],[1830593,"the",1830761],[1830793,"real",1830985],[1831025,"world",1831345],[1831425,"and",1831641],[1831673,"that",1831913],[1831969,"you",1832137],[1832161,"only",1832417],[1832481,"get",1832753],[1832809,"in",1832953],[1832969,"the",1833073],[1833089,"intention",1833361],[1833393,"to",1833609],[1833657,"treat.",1833961],[1834033,"Because",1834289],[1834337,"if",1834473],[1834489,"you",1834617],[1834641,"are,",1835245],[1835425,"when",1835717],[1835741,"you're",1835957],[1835981,"trying",1836213],[1836269,"to",1836461],[1836493,"help",1836661],[1836693,"the",1836861],[1836893,"patient,",1837173],[1837229,"if",1837373],[1837389,"you",1837541],[1837573,"want",1837717],[1837741,"to",1837877],[1837901,"use",1838109],[1838157,"these",1838413],[1838469,"results.",1839065],[1839605,"It's",1840005],[1840045,"about",1840437],[1840541,"the",1840781],[1840813,"question",1841029],[1841077,"that",1841213],[1841229,"you're",1841525],[1841565,"asking",1841933],[1841989,"right",1842205],[1842245,"now.",1842517],[1842581,"If",1842733],[1842749,"I",1842925],[1842965,"make",1843117],[1843141,"a",1843277],[1843301,"decision",1843605],[1843685,"right",1843925],[1843965,"now,",1844213],[1844269,"what",1844461],[1844493,"is",1844613],[1844629,"it",1844757],[1844781,"that",1844917],[1844941,"I",1845077],[1845101,"can",1845333],[1845389,"expect?",1845965],[1846125,"And",1846445],[1846485,"right",1846709],[1846757,"now",1847037],[1847101,"you",1847325],[1847365,"don't",1847565],[1847605,"know",1847805],[1847845,"whether",1848117],[1848181,"that",1848429],[1848477,"patient",1848773],[1848829,"is",1849021],[1849053,"going",1849173],[1849189,"to",1849341],[1849373,"start",1849541],[1849573,"dialysis",1850213],[1850269,"in",1850389],[1850397,"the",1850517],[1850541,"future",1850749],[1850797,"or",1850981],[1851013,"not.",1851469],[1851597,"Well,",1851885],[1851925,"I",1852029],[1852037,"guess",1852157],[1852181,"the",1852293],[1852309,"other",1852533],[1852589,"question",1852901],[1852973,"too",1853253],[1853309,"though",1853501],[1853533,"is",1853725],[1853765,"like",1853965],[1854005,"if",1854157],[1854181,"this",1854317],[1854341,"was",1854525],[1854565,"a",1854741],[1854773,"drug",1855345],[1855725,"like",1856085],[1856125,"we",1856325],[1856365,"use",1856565],[1856605,"intention",1856973],[1857029,"to",1857221],[1857253,"treat",1857493],[1857549,"because",1857765],[1857805,"the",1857981],[1858013,"people",1858253],[1858309,"who,",1858933],[1859109,"let's",1859437],[1859461,"say",1859789],[1859877,"don't",1860277],[1860341,"take",1860565],[1860605,"the",1860781],[1860813,"drug",1861125],[1861205,"are",1861493],[1861549,"very",1861909],[1861997,"different",1862269],[1862317,"than",1862477],[1862501,"the",1862661],[1862693,"people",1862957],[1863021,"that",1863293],[1863349,"do",1863613],[1863669,"take",1863813],[1863829,"the",1863957],[1863981,"drug.",1864165],[1864205,"The",1864309],[1864317,"people",1864437],[1864461,"who",1864549],[1864557,"are",1864677],[1864701,"adherent",1865389],[1865477,"are",1865749],[1865797,"generally",1866213],[1866269,"very",1866461],[1866493,"different",1866637],[1866661,"than",1866881],[1866933,"those",1867097],[1867121,"who",1867305],[1867345,"don't.",1867585],[1867625,"So",1867777],[1867801,"if",1867889],[1867897,"you",1868041],[1868073,"use",1868241],[1868273,"like",1868393],[1868409,"a",1868537],[1868561,"per",1868769],[1868817,"protocol",1869289],[1869337,"analysis",1870161],[1870313,"in",1870577],[1870601,"a",1870809],[1870857,"randomized",1871353],[1871409,"controlled",1871737],[1871761,"trial",1871937],[1871961,"of",1872073],[1872089,"a",1872217],[1872241,"drug,",1872809],[1872977,"it's",1873321],[1873353,"going",1873473],[1873489,"to",1873617],[1873641,"look",1873873],[1873929,"different",1874169],[1874217,"than",1874401],[1874433,"an",1874601],[1874633,"intention",1874953],[1875009,"to",1875177],[1875201,"treat",1875409],[1875457,"analysis,",1875841],[1875873,"isn't",1876033],[1876049,"it,",1876153],[1876169,"Maria?",1876825],[1876985,"Yes,",1877417],[1877481,"exactly.",1878161],[1878273,"Exactly.",1878817],[1878881,"And",1879033],[1879049,"then",1879177],[1879201,"the",1879361],[1879393,"question",1879633],[1879689,"then",1879929],[1879977,"is",1880161],[1880193,"like",1880385],[1880425,"what",1880577],[1880601,"is,",1880809],[1880857,"what",1881017],[1881041,"are",1881201],[1881233,"the",1881425],[1881465,"results",1882121],[1882313,"generalizable",1883233],[1883289,"to?",1883937],[1884121,"Right?",1884465],[1884505,"Yeah.",1884753],[1884809,"Right.",1885241],[1885353,"We're",1885593],[1885609,"going",1885689],[1885697,"to",1885817],[1885841,"force",1886129],[1886177,"you",1886361],[1886393,"to",1886585],[1886625,"stay",1886801],[1886833,"on",1886953],[1886969,"the",1887121],[1887153,"dialysis",1887865],[1887945,"pathway",1888505],[1888585,"from",1888825],[1888865,"this",1889089],[1889137,"point",1889345],[1889385,"on",1889609],[1889657,"where",1889961],[1890033,"no",1890217],[1890241,"matter",1890449],[1890497,"what",1890657],[1890681,"you",1890937],[1891001,"say",1891273],[1891329,"or",1891521],[1891553,"we're",1891673],[1891689,"going",1891793],[1891809,"to",1891937],[1891961,"force",1892161],[1892193,"you",1892313],[1892329,"to",1892457],[1892481,"stay",1892593],[1892609,"in",1892665],[1892665,"the",1892777],[1892801,"medicine",1892931],[1892953,"medical",1893231],[1893303,"management",1893679],[1893767,"pathway.",1894247],[1894311,"No",1894487],[1894511,"matter",1894695],[1894735,"what",1894935],[1894975,"you",1895223],[1895279,"say.",1895879],[1896047,"That",1896303],[1896319,"doesn't",1896591],[1896623,"make",1896791],[1896823,"any",1896991],[1897023,"sense.",1897359],[1897447,"That",1897623],[1897639,"doesn't",1897935],[1897975,"make",1898175],[1898215,"any",1898439],[1898487,"sense",1898759],[1898807,"to",1898943],[1898959,"me.",1899207],[1899271,"Exactly.",1899959],[1900127,"Exactly.",1900911],[1901023,"Yeah.",1901407],[1901471,"So",1902103],[1902279,"let",1902519],[1902527,"me",1902623],[1902639,"ask",1902743],[1902759,"you,",1903175],[1903295,"going",1903599],[1903647,"a",1903759],[1903767,"little",1903959],[1904007,"wonky",1904479],[1904527,"question.",1905191],[1905383,"So",1905687],[1905711,"you",1905847],[1905871,"did",1906031],[1906063,"this.",1906351],[1906423,"Was",1906583],[1906599,"this",1906751],[1906783,"a",1906927],[1906951,"randomized",1907399],[1907447,"controlled",1907807],[1907831,"trial?",1908435],[1908895,"No,",1909231],[1909263,"it",1909431],[1909463,"wasn't.",1910263],[1910439,"You",1910727],[1910751,"said",1911151],[1911263,"you",1911655],[1911735,"emulated",1912675],[1913735,"like",1914455],[1914615,"what",1914959],[1915007,"was",1915191],[1915223,"this?",1915439],[1915487,"This",1915599],[1915607,"is",1915727],[1915751,"a.",1915935],[1915975,"The",1916223],[1916279,"Annals",1916679],[1916727,"loves",1917047],[1917071,"this",1917255],[1917295,"stuff.",1917583],[1917639,"Right?",1917831],[1917863,"Now",1918079],[1918127,"this",1918263],[1918279,"is",1918431],[1918463,"a.",1919035],[1919995,"What's",1920363],[1920379,"the",1920555],[1920595,"official",1920915],[1920995,"title?",1921699],[1921867,"It's",1922171],[1922203,"a",1922395],[1922435,"target",1922731],[1922803,"trial",1923187],[1923251,"emulation.",1923935],[1924315,"Target",1924819],[1924907,"trial",1925307],[1925371,"emulation.",1926011],[1926163,"Is",1926451],[1926483,"that",1926723],[1926779,"just",1927067],[1927131,"an",1927403],[1927459,"observational",1928187],[1928291,"study",1928627],[1928691,"with",1928915],[1928955,"a",1929131],[1929163,"fancy",1929587],[1929651,"name",1929995],[1930075,"that",1930363],[1930419,"makes",1930659],[1930707,"it",1930939],[1930987,"sound",1931331],[1931403,"more",1931635],[1931675,"like",1931875],[1931915,"a",1932043],[1932059,"randomized",1932507],[1932571,"control",1932867],[1932931,"trial",1933243],[1933299,"or",1933563],[1933619,"are",1933763],[1933779,"you",1933955],[1933995,"doing",1934579],[1934747,"something",1935455],[1935795,"different",1936419],[1936547,"than",1936835],[1936875,"just",1937099],[1937147,"the",1937355],[1937395,"normal",1937787],[1937851,"observational",1938483],[1938579,"study?",1939215],[1940115,"Yes",1940491],[1940523,"and",1940739],[1940787,"no.",1941375],[1942715,"Because",1943455],[1943835,"I",1944171],[1944203,"think",1944467],[1944531,"that",1944827],[1944891,"what",1945163],[1945219,"the",1945435],[1945475,"target",1945795],[1945875,"trial",1946179],[1946227,"emulation",1946891],[1947043,"does",1947667],[1947811,"is",1948259],[1948347,"puts",1948739],[1948787,"you",1949375],[1949825,"in",1950137],[1950161,"a",1950345],[1950385,"place,",1950633],[1950689,"is",1950905],[1950945,"when",1951145],[1951185,"you",1951337],[1951361,"are",1951617],[1951681,"designing",1952249],[1952297,"the",1952505],[1952545,"study,",1953201],[1953393,"right.",1953721],[1953753,"It",1953897],[1953921,"puts",1954137],[1954161,"you",1954321],[1954353,"in",1954497],[1954521,"a",1954681],[1954713,"place",1954977],[1955041,"where,",1955313],[1955369,"okay,",1956137],[1956321,"let's",1956697],[1956721,"just",1956953],[1957009,"pretend",1957617],[1957681,"that",1957881],[1957913,"this",1958057],[1958081,"is",1958193],[1958209,"a",1958841],[1959033,"clinical",1959577],[1959641,"trial,",1960089],[1960177,"right?",1960689],[1960817,"And",1961393],[1961529,"when",1961777],[1961801,"you're",1962017],[1962041,"thinking",1962281],[1962313,"of",1962505],[1962545,"a",1962697],[1962721,"clinical",1962985],[1963025,"trial,",1963265],[1963305,"we",1963433],[1963449,"are",1963577],[1963601,"in",1963713],[1963729,"the",1963905],[1963945,"mindset",1964561],[1964633,"that,",1964889],[1964937,"okay,",1965161],[1965193,"we",1965361],[1965393,"have",1965609],[1965657,"protocols",1966201],[1966233,"that",1966401],[1966433,"we",1966625],[1966665,"have",1966817],[1966841,"to",1967049],[1967097,"follow,",1967685],[1968305,"we",1968689],[1968737,"have",1969329],[1969497,"standards",1970081],[1970153,"that",1970337],[1970361,"we",1970497],[1970521,"need",1970681],[1970713,"to",1970929],[1970977,"follow,",1971617],[1971801,"like",1972193],[1972249,"we",1972441],[1972473,"want",1972617],[1972641,"to",1972801],[1972833,"keep",1973073],[1973129,"those.",1973513],[1973609,"So",1973793],[1973809,"in",1973913],[1973929,"the",1974057],[1974081,"target",1974361],[1974433,"trial",1974705],[1974745,"emulation,",1975313],[1975449,"that's",1975857],[1975921,"let's",1976497],[1976641,"basically",1977073],[1977129,"puts",1977441],[1977473,"us",1977641],[1977673,"in",1977841],[1977873,"that",1978161],[1978233,"mindset",1979001],[1979113,"that",1979697],[1979841,"even",1980097],[1980121,"though",1980281],[1980313,"it's",1980553],[1980609,"observational",1981297],[1981401,"data,",1981905],[1982025,"even",1982257],[1982281,"though",1982441],[1982473,"the",1982689],[1982737,"data",1983185],[1983305,"has",1983585],[1983625,"already",1983873],[1983929,"been",1984289],[1984377,"collected",1985209],[1985337,"and",1985577],[1985601,"we",1985761],[1985793,"are",1985961],[1985