| Use of experiential knowledge | Depends on where you trained and how much of the literature you believe or you think is more relevant. (Nephrologist 4, site C) |
| The problem is that there is not a lot of good evidence in nephrotic syndrome. (Nephrologist 3, site H) |
| I think we are regrettably influenced by whatever happened to our patients. So if you miss something, nobody wants to feel, like, "Oh, I missed that diagnosis." Even though it might be not, maybe it is super rare, that's never going to happen again to anyone in North America, the fact that it happened you, it somehow influences, it strongly influences the way you manage the next patient. I think your own personal experience is the trump card of all, regrettably whether that's evident and it is not evidence based. (Nephrologist 4, site E) |
| Use of empirical knowledge | We developed the guidelines, because everybody has their own recipe, and I think we all acknowledge that from the outset, and we really wanted to, as much as possible, base it on available evidence rather than base it on, you know, somebody's favourite recipe. (Nephrologist 1, site B) |
| I mean, there were the KDIGO guidelines that came out for the treatment of nephrotic syndrome a couple years ago, and I think a review of our treatment protocols would suggest that we're actually right online with what they recommend. (Nephrologist 2, site A) |
| Interpretation of patient characteristics | The reality of the nephrotics is that there are going to be some subgroups of people where there is need to modify your simple original prescription because they don't respond in the way you expected them to. (Nephrologist 1, site E) |
| I think there is a variability component that has to do with patient adherence as well, in the sense that if they are either experiencing toxicity or they don't believe in the therapy, or they have different ideas, whatever it is, they may wean themselves in a different way from what was prescribed, which is still a variation in therapy. (Nephrologist 1, site B) |
| I tend to use [mycophenolate mofetil] as a first-line for my steroid-sparing because it doesn't have nephrotoxicity and sometimes it works. (Nephrologist 4, site E) |