993,"just",1986329],[1986417,"repurposing",1987193],[1987249,"it",1987513],[1987569,"for",1987833],[1987889,"this",1988249],[1988337,"study,",1988965],[1989945,"we",1990281],[1990313,"can",1990505],[1990545,"still",1990817],[1990881,"follow",1991225],[1991305,"these",1991593],[1991649,"strict",1992073],[1992169,"Protocols",1992937],[1993001,"that",1993249],[1993297,"make",1993577],[1993641,"then",1993985],[1994065,"the",1994329],[1994377,"results",1994801],[1994913,"more",1995233],[1995289,"reliable.",1996165],[1996865,"And",1997201],[1997233,"so",1997521],[1997593,"for",1997849],[1997897,"me,",1998537],[1998721,"it's",1999121],[1999153,"a",1999297],[1999321,"good",1999625],[1999705,"strategy",2000565],[2000865,"and",2001177],[2001201,"it",2001385],[2001425,"helps",2001729],[2001777,"me",2002365],[2002855,"when",2003167],[2003191,"I",2003399],[2003447,"discuss",2003799],[2003887,"these",2004183],[2004239,"with",2004479],[2004527,"the",2004711],[2004743,"researchers",2005215],[2005255,"that",2005407],[2005431,"I",2005591],[2005623,"work",2005815],[2005855,"with",2006435],[2006975,"to",2007335],[2007375,"really",2007647],[2007711,"say,",2007959],[2008007,"look,",2008311],[2008383,"let's",2008607],[2008631,"just",2008863],[2008919,"pretend",2009295],[2009335,"that",2009511],[2009543,"this",2009663],[2009679,"is",2009831],[2009863,"a",2009983],[2009999,"clinical",2010327],[2010391,"trial,",2010703],[2010759,"let's",2010951],[2010983,"follow",2011223],[2011279,"these",2011519],[2011567,"protocols",2012431],[2012543,"and",2012935],[2013015,"let's",2013271],[2013303,"be",2013471],[2013503,"strict",2014115],[2015175,"with",2015559],[2015607,"what",2015839],[2015887,"we",2016095],[2016135,"do",2016455],[2016535,"to",2016751],[2016783,"make",2016951],[2016983,"sure",2017199],[2017247,"that",2017503],[2017559,"we",2017727],[2017751,"can",2017935],[2017975,"trust",2018215],[2018255,"the",2018455],[2018495,"results",2018791],[2018863,"that",2019047],[2019071,"we",2019207],[2019231,"get",2019391],[2019423,"at",2019543],[2019559,"the",2019711],[2019743,"end.",2020247],[2020391,"Yeah,",2020647],[2020671,"it",2020783],[2020799,"seems",2020967],[2020991,"like",2021103],[2021119,"you're",2021311],[2021343,"putting",2021623],[2021679,"all",2021871],[2021903,"the",2022071],[2022103,"best",2022391],[2022463,"practices",2022919],[2023007,"for",2023207],[2023231,"an",2023391],[2023423,"observational",2023951],[2024023,"trial.",2024367],[2024431,"Exactly.",2025023],[2025119,"Meshing",2025575],[2025615,"that",2025863],[2025919,"together,",2026515],[2027215,"maybe",2027727],[2027791,"branding",2028167],[2028191,"it",2028255],[2028255,"a",2028295],[2028295,"little",2028359],[2028367,"bit.",2028439],[2028447,"I",2028495],[2028495,"would",2028559],[2028567,"say",2028663],[2028679,"that",2028807],[2028831,"there",2028943],[2028959,"are",2029279],[2029367,"two",2029987],[2030151,"big",2030499],[2030547,"pitfalls",2031139],[2031187,"that",2031395],[2031435,"you",2031683],[2031739,"see",2032387],[2032571,"with",2033035],[2033115,"studies",2033731],[2033883,"that",2034387],[2034491,"don't",2034819],[2034867,"use",2035075],[2035115,"target",2035363],[2035419,"trial",2035787],[2035851,"emulation",2036299],[2036387,"and",2036611],[2036643,"use",2036787],[2036811,"an",2036971],[2037003,"observational",2037563],[2037659,"framework",2038035],[2038075,"when",2038203],[2038219,"they're",2038387],[2038411,"trying",2038547],[2038571,"to",2038683],[2038699,"do",2038851],[2038883,"these",2039075],[2039115,"comparisons.",2040135],[2040555,"One",2041059],[2041147,"is",2041803],[2041979,"they're",2042355],[2042395,"defining",2042899],[2042947,"the",2043179],[2043227,"intervention",2043867],[2043931,"using",2044227],[2044291,"future",2044731],[2044843,"information,",2045495],[2046115,"which",2046451],[2046483,"Maria",2046955],[2047035,"always",2047323],[2047379,"tells",2047627],[2047651,"me",2047811],[2047843,"is",2048011],[2048043,"a",2048163],[2048179,"big",2048379],[2048427,"no,",2048683],[2048739,"no.",2049335],[2051275,"You",2051611],[2051643,"can't",2051875],[2051915,"define",2052575],[2053075,"the",2053459],[2053507,"groups",2054035],[2054115,"by",2054523],[2054619,"who",2054851],[2054883,"got",2055051],[2055083,"dialysis",2055699],[2055747,"in",2055883],[2055899,"the",2056027],[2056051,"future.",2056331],[2056403,"That's",2056627],[2056651,"a",2056763],[2056779,"big",2056979],[2057027,"no,",2057259],[2057307,"no.",2057895],[2058715,"And",2059051],[2059083,"two,",2059347],[2059411,"related",2059731],[2059803,"to",2060059],[2060107,"that,",2060651],[2060803,"a",2061043],[2061059,"lot",2061235],[2061275,"of",2061475],[2061515,"these",2062051],[2062203,"earlier",2062659],[2062747,"studies",2063227],[2063331,"are",2063595],[2063635,"affected",2063859],[2063907,"by",2064091],[2064123,"immortal",2064579],[2064627,"time",2064859],[2064907,"bias.",2065575],[2066635,"And",2066947],[2066971,"so",2067227],[2067291,"target",2067587],[2067651,"trial",2067963],[2068019,"emulation",2068695],[2069195,"is",2069531],[2069563,"an",2069731],[2069763,"approach",2070075],[2070155,"to",2070347],[2070371,"try",2070507],[2070531,"to",2070715],[2070755,"handle",2071415],[2071955,"those",2072603],[2072739,"design",2073155],[2073235,"issues",2073619],[2073707,"that",2073907],[2073931,"we",2074091],[2074123,"get",2074363],[2074419,"with",2074707],[2074771,"observational",2075427],[2075531,"studies.",2076035],[2076155,"And",2076387],[2076411,"in",2076595],[2076635,"one",2076859],[2076907,"sentence,",2077315],[2077395,"if",2077539],[2077547,"you",2077667],[2077691,"can,",2077851],[2077883,"in",2078003],[2078019,"one",2078147],[2078171,"sentence,",2078443],[2078499,"anybody,",2078859],[2078907,"what",2079067],[2079091,"is",2079251],[2079283,"a",2079379],[2079387,"mortal",2079787],[2079851,"time",2080243],[2080339,"bias?",2081095],[2081835,"I",2082123],[2082139,"got",2082291],[2082323,"to",2082443],[2082459,"turn",2082587],[2082611,"that",2082747],[2082771,"over",2082907],[2082931,"to",2083067],[2083091,"Maria",2083491],[2083563,"again.",2083867],[2083931,"Maria.",2084615],[2086755,"So",2087163],[2087219,"is",2087459],[2087507,"when.",2088095],[2088475,"Let's",2089163],[2089299,"go",2089523],[2089539,"back",2090095],[2091115,"thinking",2091547],[2091571,"of",2091731],[2091763,"the",2091931],[2091963,"dialysis,",2092707],[2092771,"right?",2093375],[2093715,"You",2094051],[2094083,"don't",2094275],[2094315,"really",2094587],[2094651,"know.",2095307],[2095491,"You",2095811],[2095843,"don't",2096139],[2096187,"have",2096659],[2096787,"a",2097099],[2097147,"starting",2097571],[2097643,"time",2097971],[2098043,"for",2098443],[2098539,"medical",2098987],[2099091,"management.",2099735],[2100715,"And",2101003],[2101019,"so",2101507],[2101651,"if",2101883],[2101899,"you're",2102211],[2102243,"only",2102483],[2102539,"waiting",2102851],[2102923,"until",2103371],[2103483,"someone",2103947],[2104051,"starts",2104507],[2104531,"the",2104691],[2104723,"medication,",2105315],[2105395,"then",2105659],[2105707,"that",2105939],[2105987,"waiting",2106379],[2106467,"time",2106739],[2106787,"is",2106995],[2107035,"not",2107307],[2107371,"counted",2107859],[2107907,"for",2108187],[2108251,"or",2108475],[2108515,"medication",2108979],[2109027,"or",2109259],[2109307,"treatment.",2109771],[2109843,"Right.",2110455],[2110795,"And",2111155],[2111195,"so",2111665],[2111795,"like",2112157],[2112221,"that's",2112477],[2112501,"the",2112613],[2112629,"immortal",2113093],[2113149,"time",2113389],[2113437,"bias,",2113837],[2113901,"where",2114317],[2114421,"someone",2114829],[2114917,"would",2115213],[2115269,"not",2115509],[2115557,"be",2115741],[2115773,"eligible",2116277],[2116341,"to",2116541],[2116573,"really",2116765],[2116805,"start",2117005],[2117045,"the",2117197],[2117221,"treatment",2117845],[2117965,"or",2118245],[2118285,"is",2118461],[2118493,"eligible,",2118893],[2118949,"but",2119093],[2119109,"you",2119237],[2119261,"don't",2119517],[2119581,"know",2120117],[2120261,"and",2120517],[2120541,"you",2120677],[2120701,"are",2120909],[2120957,"counting",2121413],[2121469,"that",2122069],[2122237,"or",2122589],[2122637,"not",2122893],[2122949,"counting",2123285],[2123325,"it",2123789],[2123917,"in",2124181],[2124213,"towards",2124581],[2124653,"your",2125005],[2125085,"analysis.",2125805],[2125885,"And",2126077],[2126101,"so",2126261],[2126293,"that",2126629],[2126717,"your",2126965],[2127005,"follow",2127229],[2127277,"up",2127557],[2127621,"time",2127941],[2128013,"then",2128245],[2128285,"at",2128437],[2128461,"the",2128597],[2128621,"end",2128805],[2128845,"is",2129045],[2129085,"basically",2129373],[2129429,"incorrect.",2130265],[2130965,"Go",2131253],[2131269,"ahead,",2131373],[2131389,"Alex.",2131717],[2131781,"Well,",2131957],[2131981,"I",2132093],[2132109,"was",2132261],[2132293,"just",2132461],[2132493,"going",2132613],[2132629,"to",2132733],[2132749,"try",2132877],[2132901,"to",2133061],[2133093,"take",2133237],[2133261,"a",2133421],[2133453,"stab",2133709],[2133757,"to",2133893],[2133909,"answer",2134077],[2134101,"your",2134189],[2134197,"question.",2134341],[2134373,"Take",2134493],[2134509,"a",2134613],[2134629,"stab,",2134909],[2134957,"Alex,",2135205],[2135245,"in",2135445],[2135485,"one",2135733],[2135789,"sentence,",2136505],[2137165,"I",2137429],[2137437,"think",2137629],[2137677,"more",2137849],[2137877,"total",2138137],[2138201,"time",2138425],[2138465,"bias",2138857],[2138921,"is",2139169],[2139217,"when",2139833],[2140009,"the",2140489],[2140577,"start",2141041],[2141153,"time",2141785],[2141945,"for",2142289],[2142337,"one",2142665],[2142745,"group",2143153],[2143249,"doesn't",2143849],[2143937,"begin",2144553],[2144689,"until",2145365],[2146305,"some",2146905],[2147025,"event",2147521],[2147633,"happens",2148405],[2149145,"and",2149937],[2150121,"therefore",2150617],[2150681,"they",2150977],[2151041,"have",2151241],[2151273,"to",2151537],[2151601,"survive",2152513],[2152689,"until",2153169],[2153257,"that",2153529],[2153577,"event.",2154241],[2154433,"And",2154737],[2154761,"you're",2155049],[2155097,"counting",2155529],[2155577,"that",2155833],[2155889,"survival",2156385],[2156465,"time",2156705],[2156745,"in",2156897],[2156921,"your",2157105],[2157145,"analysis.",2158113],[2158289,"And",2158601],[2158633,"that",2158849],[2158897,"biases",2159361],[2159393,"them",2159585],[2159625,"because",2160065],[2160185,"they're",2160457],[2160481,"immortal",2160945],[2160985,"in",2161113],[2161129,"a",2161233],[2161249,"sense,",2161593],[2161689,"until",2162065],[2162145,"that",2162409],[2162457,"event",2162809],[2162897,"happens.",2163623],[2163809,"Yes.",2164203],[2164259,"Is",2164379],[2164387,"that",2164507],[2164531,"fair?",2164763],[2164819,"All",2164915],[2164915,"right.",2165363],[2165499,"Yes,",2165859],[2165907,"that's",2166067],[2166091,"fair.",2166659],[2166827,"My",2167155],[2167195,"last",2167419],[2167467,"wonky",2168003],[2168059,"question,",2168655],[2170555,"fundamentally",2171395],[2171515,"though,",2171915],[2171995,"you're",2172291],[2172323,"not",2172515],[2172555,"randomizing",2173451],[2173563,"two",2173859],[2173907,"groups.",2174475],[2174595,"There's",2174971],[2175003,"no",2175219],[2175267,"emulation",2175859],[2175987,"for",2176275],[2176315,"randomization.",2177175],[2178395,"The",2178731],[2178763,"biggest",2179059],[2179107,"issue",2179387],[2179451,"here",2179675],[2179715,"is",2180295],[2180635,"there's",2181179],[2181227,"going",2181387],[2181411,"to",2181547],[2181571,"be",2181707],[2181731,"a",2181915],[2181955,"difference",2182243],[2182299,"between",2182611],[2182683,"people",2182987],[2183051,"who",2183323],[2183379,"start",2183643],[2183699,"dialysis",2184483],[2184579,"and",2184859],[2184907,"don't",2185179],[2185227,"stop",2185483],[2185539,"dialysis",2186495],[2187075,"no",2187459],[2187507,"matter",2187715],[2187755,"what",2188027],[2188091,"fancy",2188459],[2188507,"statistics",2188995],[2189035,"we",2189187],[2189211,"use.",2189371],[2189403,"We.",2189847],[2189981,"Right.",2190731],[2190923,"Can",2191227],[2191251,"we",2191483],[2191539,"really",2192163],[2192339,"ignore",2192819],[2192867,"the",2193027],[2193051,"need",2193211],[2193243,"for",2193411],[2193443,"randomization",2194115],[2194235,"or",2194515],[2194555,"like",2194683],[2194699,"I",2194779],[2194787,"was",2194907],[2194931,"asking",2195083],[2195099,"you",2195227],[2195251,"Susan",2195555],[2195595,"earlier,",2195795],[2195835,"like",2196035],[2196075,"a",2196251],[2196283,"randomized",2196739],[2196787,"controlled",2197107],[2197131,"trial.",2197691],[2197843,"Thoughts?",2198615],[2199275,"So,",2199635],[2199675,"yeah,",2199891],[2199923,"a",2200043],[2200059,"couple",2200275],[2200315,"of",2200635],[2200715,"thoughts.",2201495],[2201875,"So",2202451],[2202563,"why",2202811],[2202843,"I",2202987],[2203011,"like",2203195],[2203235,"this",2203435],[2203475,"target",2203723],[2203779,"emulation",2204435],[2204595,"trial",2205043],[2205099,"design",2205411],[2205483,"is",2205691],[2205723,"that",2206299],[2206467,"one",2206891],[2206963,"tries",2207259],[2207307,"their",2207563],[2207619,"very",2207931],[2208003,"best",2208451],[2208563,"to",2209075],[2209195,"account",2209523],[2209579,"for",2209747],[2209771,"that",2209931],[2209963,"kind",2210083],[2210099,"of",2210227],[2210251,"selection",2210611],[2210683,"bias.",2211019],[2211067,"There's",2211491],[2211563,"all",2211747],[2211771,"this",2211931],[2211963,"propensity",2212499],[2212547,"score",2212843],[2212899,"matching",2213171],[2213203,"and",2213587],[2213691,"versus",2214083],[2214139,"probability",2214643],[2214739,"waiting",2215107],[2215171,"and",2215515],[2215595,"all",2215763],[2215779,"the,",2215953],[2215999,"the",2216157],[2216181,"fancy",2216397],[2216421,"stuff",2216557],[2216581,"that",2216693],[2216709,"Maria",2216989],[2217037,"does.",2217509],[2217637,"Is",2217877],[2217901,"there",2218085],[2218125,"still",2218301],[2218333,"residual",2218773],[2218829,"compounding?",2219349],[2219397,"Absolutely.",2219765],[2219805,"And",2219933],[2219949,"I",2220029],[2220037,"think",2220157],[2220181,"that's",2220333],[2220349,"always",2220525],[2220565,"going",2220669],[2220677,"to",2220773],[2220789,"be",2220869],[2220877,"the",2221069],[2221117,"case.",2221613],[2221749,"Observational",2222357],[2222421,"studies,",2222709],[2222757,"but",2223157],[2223261,"it",2223477],[2223501,"gets",2223677],[2223701,"us",2223957],[2224021,"as",2224269],[2224317,"close",2224549],[2224597,"as",2224805],[2224845,"one",2225069],[2225117,"can",2225373],[2225429,"possibly",2225845],[2225925,"get",2226545],[2227445,"to",2227781],[2227813,"the",2228005],[2228045,"answer,",2228581],[2228693,"you",2228869],[2228877,"know,",2228997],[2229021,"to",2229157],[2229181,"answering",2229445],[2229485,"the",2229685],[2229725,"question,",2230213],[2230349,"you",2230573],[2230589,"know,",2230765],[2230805,"should",2231005],[2231045,"there",2231245],[2231285,"be",2231533],[2231589,"a",2231925],[2232005,"clinical",2232325],[2232365,"trial?",2232613],[2232669,"There",2232909],[2232957,"is",2233309],[2233397,"actually",2233669],[2233717,"a",2233853],[2233869,"couple",2234253],[2234349,"ongoing.",2235141],[2235293,"Oh",2235533],[2235549,"really?",2236061],[2236213,"Patients.",2236589],[2236637,"Yeah.",2237077],[2237181,"So",2237733],[2237869,"you",2238069],[2238077,"know,",2238197],[2238221,"for",2238357],[2238381,"a",2238493],[2238509,"long",2238637],[2238661,"time",2238893],[2238949,"people",2239237],[2239301,"have",2239501],[2239533,"thought",2239773],[2239829,"that",2240069],[2240117,"doing",2240325],[2240365,"a",2240565],[2240605,"clinical",2240917],[2240981,"trial,",2241557],[2241701,"randomizing",2242389],[2242437,"patients",2242749],[2242797,"to",2242957],[2242981,"dialysis",2243525],[2243565,"or",2243741],[2243773,"to",2243917],[2243941,"conservative",2244309],[2244357,"kidney",2244645],[2244685,"management",2244933],[2244989,"was,",2245181],[2245213,"was",2245813],[2245989,"unethical.",2247105],[2247605,"Others",2247989],[2248037,"have",2248197],[2248221,"argued",2248509],[2248557,"now",2248693],[2248709,"that",2248837],[2248861,"there's",2249061],[2249093,"so",2249189],[2249197,"much",2249389],[2249437,"observational",2250357],[2250541,"data",2251029],[2251117,"suggesting",2251653],[2251709,"clinical",2251989],[2252037,"equipoise",2252733],[2252789,"between",2253029],[2253077,"the",2253237],[2253261,"two,",2253589],[2253677,"it's",2253901],[2253933,"now",2254125],[2254165,"unethical",2254917],[2254981,"to",2255253],[2255309,"not",2255765],[2255885,"explore",2256381],[2256453,"this",2256733],[2256789,"possibility.",2257301],[2257413,"So",2257901],[2258013,"in",2258189],[2258197,"the",2258317],[2258341,"UK",2258573],[2258629,"at",2258773],[2258789,"the",2258941],[2258973,"University",2259261],[2259333,"of",2259565],[2259605,"Bristol",2260133],[2260229,"they",2260485],[2260525,"have,",2260845],[2260925,"they're",2261245],[2261285,"maybe",2261541],[2261573,"three",2261693],[2261709,"or",2261837],[2261861,"four",2262045],[2262085,"years",2262333],[2262389,"now",2262653],[2262709,"into",2263305],[2263805,"a",2264117],[2264141,"clinical",2264453],[2264509,"trial",2264861],[2264933,"randomizing",2265669],[2265717,"patients",2266093],[2266149,"to",2266341],[2266373,"prepare",2266621],[2266653,"for",2266821],[2266853,"dialysis",2267453],[2267509,"and",2267749],[2267797,"or",2267981],[2268013,"to",2268157],[2268181,"prepare",2268397],[2268421,"for",2268581],[2268613,"conservative",2268989],[2269037,"kidney",2269349],[2269397,"management.",2269677],[2269741,"They",2269893],[2269909,"have",2270229],[2270317,"at",2270493],[2270509,"least",2270805],[2270885,"380",2271669],[2271717,"patients",2272077],[2272141,"now.",2272629],[2272757,"I",2272973],[2272989,"think",2273213],[2273269,"the",2273533],[2273589,"study",2274045],[2274165,"closes",2274645],[2274685,"to",2274837],[2274861,"enrollment",2275357],[2275421,"sometime",2275837],[2275901,"next",2276149],[2276197,"year.",2276453],[2276509,"So",2276677],[2276701,"we'll",2276837],[2276861,"learn.",2277465],[2279065,"And",2279329],[2279337,"then",2279505],[2279545,"right",2279673],[2279689,"now",2279841],[2279873,"there's",2280081],[2280113,"a",2280401],[2280473,"Dale",2280745],[2280785,"Lupu",2281289],[2281337,"has",2281617],[2281681,"and",2281833],[2281849,"I",2281905],[2281905,"think",2282017],[2282041,"Woody",2282345],[2282385,"Moss",2282609],[2282657,"is",2283081],[2283193,"maybe,",2283481],[2283513,"I",2283585],[2283585,"think",2283673],[2283689,"they're",2283857],[2283881,"copias",2284417],[2284441,"on",2284553],[2284569,"that.",2284937],[2285041,"A",2285233],[2285249,"PCORI",2285801],[2285873,"study",2286485],[2286905,"looking",2287241],[2287273,"at",2287465],[2287505,"randomizing",2288321],[2288393,"patients",2289165],[2289585,"with",2289993],[2290049,"late",2290337],[2290401,"stage",2290665],[2290705,"4",2290894],[2290936,"or",2291105],[2291147,"5",2291337],[2291401,"kidney",2291729],[2291777,"disease",2292297],[2292401,"to",2292833],[2292929,"receive",2293385],[2293465,"kidney",2293833],[2293889,"supportive",2294305],[2294345,"care,",2294665],[2294745,"which",2294937],[2294961,"is,",2295529],[2295697,"which",2295953],[2295969,"is",2296145],[2296185,"the",2296721],[2296873,"major",2297257],[2297321,"element",2297697],[2297761,"to",2298081],[2298153,"conservative",2298593],[2298649,"kidney",2298969],[2299017,"management",2299657],[2299841,"and",2300161],[2300193,"randomizing",2300721],[2300753,"them",2300873],[2300889,"to",2301137],[2301201,"see",2301833],[2302009,"how",2302417],[2302481,"that",2302753],[2302809,"might",2303121],[2303193,"support",2303497],[2303561,"their",2303809],[2303857,"decision",2304185],[2304265,"making",2304769],[2304897,"and",2305113],[2305129,"then",2305281],[2305313,"kind",2305433],[2305449,"of",2305601],[2305633,"long",2305825],[2305865,"term",2306065],[2306105,"follow",2306353],[2306409,"up",2306625],[2306665,"following",2307225],[2307385,"I",2307609],[2307617,"think",2308049],[2308177,"survival",2308593],[2308649,"as",2308793],[2308809,"well",2308961],[2308993,"as",2309185],[2309225,"quality",2309521],[2309553,"of",2309673],[2309689,"life",2309865],[2309905,"measures",2310209],[2310257,"and",2310417],[2310441,"things.",2311057],[2311241,"It's",2311577],[2311601,"an",2311761],[2311793,"indirect",2312337],[2312441,"study",2312873],[2312969,"of",2313201],[2313233,"what",2313473],[2313529,"happens",2313785],[2313825,"when",2313953],[2313969,"you",2314169],[2314217,"do",2314425],[2314465,"provide",2314881],[2314993,"patients",2315725],[2316905,"support",2317505],[2317625,"for",2318049],[2318137,"when",2318337],[2318361,"you",2318617],[2318681,"want",2318833],[2318849,"to",2318929],[2318937,"do",2319057],[2319081,"dial.",2319601],[2319753,"It's",2320017],[2320041,"as",2320201],[2320233,"close",2320377],[2320401,"as",2320537],[2320561,"we",2320673],[2320689,"can",2320841],[2320873,"get",2321113],[2321169,"I",2321289],[2321297,"think",2321441],[2321473,"in",2321569],[2321577,"the",2321673],[2321689,"US",2321913],[2321969,"to",2322113],[2322129,"try",2322449],[2322537,"quickly.",2322985],[2323065,"Just",2323281],[2323313,"a",2323481],[2323513,"defense",2323865],[2323905,"of",2324129],[2324177,"observational",2324793],[2324889,"studies",2325377],[2325481,"because",2325721],[2325753,"this",2325921],[2325953,"Annals",2326337],[2326401,"paper,",2326745],[2326825,"Maria",2327217],[2327281,"first",2327553],[2327609,"author",2327897],[2327961,"on",2328497],[2328641,"is",2328945],[2328985,"an",2329161],[2329193,"observational",2329793],[2329889,"study.",2330481],[2330633,"But",2331041],[2331113,"observational",2331665],[2331745,"studies",2332265],[2332385,"like",2332641],[2332673,"they're",2332881],[2332913,"more",2333153],[2333209,"real",2333425],[2333465,"world",2333713],[2333769,"in",2333937],[2333961,"some",2334121],[2334153,"sense",2334361],[2334393,"when",2334537],[2334561,"you're",2334769],[2334817,"capturing",2335425],[2335545,"like",2335993],[2336089,"what",2336417],[2336481,"happens",2336801],[2336833,"in",2336929],[2336937,"the",2337057],[2337081,"real",2337241],[2337273,"world",2337657],[2337761,"and",2338193],[2338289,"following",2338545],[2338585,"patients.",2338861],[2338913,"Patients",2339661],[2339853,"in",2340181],[2340213,"this",2340429],[2340477,"case",2340853],[2340949,"I",2341157],[2341181,"believe",2341461],[2341533,"this",2341789],[2341837,"was",2342501],[2342693,"VA",2343269],[2343357,"patients.",2343741],[2343813,"Right.",2344021],[2344053,"So",2344173],[2344189,"this",2344269],[2344277,"is",2344397],[2344421,"like",2344557],[2344581,"all",2344765],[2344805,"va.",2345413],[2345549,"Right.",2346157],[2346301,"As",2346533],[2346549,"opposed",2346805],[2346845,"to",2347021],[2347053,"randomized",2347485],[2347525,"trial,",2347741],[2347773,"you",2347893],[2347909,"get",2348085],[2348125,"highly",2348429],[2348477,"select",2348797],[2348861,"patients",2349245],[2349325,"like",2349493],[2349509,"there",2349613],[2349629,"are",2349781],[2349813,"some",2350005],[2350045,"patients",2350309],[2350357,"who",2350565],[2350605,"like",2350901],[2350973,"you",2351157],[2351181,"can",2351365],[2351405,"say",2351557],[2351581,"it's",2351949],[2352037,"equipoise",2352813],[2352869,"and",2353013],[2353029,"they're.",2353557],[2353701,"But",2353933],[2353949,"they're",2354077],[2354101,"going",2354189],[2354197,"to",2354269],[2354277,"say,",2354421],[2354453,"like,",2354597],[2354621,"no,",2354781],[2354813,"you're",2355013],[2355029,"not",2355133],[2355149,"going",2355253],[2355269,"to",2355397],[2355421,"tell",2355557],[2355581,"me,",2355813],[2355869,"randomized",2356373],[2356429,"mel",2356909],[2356957,"dialysis",2357701],[2357773,"or",2358269],[2358397,"conservative",2358981],[2359053,"management.",2359333],[2359389,"I'm",2359533],[2359549,"not",2359677],[2359701,"enrolling",2360045],[2360085,"in",2360237],[2360261,"that",2360445],[2360485,"study.",2360877],[2360981,"And",2361173],[2361189,"so",2361269],[2361277,"you're",2361413],[2361429,"going",2361533],[2361549,"to",2361701],[2361733,"lose",2362037],[2362101,"all",2362277],[2362301,"of",2362437],[2362461,"these",2362693],[2362749,"patients.",2363261],[2363373,"And",2363597],[2363621,"I.",2363757],[2363781,"So",2363989],[2364037,"I",2364245],[2364285,"worry",2364565],[2364605,"about",2365213],[2365389,"that.",2365677],[2365701,"From",2365885],[2365925,"randomized",2366285],[2366325,"trials.",2366973],[2367109,"Do",2367309],[2367317,"you",2367437],[2367461,"do",2367669],[2367717,"observational",2368269],[2368357,"research,",2368677],[2368741,"Alex?",2369465],[2370765,"Conflicts",2371341],[2371373,"of",2371541],[2371573,"interest.",2372029],[2372157,"He's",2372477],[2372501,"saying",2372637],[2372661,"I'm",2373077],[2373141,"biased.",2374025],[2375645,"I",2375957],[2375981,"want",2376069],[2376077,"to",2376149],[2376157,"acknowledge.",2376565],[2376645,"We",2376837],[2376861,"got",2376997],[2377021,"a",2377109],[2377117,"couple",2377333],[2377389,"minutes",2377749],[2377797,"left.",2378293],[2378429,"I",2378677],[2378701,"want",2378789],[2378797,"to",2378893],[2378909,"go",2379037],[2379061,"back",2379149],[2379157,"to",2379277],[2379301,"Maria.",2379717],[2379781,"Maria,",2380349],[2380437,"the",2380661],[2380693,"reason",2381029],[2381117,"you",2381365],[2381405,"did",2381581],[2381613,"this,",2381901],[2381973,"right.",2382585],[2383045,"You",2383477],[2383541,"wanted",2383861],[2383893,"to",2384013],[2384029,"be",2384157],[2384181,"able",2384317],[2384341,"to.",2384501],[2384533,"Be",2384749],[2384797,"able",2384981],[2385013,"to",2385181],[2385213,"tell",2385429],[2385477,"patients",2386029],[2386157,"what",2386493],[2386549,"to",2386837],[2386901,"expect.",2387505],[2388445,"And",2388709],[2388717,"I'm",2388957],[2388981,"wondering",2389237],[2389261,"if",2389373],[2389389,"we",2389493],[2389509,"can",2389661],[2389693,"just",2389861],[2389893,"take",2390301],[2390413,"two",2390685],[2390725,"minutes",2391109],[2391197,"to",2391373],[2391389,"think",2391517],[2391541,"about",2391821],[2391893,"if",2392077],[2392101,"you",2392261],[2392293,"were",2392485],[2392525,"going",2392677],[2392701,"to",2392813],[2392829,"have",2392981],[2393013,"a",2393181],[2393213,"discussion",2393985],[2394285,"about",2395025],[2396085,"what's",2396541],[2396573,"the",2396813],[2396869,"difference",2397149],[2397197,"between",2397453],[2397509,"conservative",2398085],[2398165,"management",2398785],[2399325,"and",2399901],[2400013,"starting",2400429],[2400477,"dialysis",2401133],[2401189,"for",2401333],[2401349,"these",2401573],[2401629,"people.",2401917],[2401981,"Let's",2402197],[2402221,"say",2402453],[2402509,"this",2402773],[2402829,"group",2403021],[2403053,"of",2403221],[2403253,"people,",2403541],[2403613,"older",2404029],[2404077,"adults,",2404933],[2405109,"maybe",2405437],[2405461,"some",2405597],[2405621,"multimorbidity,",2406865],[2407245,"GFR",2407909],[2407957,"is",2408117],[2408141,"less",2408301],[2408333,"than",2408549],[2408597,"12.",2409185],[2409525,"How",2409837],[2409861,"would",2409997],[2410021,"you",2410181],[2410213,"talk",2410333],[2410349,"to",2410477],[2410501,"them",2410661],[2410693,"about",2410981],[2411053,"survival,",2411645],[2411765,"quality",2412189],[2412237,"of",2412421],[2412453,"life,",2412717],[2412781,"or",2413005],[2413045,"any",2413197],[2413221,"other",2413477],[2413541,"benefits",2413909],[2413957,"or",2414117],[2414141,"harms",2414365],[2414405,"when",2414533],[2414549,"you're",2414741],[2414773,"thinking",2415069],[2415117,"between",2415373],[2415429,"these",2415645],[2415685,"two",2415885],[2415925,"groups?",2416585],[2417325,"Yeah.",2417765],[2417805,"So",2418101],[2418173,"I'm",2418381],[2418413,"going",2418509],[2418517,"to",2418637],[2418661,"answer",2419005],[2419085,"not",2419325],[2419365,"from",2419589],[2419637,"the",2420157],[2420301,"medical",2420701],[2420773,"doctor",2421173],[2421229,"perspective,",2421669],[2421717,"because",2421949],[2421997,"that's",2422205],[2422245,"Mendew",2422597],[2422621,"enthusiasm.",2423381],[2423453,"But",2423733],[2423789,"I.",2424355],[2424885,"Again,",2425317],[2425381,"going",2425629],[2425677,"back",2425861],[2425893,"to",2426037],[2426061,"my",2426221],[2426253,"dad,",2426493],[2426549,"if",2426669],[2426677,"I",2426797],[2426821,"had",2426957],[2426981,"to",2427165],[2427205,"have",2427357],[2427381,"a",2427565],[2427605,"discussion",2428069],[2428117,"with",2428301],[2428333,"my",2428525],[2428565,"dad,",2428837],[2428901,"how",2429077],[2429101,"would",2429261],[2429293,"I",2429509],[2429557,"argue",2429885],[2429925,"this?",2430269],[2430357,"I",2430557],[2430581,"think",2430765],[2430805,"what",2430981],[2431013,"we",2431277],[2431341,"really",2431973],[2432149,"want",2432605],[2432685,"is",2433237],[2433381,"for",2433733],[2433789,"people",2434221],[2434333,"to",2434985],[2435405,"just",2435813],[2435869,"don't",2436149],[2436197,"assume",2437037],[2437181,"that",2437581],[2437653,"dialysis",2438477],[2438541,"is",2438741],[2438773,"the",2438965],[2439005,"answer",2439705],[2440285,"for",2440645],[2440685,"these",2440957],[2441021,"elderly",2441517],[2441581,"patients.",2441917],[2441981,"Of",2442157],[2442181,"course,",2442533],[2442629,"if",2442813],[2442829,"they",2442957],[2442981,"are",2443213],[2443269,"young,",2443845],[2444005,"there's",2444429],[2444477,"really",2444685],[2444725,"no",2444949],[2444997,"question.",2445301],[2445373,"But",2445533],[2445549,"the",2445701],[2445733,"question",2446045],[2446125,"comes",2446365],[2446405,"when",2446581],[2446613,"they",2446757],[2446781,"are",2446989],[2447037,"older",2447453],[2447509,"and",2447677],[2447701,"what",2447909],[2447957,"is",2448117],[2448141,"it",2448301],[2448333,"that",2448501],[2448533,"they",2448749],[2448797,"really",2449053],[2449109,"want?",2449705],[2450025,"And",2450361],[2450393,"if",2450513],[2450529,"we",2450657],[2450681,"just",2451009],[2451097,"stay",2451441],[2451513,"with",2451865],[2451945,"survival,",2452725],[2453145,"then",2453577],[2453641,"the",2453841],[2453873,"question",2454113],[2454169,"is,",2454409],[2454457,"yes,",2454705],[2454745,"the",2454897],[2454921,"patients.",2455169],[2455217,"If",2455353],[2455369,"you",2455497],[2455521,"ask",2455681],[2455713,"the",2455881],[2455913,"patient,",2456105],[2456145,"do",2456249],[2456257,"you",2456353],[2456369,"want",2456497],[2456521,"to",2456609],[2456617,"live",2456809],[2456857,"longer?",2457185],[2457225,"They're",2457393],[2457409,"going",2457489],[2457497,"to",2457665],[2457705,"say,",2457929],[2457977,"like,",2458185],[2458225,"yes,",2458465],[2458505,"I",2458633],[2458649,"want",2458777],[2458801,"to",2458913],[2458929,"live",2459105],[2459145,"longer.",2459845],[2460185,"Do",2460473],[2460489,"you",2460569],[2460577,"want",2460697],[2460721,"to",2460857],[2460881,"live",2461065],[2461105,"longer?",2461449],[2461497,"Nine",2461777],[2461841,"days",2462445],[2464505,"for",2464865],[2464905,"me,",2465129],[2465177,"that's",2465401],[2465433,"really",2465649],[2465697,"the",2465857],[2465881,"question.",2466089],[2466137,"Not",2466297],[2466321,"even",2466625],[2466705,"70",2467089],[2467177,"days",2467449],[2467497,"out",2467657],[2467681,"of",2467865],[2467905,"three",2468153],[2468209,"years",2468805],[2470465,"with",2470801],[2470833,"the",2471001],[2471033,"idea",2471353],[2471409,"that,",2471673],[2471729,"okay,",2472433],[2472609,"I",2472921],[2472953,"can",2473145],[2473185,"give",2473385],[2473425,"you",2474005],[2474745,"three",2475129],[2475177,"months",2475697],[2475841,"of",2476553],[2476729,"extra",2477241],[2477313,"survival,",2477969],[2478097,"but",2478337],[2478361,"you're",2478577],[2478601,"going",2478761],[2478793,"to",2478961],[2478993,"spend",2479289],[2479337,"more",2479593],[2479649,"time",2479865],[2479905,"in",2480033],[2480049,"the",2480249],[2480297,"hospital,",2480625],[2480705,"and",2480873],[2480889,"you're",2481057],[2481081,"going",2481193],[2481209,"to",2481337],[2481361,"be",2481521],[2481553,"spending",2481905],[2481945,"the",2482145],[2482185,"time",2482673],[2482809,"going",2483081],[2483113,"to",2483233],[2483249,"a",2483401],[2483433,"dialysis",2484057],[2484121,"facility",2484849],[2485017,"pretty",2485297],[2485321,"much",2485625],[2485705,"every",2485945],[2485985,"other",2486257],[2486321,"day.",2486833],[2486969,"And",2487289],[2487337,"most",2487521],[2487553,"of",2487721],[2487753,"that",2487969],[2488017,"extra",2488337],[2488401,"time",2488649],[2488697,"was",2489145],[2489265,"dialysis",2489929],[2489977,"daytime.",2490805],[2491105,"A",2491417],[2491441,"lot",2491577],[2491601,"of",2491713],[2491729,"it",2491857],[2491881,"is",2492041],[2492073,"dialysis",2492721],[2492793,"time.",2493121],[2493193,"Right.",2493689],[2493817,"Because",2494105],[2494145,"they",2494345],[2494385,"have",2494537],[2494561,"to",2494697],[2494721,"go",2494833],[2494849,"to",2494953],[2494969,"a",2495073],[2495089,"dialysis",2495697],[2495761,"facility",2496225],[2496305,"for,",2496713],[2496809,"you",2497017],[2497041,"know,",2497297],[2497361,"three",2497609],[2497657,"times",2497889],[2497937,"a",2498097],[2498121,"week",2498401],[2498473,"for",2498657],[2498681,"the",2498817],[2498841,"most",2499025],[2499065,"part.",2499645],[2500385,"And",2500721],[2500753,"so",2501325],[2501785,"are",2502121],[2502153,"the",2502369],[2502417,"patients.",2502833],[2502929,"Are",2503209],[2503257,"you",2503537],[2503601,"okay?",2503953],[2504009,"Like,",2504465],[2504585,"as.",2505123],[2505249,"As",2505607],[2505671,"the",2505919],[2505967,"caregiver",2506655],[2506775,"or",2507295],[2507415,"as",2507719],[2507767,"a",2507999],[2508047,"family",2508327],[2508391,"member",2508687],[2508751,"of",2508927],[2508951,"the",2509159],[2509207,"patient?",2509915],[2510255,"Is",2510591],[2510623,"that",2510911],[2510983,"really",2511191],[2511223,"in",2511343],[2511359,"the",2511511],[2511543,"best",2511855],[2511935,"interest",2512295],[2512375,"of",2512567],[2512591,"the",2512799],[2512847,"patient?",2513595],[2513975,"Great.",2514719],[2514887,"I",2515191],[2515223,"love",2515415],[2515455,"that.",2516015],[2516175,"How",2516423],[2516439,"about",2516567],[2516591,"for",2516703],[2516719,"you,",2516871],[2516903,"Susan?",2517279],[2517327,"How",2517487],[2517511,"would",2517671],[2517703,"you",2517895],[2517935,"think",2518111],[2518143,"about",2518455],[2518535,"having",2518823],[2518879,"this",2519119],[2519167,"discussion?",2519955],[2521455,"I",2521791],[2521823,"think",2522395],[2523215,"maybe",2523995],[2524575,"I'm",2524975],[2525015,"walking",2525319],[2525367,"Away",2525575],[2525615,"with",2525767],[2525791,"the",2525951],[2525983,"Annals",2526279],[2526327,"paper",2526535],[2526575,"with",2526775],[2526815,"too",2526991],[2527023,"simplistic",2527783],[2527919,"an",2528167],[2528191,"interpretation.",2528767],[2528831,"But",2529031],[2529063,"I",2529207],[2529231,"take",2529391],[2529423,"the",2529615],[2529655,"intention",2529983],[2530039,"to",2530231],[2530263,"treat",2530455],[2530495,"analysis",2530787],[2530801,"dialysis",2531423],[2531519,"is",2531847],[2531911,"confirming",2532511],[2532583,"that",2533079],[2533207,"we",2533543],[2533599,"really",2533935],[2534015,"should",2534255],[2534295,"delay",2534599],[2534647,"dialysis",2535327],[2535391,"initiation",2536247],[2536351,"for",2536615],[2536655,"as",2536831],[2536863,"long",2537055],[2537095,"as",2537343],[2537399,"possible.",2538047],[2538231,"There's",2538527],[2538551,"no",2538711],[2538743,"reason",2538959],[2539007,"to",2539143],[2539159,"rush",2539311],[2539343,"it.",2539559],[2539607,"There's",2539831],[2539863,"no",2540031],[2540063,"reason",2540255],[2540295,"to",2540471],[2540503,"rush.",2541075],[2541655,"And",2541967],[2541991,"Manju",2542391],[2542423,"referred",2542663],[2542679,"to",2542807],[2542831,"this",2543327],[2543471,"ideal",2543967],[2544031,"trial",2544575],[2544695,"that",2544951],[2544983,"randomized",2545423],[2545479,"patients",2545735],[2545775,"to",2545951],[2545983,"early",2546199],[2546247,"versus",2546583],[2546639,"late",2546999],[2547087,"start.",2547407],[2547471,"And",2547623],[2547639,"there",2547743],[2547759,"were",2547935],[2547975,"some",2548151],[2548183,"criticism",2548687],[2548751,"about",2548951],[2548983,"it.",2549151],[2549183,"But",2549303],[2549319,"I",2549423],[2549439,"think",2549663],[2549719,"this",2549935],[2549975,"study",2550199],[2550247,"locks",2550535],[2550575,"it",2550703],[2550719,"in",2550847],[2550871,"that",2551055],[2551095,"really,",2551295],[2551335,"you",2551463],[2551479,"know,",2552035],[2552575,"you",2552911],[2552943,"don't",2553087],[2553111,"need",2553247],[2553271,"a",2553407],[2553431,"clinical",2553767],[2553831,"trial.",2554239],[2554327,"If",2554527],[2554551,"just",2554879],[2554967,"anybody",2555335],[2555375,"walking",2555647],[2555671,"into",2555879],[2555927,"your",2556159],[2556207,"clinic",2556727],[2556831,"with",2557071],[2557103,"the",2557295],[2557335,"resources",2557759],[2557807,"that",2557967],[2557991,"we",2558127],[2558151,"can",2558335],[2558375,"provide,",2558953],[2559119,"we",2559445],[2559485,"can.",2559997],[2560141,"We",2560397],[2560421,"should",2560677],[2560741,"probably",2561029],[2561077,"try",2561213],[2561229,"to",2561381],[2561413,"delay",2561661],[2561693,"this",2561861],[2561893,"as",2561989],[2561997,"much",2562117],[2562141,"as",2562301],[2562333,"we",2562501],[2562533,"can.",2563105],[2563645,"And",2563909],[2563917,"then",2564013],[2564029,"the",2564157],[2564181,"per",2564389],[2564437,"protocol",2564957],[2565021,"analysis,",2565741],[2565853,"I",2566413],[2566549,"see",2566821],[2566853,"that",2567045],[2567085,"as",2567665],[2568005,"an",2568413],[2568469,"opportunity",2569213],[2569309,"that",2569877],[2570021,"indeed",2570541],[2570613,"patients",2570949],[2570997,"who",2571205],[2571245,"were",2571469],[2571517,"started",2571773],[2571829,"on",2572045],[2572085,"dialysis",2573045],[2573165,"did",2573469],[2573517,"live",2573725],[2573765,"a",2573893],[2573909,"little",2574085],[2574125,"longer.",2574565],[2574645,"77",2575325],[2575405,"days,",2575765],[2575845,"but",2576061],[2576093,"that's",2576349],[2576397,"not",2576677],[2576741,"very",2577013],[2577069,"long",2577285],[2577325,"at",2577477],[2577501,"all,",2577733],[2577789,"you",2577909],[2577917,"know,",2578229],[2578317,"at",2578493],[2578509,"least",2578637],[2578661,"in",2578749],[2578757,"my",2578853],[2578869,"book.",2579309],[2579437,"77",2579965],[2580005,"out",2580157],[2580181,"of",2580413],[2580469,"three",2580661],[2580693,"years.",2581221],[2581373,"Yeah,",2581685],[2581725,"three",2581877],[2581901,"years.",2582445],[2582605,"How",2582901],[2582933,"can",2583101],[2583133,"we",2583373],[2583429,"close",2583693],[2583749,"the",2583965],[2584005,"gap?",2584413],[2584509,"And",2584741],[2584773,"that's",2584917],[2584941,"where",2585101],[2585133,"I",2585253],[2585269,"think",2585445],[2585485,"this",2585613],[2585629,"is",2585733],[2585749,"where",2585877],[2585901,"kidney",2586213],[2586269,"supportive",2586685],[2586725,"care",2586949],[2586997,"can",2587205],[2587245,"close",2587469],[2587517,"that",2587749],[2587797,"gap.",2588125],[2588205,"You",2588349],[2588357,"know,",2588717],[2588821,"I",2589037],[2589061,"think",2589647],[2589821,"we",2590107],[2590131,"were",2590315],[2590355,"very",2590555],[2590595,"measured",2590899],[2590947,"in",2591131],[2591163,"saying",2591331],[2591363,"it's",2591579],[2591627,"continuing",2592083],[2592139,"medical",2592475],[2592555,"management",2592891],[2592963,"because",2593171],[2593203,"we",2593347],[2593371,"didn't",2593707],[2593771,"know",2594091],[2594163,"exactly",2594827],[2594891,"the",2595115],[2595155,"kind",2595331],[2595363,"of",2595483],[2595499,"care",2595651],[2595683,"that",2595851],[2595883,"patients",2596195],[2596235,"were",2596387],[2596411,"getting.",2596643],[2596699,"Maybe",2596947],[2596971,"they",2597083],[2597099,"were",2597227],[2597251,"getting",2597435],[2597475,"kidney",2597803],[2597859,"supportive",2598211],[2598243,"care",2598411],[2598443,"or",2598587],[2598611,"conserved",2598971],[2599003,"kidney",2599299],[2599347,"management",2599651],[2599723,"as",2599907],[2599931,"a",2600067],[2600091,"whole,",2600539],[2600667,"but",2600907],[2600931,"maybe",2601243],[2601299,"not.",2601827],[2601971,"But",2602227],[2602251,"even",2602411],[2602443,"if",2602563],[2602579,"you",2602755],[2602795,"didn't",2603099],[2603147,"have",2603331],[2603363,"these",2603531],[2603563,"formal",2603899],[2603947,"structures",2604363],[2604419,"in",2604611],[2604643,"place",2604883],[2604939,"like",2605083],[2605099,"they",2605299],[2605347,"have",2605531],[2605563,"in",2605683],[2605699,"the",2605851],[2605883,"uk,",2606507],[2606691,"you",2606963],[2606979,"know,",2607155],[2607195,"they.",2607827],[2608011,"There",2608331],[2608363,"was",2608555],[2608595,"not",2608795],[2608835,"that.",2609275],[2609395,"The",2609627],[2609651,"distance",2609875],[2609915,"was",2610091],[2610123,"not",2610267],[2610291,"that",2610475],[2610515,"wide.",2610883],[2610979,"So",2611523],[2611659,"it",2611907],[2611931,"gives",2612107],[2612131,"me",2612315],[2612355,"hope",2612531],[2612563,"that",2612707],[2612731,"we",2612891],[2612923,"can",2613067],[2613091,"close",2613371],[2613443,"that",2613747],[2613811,"distance",2614163],[2614219,"if",2614363],[2614379,"we",2614531],[2614563,"can",2614731],[2614763,"provide",2614955],[2614995,"the",2615147],[2615171,"right",2615661],[2615803,"infrastructure",2616401],[2616433,"of",2616601],[2616633,"care",2616801],[2616833,"for",2616977],[2617001,"them.",2617233],[2617289,"So,",2617885],[2618225,"yeah,",2618889],[2619017,"that's",2619329],[2619377,"what",2619513],[2619529,"I'm",2619657],[2619681,"walking",2620001],[2620033,"away",2620249],[2620297,"with",2620457],[2620481,"this.",2621045],[2621385,"Oh,",2621745],[2621785,"lovely.",2622305],[2622425,"My",2622705],[2622745,"patients.",2623097],[2623161,"Yeah.",2623561],[2623633,"It's",2623857],[2623881,"just",2624041],[2624073,"a",2624217],[2624241,"far",2624449],[2624497,"more",2624729],[2624777,"measured",2625489],[2625657,"framing",2626337],[2626401,"of",2626697],[2626761,"what",2627033],[2627089,"dialysis",2627777],[2627841,"can",2628089],[2628137,"offer",2628393],[2628449,"somebody.",2628761],[2628793,"It's",2628913],[2628929,"not",2629057],[2629081,"a",2629193],[2629209,"panacea.",2630193],[2630369,"Manju,",2631073],[2631129,"how",2631249],[2631257,"about",2631449],[2631497,"you?",2632085],[2633065,"I",2633329],[2633337,"think",2633457],[2633481,"Maria",2633833],[2633889,"and",2634033],[2634049,"Susan",2634433],[2634489,"expressed",2635249],[2635377,"what",2635689],[2635737,"to",2635897],[2635921,"say",2636033],[2636049,"to",2636225],[2636265,"patients",2636577],[2636641,"so",2636817],[2636841,"well.",2637049],[2637097,"So",2637281],[2637313,"maybe",2637553],[2637609,"I'll",2637889],[2637937,"express",2638313],[2638409,"what",2638689],[2638737,"to",2638921],[2638953,"say",2639073],[2639089,"to",2639217],[2639241,"our",2639593],[2639689,"colleagues",2640145],[2640185,"in",2640313],[2640329,"nephrology",2641137],[2641201,"and",2641401],[2641433,"in",2641577],[2641601,"the",2641833],[2641889,"policy",2642273],[2642369,"world,",2643005],[2643435,"which",2643843],[2643899,"is",2644379],[2644507,"that",2644771],[2644803,"we",2644947],[2644971,"have",2645155],[2645195,"equipoise",2646083],[2646179,"here.",2646815],[2647115,"There",2647475],[2647515,"is",2647835],[2647915,"enough",2648251],[2648323,"evidence",2648771],[2648843,"here",2649051],[2649083,"to",2649275],[2649315,"suggest",2649587],[2649651,"that",2649827],[2649851,"we",2650131],[2650203,"actually",2650531],[2650603,"don't",2650827],[2650851,"know",2651155],[2651235,"which",2651499],[2651547,"path",2651859],[2651907,"is",2652115],[2652155,"beneficial",2653095],[2653395,"and",2653755],[2653795,"we",2654067],[2654131,"really",2654451],[2654523,"need",2654971],[2655083,"more",2655595],[2655715,"trials.",2656283],[2656339,"Although",2656611],[2656643,"I'm",2656827],[2656851,"an",2657011],[2657043,"observational",2657691],[2657803,"study",2658411],[2658563,"sort",2658867],[2658891,"of",2659099],[2659147,"person,",2659619],[2659747,"I",2660035],[2660075,"really",2660323],[2660379,"do",2660643],[2660699,"think",2661203],[2661339,"that",2661683],[2661739,"the",2661907],[2661931,"way",2662067],[2662091,"to",2662227],[2662251,"move",2662387],[2662411,"the",2662547],[2662571,"needle",2662811],[2662843,"in",2663035],[2663075,"practice",2663379],[2663427,"is",2663611],[2663643,"with",2663859],[2663907,"trials",2664775],[2665235,"and",2665883],[2666019,"I",2666315],[2666355,"think",2666627],[2666691,"that",2666939],[2666987,"we.",2667651],[2667843,"There's",2668275],[2668315,"so",2668443],[2668459,"many",2668683],[2668739,"unanswered",2669331],[2669403,"questions",2669867],[2669931,"now",2670179],[2670227,"about",2670815],[2671125,"how",2671509],[2671557,"to",2671933],[2672029,"deliver",2672665],[2673205,"really",2673613],[2673669,"good",2674221],[2674373,"conservative",2674957],[2675021,"kidney",2675373],[2675429,"management",2675789],[2675877,"that",2676101],[2676133,"we",2676301],[2676333,"should",2676549],[2676597,"not",2677069],[2677197,"wait",2677485],[2677525,"for",2677725],[2677765,"just",2678013],[2678069,"England",2678501],[2678573,"to",2678757],[2678781,"do",2678941],[2678973,"these",2679141],[2679173,"trials,",2679549],[2679597,"we",2679757],[2679781,"should",2679965],[2680005,"do",2680157],[2680181,"them",2680389],[2680437,"here",2680765],[2680845,"as",2681037],[2681061,"well.",2681605],[2681765,"Yeah.",2682317],[2682421,"And",2682637],[2682661,"I",2682797],[2682821,"also",2683005],[2683045,"love.",2683221],[2683253,"I'm",2683397],[2683421,"going",2683485],[2683485,"to",2683573],[2683589,"go",2683693],[2683709,"back",2683789],[2683797,"to",2683893],[2683909,"that",2684037],[2684061,"new",2684509],[2684637,"paper",2684973],[2685029,"from",2685221],[2685253,"2009",2685885],[2685925,"which",2686053],[2686069,"we'll",2686173],[2686189,"have",2686317],[2686341,"linked",2686637],[2686661,"to.",2687157],[2687301,"Just",2687653],[2687709,"don't",2687917],[2687941,"assume",2688221],[2688253,"that",2688469],[2688517,"function",2688885],[2688925,"is",2689077],[2689101,"going",2689213],[2689229,"to",2689357],[2689381,"improve",2689685],[2689765,"post",2690029],[2690077,"dialysis",2690805],[2690885,"because",2691505],[2692565,"they're",2692981],[2693013,"in",2693205],[2693245,"dialysis",2693893],[2693949,"for",2694141],[2694173,"three",2694317],[2694341,"days",2694573],[2694629,"a",2694773],[2694789,"week,",2695157],[2695261,"they're",2695613],[2695669,"sleepy",2696325],[2696405,"afterwards.",2696965],[2697045,"They're",2697341],[2697373,"just",2697945],[2698475,"function",2699043],[2699099,"is",2699387],[2699451,"going",2699675],[2699715,"to",2700011],[2700083,"likely",2700483],[2700579,"get",2700883],[2700939,"worse",2701259],[2701307,"for",2701515],[2701555,"many",2701779],[2701827,"of",2702035],[2702075,"these",2702323],[2702379,"patients.",2702995],[2703155,"And",2703427],[2703451,"this",2703587],[2703611,"is",2703819],[2703867,"not",2704051],[2704083,"the",2704275],[2704315,"fix.",2704895],[2705475,"So",2706215],[2706555,"I",2706867],[2706891,"thought,",2707363],[2707499,"Manju,",2708099],[2708147,"I",2708283],[2708299,"thought",2708547],[2708611,"your",2709003],[2709099,"last",2709355],[2709395,"phrase",2709651],[2709683,"was",2709827],[2709851,"going",2709939],[2709947,"to",2709995],[2709995,"be",2710131],[2710163,"let",2710283],[2710299,"it",2710475],[2710515,"be,",2711099],[2711267,"which",2711571],[2711603,"I",2711699],[2711707,"was",2711827],[2711851,"going",2711939],[2711947,"to",2712043],[2712059,"argue",2712627],[2712771,"is",2713027],[2713051,"my",2713211],[2713243,"line.",2713603],[2713699,"I",2713907],[2713931,"should",2714091],[2714123,"have",2714267],[2714291,"worked",2714507],[2714531,"that",2714667],[2714691,"in.",2714899],[2714947,"I",2715107],[2715131,"was",2715291],[2715323,"not",2715515],[2715555,"thinking",2715899],[2715947,"ahead.",2716535],[2717555,"So",2718131],[2718243,"should",2718491],[2718523,"I",2718691],[2718723,"say",2719275],[2719435,"we",2719731],[2719763,"should",2719931],[2719963,"just",2720155],[2720195,"let",2720323],[2720339,"it",2720491],[2720523,"be?",2720811],[2720883,"Oh,",2721227],[2721291,"there",2721515],[2721555,"you",2721731],[2721763,"go.",2722335],[2724395,"And",2724755],[2724795,"with",2724911],[2724933,"when",2725211],[2725283,"the",2725539],[2725587,"broken",2726267],[2726371,"hearted",2727051],[2727123,"people",2727735],[2728155,"living",2728683],[2728779,"in",2729323],[2729459,"the",2729779],[2729827,"world",2730203],[2730299,"agree",2730935],[2731755,"There",2732211],[2732283,"will",2732611],[2732683,"be",2733083],[2733179,"an",2733459],[2733507,"answer",2734215],[2734715,"Let",2735027],[2735051,"it",2735235],[2735275,"be",2735855],[2738635,"but",2739019],[2739067,"though",2739371],[2739443,"they",2739699],[2739747,"may",2740147],[2740251,"be",2740515],[2740555,"parted",2741415],[2741715,"There",2742099],[2742147,"is",2742403],[2742459,"still",2742723],[2742779,"a",2742995],[2743035,"chance",2743691],[2743843,"that",2744179],[2744227,"they",2744435],[2744475,"will",2744771],[2744843,"see",2745455],[2746195,"There",2746651],[2746723,"will",2747099],[2747187,"be",2747579],[2747667,"an",2747939],[2747987,"answer",2748735],[2749115,"Let",2749451],[2749483,"it.",2749675],[2749715,"Be.",2750295],[2752565,"Let",2752901],[2752933,"it",2753173],[2753229,"be,",2753825],[2754325,"Let",2754637],[2754661,"it",2754869],[2754917,"be,",2755505],[2756205,"Let",2756517],[2756541,"it",2756725],[2756765,"be,",2757345],[2758045,"Let",2758429],[2758477,"it",2758757],[2758821,"be",2759425],[2760845,"There",2761325],[2761405,"will",2761789],[2761877,"be",2762269],[2762357,"an",2762629],[2762677,"answer",2763425],[2763885,"Let",2764197],[2764221,"it",2764405],[2764445,"be.",2765025],[2769605,"Susan",2770141],[2770173,"Maria,",2770429],[2770477,"Manju,",2771013],[2771069,"thank",2771213],[2771229,"you",2771333],[2771349,"for",2771477],[2771501,"joining",2771717],[2771741,"us",2771853],[2771869,"on",2771973],[2771989,"this",2772117],[2772141,"Jerry",2772381],[2772413,"Bell",2772709],[2772757,"podcast.",2773585],[2773885,"Thank",2774173],[2774189,"you",2774389],[2774437,"so",2774573],[2774589,"much.",2775145],[2777255,"And",2777567],[2777591,"to",2777775],[2777815,"all",2777967],[2777991,"of",2778103],[2778119,"our",2778319],[2778367,"listeners.",2778783],[2778839,"Again,",2779007],[2779031,"we",2779167],[2779191,"have",2779303],[2779319,"a",2779399],[2779407,"ton",2779527],[2779551,"of",2779663],[2779679,"stuff",2779847],[2779871,"in",2779959],[2779967,"the",2780087],[2780111,"show",2780271],[2780303,"notes.",2780559],[2780607,"Check",2780743],[2780759,"it",2780863],[2780879,"out",2780983],[2780999,"for",2781127],[2781151,"the",2781311],[2781343,"articles",2781847],[2781911,"and",2782111],[2782143,"thank",2782327],[2782351,"you",2782487],[2782511,"for",2782647],[2782671,"your",2782903],[2782959,"continued",2783503],[2783559,"support.",2784135],[2784295,"We'd",2784655],[2784695,"also",2784919],[2784967,"like",2785079],[2785087,"to",2785207],[2785231,"say",2785343],[2785359,"a",2785487],[2785511,"very",2785695],[2785735,"big",2785911],[2785943,"thank",2786087],[2786111,"you",2786247],[2786271,"to",2786383],[2786399,"the",2786527],[2786551,"donors",2786839],[2786887,"who've",2787127],[2787151,"donated",2787391],[2787423,"more",2787543],[2787559,"than",2787687],[2787711,"$250",2788727],[2788831,"in",2789023],[2789039,"the",2789191],[2789223,"last",2789391],[2789423,"year",2789567],[2789591,"to",2789703],[2789719,"support",2789847],[2789871,"the",2789983],[2789999,"Jerry",2790231],[2790263,"Powell",2790511],[2790543,"podcast.",2790975],[2791055,"Including",2791583],[2791719,"Asher",2792191],[2792263,"Edwards,",2792847],[2792991,"Jerry",2793367],[2793391,"Gerwitz,",2794047],[2794111,"Victoria",2794535],[2794575,"Braund,",2795095],[2795175,"Meg",2795431],[2795463,"Walhagen",2796047],[2796071,"and",2796207],[2796231,"William",2796479],[2796527,"Strawbridge,",2797415],[2797535,"Jessica",2798071],[2798103,"McFarland,",2798935],[2799055,"James",2799335],[2799375,"Tulsky,",2800183],[2800279,"Susan",2800743],[2800799,"Nelson,",2801351],[2801463,"Sharon",2801855],[2801895,"Brangman,",2802591],[2802703,"Darrell",2803087],[2803111,"Lowens,",2803639],[2803727,"Craig",2804055],[2804095,"China,",2804535],[2804655,"Mike",2804935],[2804975,"Steinman",2805431],[2805463,"and",2805583],[2805599,"Dorothy",2805991],[2806023,"Richman,",2806655],[2806775,"Diane",2807247],[2807271,"Meyer,",2807863],[2807959,"Matt",2808183],[2808199,"Schuster,",2808895],[2808975,"Harry",2809295],[2809335,"Hahn,",2809775],[2809855,"Elizabeth",2810311],[2810343,"Chung,",2810943],[2811039,"Wendy",2811527],[2811551,"Peltier,",2812287],[2812431,"Kelly",2812855],[2812895,"Straight,",2813479],[2813567,"Jeffrey",2813887],[2813911,"Galbraith,",2814655],[2814735,"Ron",2815015],[2815055,"Sabar,",2815831],[2815983,"Rebecca",2816495],[2816535,"Goldstein,",2817431],[2817543,"Anna",2817927],[2817951,"Lynch,",2818567],[2818711,"Deborah",2819167],[2819191,"and",2819303],[2819319,"Jeffrey",2819671],[2819703,"Larson,",2820351],[2820503,"Krista",2821007],[2821031,"Mossack,",2821847],[2821991,"Ed",2822295],[2822335,"Martin",2822903],[2822999,"and",2823207],[2823231,"Stuart",2823551],[2823583,"Oserman,",2824631],[2824823,"thank",2825143],[2825159,"you",2825335],[2825375,"very",2825527],[2825551,"much.",2825615]],"speakers":[{"id":"bb0cfb3b-893b-4e7e-a4f5-5dbdb6f117a9","name":"Speaker 5"},{"id":"b9089942-7a34-468c-bcb4-b5ebda0fc6ff","name":"Speaker 4"},{"id":"b9f4bef4-ff99-4790-aa25-5ab217ba5c80","name":"Speaker 3"},{"id":"9e1566ce-8fec-4212-834c-009774412723","name":"Speaker 2"},{"id":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","name":"Speaker 1"}],"speakerRanges":[{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":0,"endIndex":9,"endMs":4209,"startMs":1040},{"speakerId":"9e1566ce-8fec-4212-834c-009774412723","startIndex":10,"endIndex":26,"endMs":11481,"startMs":4337},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":27,"endIndex":30,"endMs":12409,"startMs":11513},{"speakerId":"9e1566ce-8fec-4212-834c-009774412723","startIndex":31,"endIndex":34,"endMs":13745,"startMs":12457},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":35,"endIndex":84,"endMs":30233,"startMs":13905},{"speakerId":"9e1566ce-8fec-4212-834c-009774412723","startIndex":85,"endIndex":129,"endMs":46597,"startMs":30289},{"speakerId":"b9f4bef4-ff99-4790-aa25-5ab217ba5c80","startIndex":130,"endIndex":134,"endMs":48093,"startMs":46701},{"speakerId":"9e1566ce-8fec-4212-834c-009774412723","startIndex":135,"endIndex":164,"endMs":60461,"startMs":48269},{"speakerId":"b9089942-7a34-468c-bcb4-b5ebda0fc6ff","startIndex":165,"endIndex":169,"endMs":62125,"startMs":60653},{"speakerId":"9e1566ce-8fec-4212-834c-009774412723","startIndex":170,"endIndex":192,"endMs":71957,"startMs":62285},{"speakerId":"bb0cfb3b-893b-4e7e-a4f5-5dbdb6f117a9","startIndex":193,"endIndex":201,"endMs":75345,"startMs":72141},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":202,"endIndex":239,"endMs":87099,"startMs":75645},{"speakerId":"b9f4bef4-ff99-4790-aa25-5ab217ba5c80","startIndex":240,"endIndex":253,"endMs":92335,"startMs":87187},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":254,"endIndex":260,"endMs":95255,"startMs":92915},{"speakerId":"b9f4bef4-ff99-4790-aa25-5ab217ba5c80","startIndex":261,"endIndex":276,"endMs":106295,"startMs":96155},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":277,"endIndex":278,"endMs":108535,"startMs":106635},{"speakerId":"9e1566ce-8fec-4212-834c-009774412723","startIndex":279,"endIndex":339,"endMs":150615,"startMs":110955},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":340,"endIndex":340,"endMs":155535,"startMs":154755},{"speakerId":"b9f4bef4-ff99-4790-aa25-5ab217ba5c80","startIndex":341,"endIndex":343,"endMs":157615,"startMs":155915},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":344,"endIndex":534,"endMs":236135,"startMs":158555},{"speakerId":"bb0cfb3b-893b-4e7e-a4f5-5dbdb6f117a9","startIndex":535,"endIndex":654,"endMs":299051,"startMs":236955},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":655,"endIndex":679,"endMs":308955,"startMs":299233},{"speakerId":"bb0cfb3b-893b-4e7e-a4f5-5dbdb6f117a9","startIndex":680,"endIndex":810,"endMs":370297,"startMs":309735},{"speakerId":"9e1566ce-8fec-4212-834c-009774412723","startIndex":811,"endIndex":824,"endMs":376961,"startMs":370481},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":825,"endIndex":830,"endMs":378241,"startMs":376993},{"speakerId":"9e1566ce-8fec-4212-834c-009774412723","startIndex":831,"endIndex":846,"endMs":384845,"startMs":378313},{"speakerId":"b9f4bef4-ff99-4790-aa25-5ab217ba5c80","startIndex":847,"endIndex":1112,"endMs":480705,"startMs":385485},{"speakerId":"9e1566ce-8fec-4212-834c-009774412723","startIndex":1113,"endIndex":1147,"endMs":495865,"startMs":481125},{"speakerId":"bb0cfb3b-893b-4e7e-a4f5-5dbdb6f117a9","startIndex":1148,"endIndex":1218,"endMs":528485,"startMs":496645},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":1219,"endIndex":1343,"endMs":572765,"startMs":528985},{"speakerId":"bb0cfb3b-893b-4e7e-a4f5-5dbdb6f117a9","startIndex":1344,"endIndex":1504,"endMs":641635,"startMs":573105},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":1505,"endIndex":1511,"endMs":644915,"startMs":642815},{"speakerId":"bb0cfb3b-893b-4e7e-a4f5-5dbdb6f117a9","startIndex":1512,"endIndex":1649,"endMs":709245,"startMs":645815},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":1650,"endIndex":1749,"endMs":748797,"startMs":710495},{"speakerId":"bb0cfb3b-893b-4e7e-a4f5-5dbdb6f117a9","startIndex":1750,"endIndex":1762,"endMs":753945,"startMs":748981},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":1763,"endIndex":1770,"endMs":757429,"startMs":754885},{"speakerId":"bb0cfb3b-893b-4e7e-a4f5-5dbdb6f117a9","startIndex":1771,"endIndex":1893,"endMs":810819,"startMs":757597},{"speakerId":"b9f4bef4-ff99-4790-aa25-5ab217ba5c80","startIndex":1894,"endIndex":1896,"endMs":811827,"startMs":810867},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":1897,"endIndex":1911,"endMs":817735,"startMs":811931},{"speakerId":"bb0cfb3b-893b-4e7e-a4f5-5dbdb6f117a9","startIndex":1912,"endIndex":2063,"endMs":883145,"startMs":818435},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":2064,"endIndex":2086,"endMs":890245,"startMs":883305},{"speakerId":"bb0cfb3b-893b-4e7e-a4f5-5dbdb6f117a9","startIndex":2087,"endIndex":2198,"endMs":938571,"startMs":890585},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":2199,"endIndex":2280,"endMs":967455,"startMs":938643},{"speakerId":"9e1566ce-8fec-4212-834c-009774412723","startIndex":2281,"endIndex":2321,"endMs":987915,"startMs":968115},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":2322,"endIndex":2341,"endMs":993411,"startMs":988075},{"speakerId":"bb0cfb3b-893b-4e7e-a4f5-5dbdb6f117a9","startIndex":2342,"endIndex":2367,"endMs":1001415,"startMs":993523},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":2368,"endIndex":2471,"endMs":1037935,"startMs":1002955},{"speakerId":"b9f4bef4-ff99-4790-aa25-5ab217ba5c80","startIndex":2472,"endIndex":3004,"endMs":1242815,"startMs":1038555},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":3005,"endIndex":3049,"endMs":1260635,"startMs":1242895},{"speakerId":"b9089942-7a34-468c-bcb4-b5ebda0fc6ff","startIndex":3050,"endIndex":3376,"endMs":1393415,"startMs":1261145},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":3377,"endIndex":3425,"endMs":1415949,"startMs":1393995},{"speakerId":"b9089942-7a34-468c-bcb4-b5ebda0fc6ff","startIndex":3426,"endIndex":3632,"endMs":1497771,"startMs":1415997},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":3633,"endIndex":3671,"endMs":1509739,"startMs":1497963},{"speakerId":"b9089942-7a34-468c-bcb4-b5ebda0fc6ff","startIndex":3672,"endIndex":3683,"endMs":1513339,"startMs":1509907},{"speakerId":"bb0cfb3b-893b-4e7e-a4f5-5dbdb6f117a9","startIndex":3684,"endIndex":3768,"endMs":1546565,"startMs":1513427},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":3769,"endIndex":3780,"endMs":1553121,"startMs":1547345},{"speakerId":"bb0cfb3b-893b-4e7e-a4f5-5dbdb6f117a9","startIndex":3781,"endIndex":3810,"endMs":1564409,"startMs":1553233},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":3811,"endIndex":3827,"endMs":1569409,"startMs":1564497},{"speakerId":"bb0cfb3b-893b-4e7e-a4f5-5dbdb6f117a9","startIndex":3828,"endIndex":3857,"endMs":1583565,"startMs":1569457},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":3858,"endIndex":3861,"endMs":1586285,"startMs":1583865},{"speakerId":"bb0cfb3b-893b-4e7e-a4f5-5dbdb6f117a9","startIndex":3862,"endIndex":3867,"endMs":1590867,"startMs":1588275},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":3868,"endIndex":3878,"endMs":1592835,"startMs":1590891},{"speakerId":"bb0cfb3b-893b-4e7e-a4f5-5dbdb6f117a9","startIndex":3879,"endIndex":3940,"endMs":1616129,"startMs":1592875},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":3941,"endIndex":3960,"endMs":1622977,"startMs":1616257},{"speakerId":"bb0cfb3b-893b-4e7e-a4f5-5dbdb6f117a9","startIndex":3961,"endIndex":3963,"endMs":1623929,"startMs":1623041},{"speakerId":"b9089942-7a34-468c-bcb4-b5ebda0fc6ff","startIndex":3964,"endIndex":4035,"endMs":1652671,"startMs":1623977},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":4036,"endIndex":4072,"endMs":1662967,"startMs":1652743},{"speakerId":"b9089942-7a34-468c-bcb4-b5ebda0fc6ff","startIndex":4073,"endIndex":4117,"endMs":1684233,"startMs":1663071},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":4118,"endIndex":4124,"endMs":1686113,"startMs":1684409},{"speakerId":"9e1566ce-8fec-4212-834c-009774412723","startIndex":4125,"endIndex":4214,"endMs":1717085,"startMs":1686169},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":4215,"endIndex":4222,"endMs":1720547,"startMs":1717505},{"speakerId":"bb0cfb3b-893b-4e7e-a4f5-5dbdb6f117a9","startIndex":4223,"endIndex":4252,"endMs":1735471,"startMs":1720721},{"speakerId":"9e1566ce-8fec-4212-834c-009774412723","startIndex":4253,"endIndex":4299,"endMs":1752405,"startMs":1735623},{"speakerId":"bb0cfb3b-893b-4e7e-a4f5-5dbdb6f117a9","startIndex":4300,"endIndex":4306,"endMs":1754217,"startMs":1752705},{"speakerId":"b9089942-7a34-468c-bcb4-b5ebda0fc6ff","startIndex":4307,"endIndex":4576,"endMs":1851469,"startMs":1754401},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":4577,"endIndex":4662,"endMs":1876825,"startMs":1851597},{"speakerId":"b9089942-7a34-468c-bcb4-b5ebda0fc6ff","startIndex":4663,"endIndex":4680,"endMs":1883937,"startMs":1876985},{"speakerId":"9e1566ce-8fec-4212-834c-009774412723","startIndex":4681,"endIndex":4682,"endMs":1884753,"startMs":1884121},{"speakerId":"b9089942-7a34-468c-bcb4-b5ebda0fc6ff","startIndex":4683,"endIndex":4683,"endMs":1885241,"startMs":1884809},{"speakerId":"9e1566ce-8fec-4212-834c-009774412723","startIndex":4684,"endIndex":4728,"endMs":1897359,"startMs":1885353},{"speakerId":"b9089942-7a34-468c-bcb4-b5ebda0fc6ff","startIndex":4729,"endIndex":4738,"endMs":1901407,"startMs":1897447},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":4739,"endIndex":4758,"endMs":1908435,"startMs":1901471},{"speakerId":"b9089942-7a34-468c-bcb4-b5ebda0fc6ff","startIndex":4759,"endIndex":4761,"endMs":1910263,"startMs":1908895},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":4762,"endIndex":4777,"endMs":1917583,"startMs":1910439},{"speakerId":"9e1566ce-8fec-4212-834c-009774412723","startIndex":4778,"endIndex":4778,"endMs":1917831,"startMs":1917639},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":4779,"endIndex":4786,"endMs":1921699,"startMs":1917863},{"speakerId":"b9089942-7a34-468c-bcb4-b5ebda0fc6ff","startIndex":4787,"endIndex":4791,"endMs":1923935,"startMs":1921867},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":4792,"endIndex":4826,"endMs":1939215,"startMs":1924315},{"speakerId":"b9089942-7a34-468c-bcb4-b5ebda0fc6ff","startIndex":4827,"endIndex":5022,"endMs":2020247,"startMs":1940115},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":5023,"endIndex":5036,"endMs":2024367,"startMs":2020391},{"speakerId":"b9089942-7a34-468c-bcb4-b5ebda0fc6ff","startIndex":5037,"endIndex":5037,"endMs":2025023,"startMs":2024431},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":5038,"endIndex":5046,"endMs":2028439,"startMs":2025119},{"speakerId":"bb0cfb3b-893b-4e7e-a4f5-5dbdb6f117a9","startIndex":5047,"endIndex":5152,"endMs":2076035,"startMs":2028447},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":5153,"endIndex":5169,"endMs":2081095,"startMs":2076155},{"speakerId":"bb0cfb3b-893b-4e7e-a4f5-5dbdb6f117a9","startIndex":5170,"endIndex":5178,"endMs":2083867,"startMs":2081835},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":5179,"endIndex":5179,"endMs":2084615,"startMs":2083931},{"speakerId":"b9089942-7a34-468c-bcb4-b5ebda0fc6ff","startIndex":5180,"endIndex":5280,"endMs":2130265,"startMs":2086755},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":5281,"endIndex":5283,"endMs":2131717,"startMs":2130965},{"speakerId":"9e1566ce-8fec-4212-834c-009774412723","startIndex":5284,"endIndex":5357,"endMs":2163623,"startMs":2131781},{"speakerId":"b9089942-7a34-468c-bcb4-b5ebda0fc6ff","startIndex":5358,"endIndex":5358,"endMs":2164203,"startMs":2163809},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":5359,"endIndex":5433,"endMs":2198615,"startMs":2164259},{"speakerId":"b9f4bef4-ff99-4790-aa25-5ab217ba5c80","startIndex":5434,"endIndex":5534,"endMs":2235141,"startMs":2199275},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":5535,"endIndex":5536,"endMs":2236061,"startMs":2235293},{"speakerId":"b9f4bef4-ff99-4790-aa25-5ab217ba5c80","startIndex":5537,"endIndex":5766,"endMs":2322985,"startMs":2236213},{"speakerId":"9e1566ce-8fec-4212-834c-009774412723","startIndex":5767,"endIndex":5895,"endMs":2366973,"startMs":2323065},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":5896,"endIndex":5904,"endMs":2372029,"startMs":2367109},{"speakerId":"9e1566ce-8fec-4212-834c-009774412723","startIndex":5905,"endIndex":5908,"endMs":2374025,"startMs":2372157},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":5909,"endIndex":6020,"endMs":2416585,"startMs":2375645},{"speakerId":"b9089942-7a34-468c-bcb4-b5ebda0fc6ff","startIndex":6021,"endIndex":6207,"endMs":2486833,"startMs":2417325},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":6208,"endIndex":6216,"endMs":2490805,"startMs":2486969},{"speakerId":"b9089942-7a34-468c-bcb4-b5ebda0fc6ff","startIndex":6217,"endIndex":6275,"endMs":2513595,"startMs":2491105},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":6276,"endIndex":6292,"endMs":2519955,"startMs":2513975},{"speakerId":"b9f4bef4-ff99-4790-aa25-5ab217ba5c80","startIndex":6293,"endIndex":6330,"endMs":2538047,"startMs":2521455},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":6331,"endIndex":6336,"endMs":2539559,"startMs":2538231},{"speakerId":"b9f4bef4-ff99-4790-aa25-5ab217ba5c80","startIndex":6337,"endIndex":6450,"endMs":2579309,"startMs":2539607},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":6451,"endIndex":6455,"endMs":2581221,"startMs":2579437},{"speakerId":"b9f4bef4-ff99-4790-aa25-5ab217ba5c80","startIndex":6456,"endIndex":6584,"endMs":2621045,"startMs":2581373},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":6585,"endIndex":6586,"endMs":2622305,"startMs":2621385},{"speakerId":"b9f4bef4-ff99-4790-aa25-5ab217ba5c80","startIndex":6587,"endIndex":6606,"endMs":2630193,"startMs":2622425},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":6607,"endIndex":6610,"endMs":2632085,"startMs":2630369},{"speakerId":"bb0cfb3b-893b-4e7e-a4f5-5dbdb6f117a9","startIndex":6611,"endIndex":6732,"endMs":2681605,"startMs":2633065},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":6733,"endIndex":6821,"endMs":2713603,"startMs":2681765},{"speakerId":"bb0cfb3b-893b-4e7e-a4f5-5dbdb6f117a9","startIndex":6822,"endIndex":6842,"endMs":2720811,"startMs":2713699},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":6843,"endIndex":6846,"endMs":2722335,"startMs":2720883},{"speakerId":"9e1566ce-8fec-4212-834c-009774412723","startIndex":6847,"endIndex":6888,"endMs":2749675,"startMs":2724395},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":6889,"endIndex":6889,"endMs":2750295,"startMs":2749715},{"speakerId":"9e1566ce-8fec-4212-834c-009774412723","startIndex":6890,"endIndex":6909,"endMs":2765025,"startMs":2752565},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":6910,"endIndex":6922,"endMs":2773585,"startMs":2769605},{"speakerId":"bb0cfb3b-893b-4e7e-a4f5-5dbdb6f117a9","startIndex":6923,"endIndex":6926,"endMs":2775145,"startMs":2773885},{"speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd","startIndex":6927,"endIndex":6984,"endMs":2790975,"startMs":2777255},{"speakerId":"9e1566ce-8fec-4212-834c-009774412723","startIndex":6985,"endIndex":7048,"endMs":2825615,"startMs":2791055}],"speakerStatistics":[{"speaker":{"name":"Speaker 5","speakerId":"bb0cfb3b-893b-4e7e-a4f5-5dbdb6f117a9"},"transcriptTimeMs":676386},{"speaker":{"name":"Speaker 1","speakerId":"c7c68d5e-1062-4ed3-b766-e76a04f228dd"},"transcriptTimeMs":602089},{"speaker":{"name":"Speaker 4","speakerId":"b9089942-7a34-468c-bcb4-b5ebda0fc6ff"},"transcriptTimeMs":597278},{"speaker":{"name":"Speaker 3","speakerId":"b9f4bef4-ff99-4790-aa25-5ab217ba5c80"},"transcriptTimeMs":545192},{"speaker":{"name":"Speaker 2","speakerId":"9e1566ce-8fec-4212-834c-009774412723"},"transcriptTimeMs":344262}]},"state":"PROCESSED"},"intelligence":{"status":"COMPLETE","sections":[{"data":{"id":"740847f7-5ca4-4cac-96d8-a8f438be0897","text":"The podcast features a discussion on the evolving practices in nephrology, particularly the trend of initiating dialysis at higher EGFR levels, which may not benefit patients as previously thought. Concerns were raised about financial incentives affecting dialysis decisions and the lack of recovery in functional status post-dialysis, emphasizing the need for a reevaluation of treatment options for older patients with multimorbidity. The speakers advocate for more clinical trials to better understand the benefits of conservative kidney management compared to dialysis."},"status":"SUCCESS","__typename":"IntelligenceTextSection","section":{"type":"summary_overview","description":"Paragraph summary of your meeting","title":"Summary"}},{"data":[{"id":"0193038c-e8a6-73da-ad6a-757e117abc2e","timestamp":2538000,"text":"Susan and Maria to emphasize the importance of delaying dialysis initiation as much as possible based on the findings, ensuring patients understand there is no rush.","endTimestamp":2549000},{"id":"0193038c-e8a6-7bc2-beb2-97ff41a892f0","timestamp":2630000,"text":"Manju to convey to colleagues in nephrology and the policy world the need for more trials due to existing equipoise, advocating for additional research to address unanswered questions regarding conservative kidney management.","endTimestamp":2647000}],"status":"SUCCESS","__typename":"IntelligenceMarkSection","section":{"type":"next_steps","description":"List of time stamped action items from your meeting","title":"Next Steps"}},{"data":[{"id":"0193038c-f52a-793b-81fa-61bc4146a46b","timestamp":30000,"text":"Alex Smith welcomes Susan Wong, a nephrologist and Fulbright scholar, to the podcast.","endTimestamp":43000},{"id":"0193038c-f52a-767e-a2a1-e440c1b28a71","timestamp":236000,"text":"Manju Karela Tamura discusses the shift in nephrology practice towards starting dialysis at higher levels of EGFR and how recent evidence suggests this may not benefit patients.","endTimestamp":281000},{"id":"0193038c-f52a-784d-b999-19ad7f2351df","timestamp":370000,"text":"Maria Marquez Rath highlights concerns about financial incentives influencing dialysis initiation decisions, referencing her study on veterans' care.","endTimestamp":410000},{"id":"0193038c-f52a-7870-8bfb-71d0bfa12be0","timestamp":890000,"text":"Maria Marquez Rath describes her New England Journal article findings, noting that most patients do not recover functional status after starting dialysis, countering clinical instincts to intervene.","endTimestamp":934000},{"id":"0193038c-f52a-7695-be81-cda1e8e0ca23","timestamp":1038000,"text":"Speaker 3 discusses the need to reevaluate the benefits of dialysis for older patients with multimorbidity and highlights the importance of conservative kidney management.","endTimestamp":1170000},{"id":"0193038c-f52a-7a5d-b832-27ea59c5ab2c","timestamp":1509000,"text":"Speaker 5 presents findings from the Annals paper, detailing survival rates and home time for patients starting dialysis compared to those receiving conservative management.","endTimestamp":1603000},{"id":"0193038c-f52a-7e72-8c8d-1a351ab4ed3f","timestamp":2417000,"text":"Speaker 4 reflects on discussing treatment options with elderly patients, stressing the importance of understanding patient preferences regarding dialysis versus conservative management.","endTimestamp":2504000},{"id":"0193038c-f52a-736f-ac80-4619dcb58adb","timestamp":2633000,"text":"Speaker 5 advocates for more clinical trials in nephrology, highlighting the need for further research to determine the best practices for conservative kidney management.","endTimestamp":2667000}],"status":"SUCCESS","__typename":"IntelligenceMarkSection","section":{"type":"summary_points","description":"List of time stamped key points from your meeting","title":"Key Points"}}]},"startDatetime":"2024-11-06T21:28:30.962485Z","endDatetime":"2024-11-06T22:15:37.482485Z","widthPx":640,"heightPx":360,"videoUrl":"https://media.grain.com/recordings/ecfc6a3c-71f6-4141-b925-4236e6caf162.mp4?Expires=1732424172&Key-Pair-Id=APKAJVV5JYWNSB7CAGWA&Signature=FrZTNsAXTuxFbRd9auS7FNq0ZfIiFiuS-GS-fygDUWxcsKMpqQqh6flJ2CVOdBiptIgCV-CXRw5Reo7-pjQZl9~0ol5dO-IUKPNghtxfGoZ1-HX-icw0LZZiSXLRSi628I36gW~AbdMuP2REfTSd-vO0KbOu4GH8m8QhTp3rQcLGp~L7mABrvOA7vguP2lzznwbu0tCZqUPw11Bs7RalvOAr8vN5M~IUEXc~M483azntP0A4T3p8cx1oSEi4MwvmhON~45G0sFLBMTnvYbAPD-9yJE6SdiiJQ6MWQqkbB~WsaQane86fn6yn~pRplx4YyJbp5ju9eng5FFqXqWz8pQ__","fullJpegThumbnailUrl":"https://media.grain.com/thumbnails/ecfc6a3c-71f6-4141-b925-4236e6caf162/K4yOZ7Kz_recording_thumb.jpeg?Expires=1732424172&Key-Pair-Id=APKAJVV5JYWNSB7CAGWA&Signature=AzGmaw5r0jzprdg--0nhypegtNg1beqWcQ4lOg1ElZnFUH5~9sd8iZHvbGi03-Wpg0-mwk4SExmlmDEkHtZuANVAsvM57Xh6datvgaPjg6wGwEN3CgYtzkTAY15n2twdcmrGhzvovq8lejZefmBFitY7kSomNE4qtdje62q4v2MAv9bY1pXo-QNO0TplId~iriJzFXWT0z1sZfanEqSGhXxkIDw809N2lLCHxRq9y3VF06kQaJHXADXKQHAbaifuiC0~gYiQ3Tjk1v~Ym9six-5o81r-aXe0Ye-kkaCs4pHfQgQSjM7ZWd~L~B0nUooCeCNFV6nsUzW1QqJ7ezx~-w__","downloadUrl":"https://media.grain.com/recordings/ecfc6a3c-71f6-4141-b925-4236e6caf162.mp4?response-content-disposition=attachment%3B+filename%3D%22GeriPal+EP333+Dialysis+vs+Conservative+Management+ecfc6a3c-71f6-4141-b925-4236e6caf162.mp4%22%3B+filename%2A%3DUTF-8%27%27GeriPal%2520EP333%2520Dialysis%2520vs%2520Conservative%2520Management%2520ecfc6a3c-71f6-4141-b925-4236e6caf162.mp4&response-content-type=video%2Fmp4&Expires=1732424172&Key-Pair-Id=APKAJVV5JYWNSB7CAGWA&Signature=NwWD55q5Hz3nM3DpdVfax3DAJtpjKGGBo4u30XR3DijSjkjMuM1aBgvXSVea6R8in9I6IEcNQNcooGN9JUQPvLZoUCeZUJgmfw6u1c2gEOUFaYWeXOVv705KyuzRikvYv4cxc10rOccLtk75ozmroQorDMUt0WehW43H6y8iWB1ZOMVoOR236OxICjLzrTFi3xfGAaY31NQT2CI0Gx7EElzIYp0FXYvwF7DT9FvCixy~202JxCSDJGIh1rKt4oDfYxy00kxUNxnw2LLDArFroHrihiaMUjNzInIFXK7KrBqGG5xgUc1vtfRnwh5p0y3GMMnDpKwRJ8~I9wirPCPjsQ__","downloadUrlExpiry":1732423992,"fullWebpThumbnailUrl":"https://media.grain.com/thumbnails/ecfc6a3c-71f6-4141-b925-4236e6caf162/BgRfkcei_recording_thumb.webp?Expires=1732424172&Key-Pair-Id=APKAJVV5JYWNSB7CAGWA&Signature=kpFZ2lPjI4wV~2UHE5aLm100jNGOVFWfPEAu0-w4mMgXpzskzbJrICaTjnJJbCquRGchCGV-uelezj3ofZNm~TD4~SnIn2Q7LKCfmjuSl1c0qRLd-lEkecDNMxWCwIx2tDFLZa8HgtcSPEkzBqSNyfNlr66rQBfbK9aFzS9BiHaZcA0h4EvD8~F1Sm1j-AsE7GvZTV4k5Q6IvmpMn1dPfnRMVy3K3vaUG2g6B5Xx0FLR6LoywzV6Z25N17q7FMOUvooDwM5BL7gV1PkvOpDpou0ugpwTVPNkH-SmNATRo3hm1UkKlN8kLpVWTe5Mf48mJWBUQdGdLx89T5~UwO1-qQ__","mediaType":"VIDEO","storyboardImageUrl":"https://media.grain.com/v1/storyboards/ecfc6a3c-71f6-4141-b925-4236e6caf162/VtZ4zN4C_storyboard.jpg?Expires=1732424172&Key-Pair-Id=APKAJVV5JYWNSB7CAGWA&Signature=Lki-oUekExL6~GVftBn2iziuxEqXDt5BeNIi9rKD1JY9bmuZzhaXRjqw9fu1zezv~RXjhp4ujdh2-85c4yOHILMUzWps19q25otV6MH1y5shUdaydIRNr1nHtP5gbSB1aU0yWqo85l2QdOufAOZWDQc4r1uQLgr4nDmafQOZmMLfj9BugG3FTRljvlUaXs2Ki88NWxx4~Ac~3SunaXJvV4kyy3a8xalVFayWTlXPGC8ryJpIbK-5kDL0YOk8N4W-qS-vK2QV4wPAVN9THPl5ITJ6yy4JoH4T~9N~ELfmZDkokE1xqG69HBsNL4gxCu~nO5NnN9lLoeFpP6thAPxM-w__","videoStream":null,"videoUrlExpiry":1732423992}"> <meta name="grain:recording:in_workspace" content="no"> <meta name="grain:recording:has_edit_access" content="no"> <meta name="grain:hide_watermark" content="no"> <link rel="stylesheet" type="text/css" href="https://static.grain.com/css/style.ef848caa1860e553433f42be2c98754dd93b8668.css"> </head> <body> <noscript> Grain heavily relies on JavaScript, please consider enabling JavaScript here. </noscript> <div id="app"></div> <script type="module" src="https://static.grain.com/js/app-public-recording-page.ef848caa1860e553433f42be2c98754dd93b8668.js"> </script> </body> </html>