{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T09:59:37Z","timestamp":1790330377220,"version":"4.1.0"},"reference-count":53,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82674774"],"award-info":[{"award-number":["82674774"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82273732"],"award-info":[{"award-number":["82273732"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["72342014"],"award-info":[{"award-number":["72342014"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Evidence Based Medicine"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the population representativeness of randomized controlled trials (RCTs) and real\u2010world evidence (RWE) studies in end\u2010stage kidney disease (ESKD) relative to the United States Renal Data System (USRDS) target population. The primary aim was to evaluate the generalizability of US\u2010based evidence, and the secondary aim to examine the transportability of non\u2010US evidence to the US dialysis population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched PubMed for RCTs and RWE studies in ESKD dialysis populations (2007\u20132024). Random\u2010effects models were used to pool effect modifiers and mortality rates separately for US\u2010based and non\u2010US RCTs and RWE studies. The primary outcome was a composite representativeness measure, defined as no meaningful deviation across all effect modifiers and mortality rate relative to USRDS benchmarks. Secondary outcomes were single\u2010component representativeness measures for age, diabetes prevalence, and mortality rate. Meaningful deviation was defined as absolute standardized mean difference (SMD) &gt;0.25. Subgroup and sensitivity analyses were conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 194 RCTs (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a071,119) and 173 RWE studies (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a050,931,214). For the primary aim, neither US\u2010based RCT samples nor US\u2010based RWE samples were representative. RCT participants were younger (SMD\u00a0=\u00a0\u22120.27) and had lower mortality rates (SMD\u00a0=\u00a0\u22121.52) than the USRDS population, whereas RWE samples showed no meaningful deviations in age, diabetes prevalence, or mortality rate (SMDs\u00a0=\u00a00.00, \u22120.11, and 0.08). Meaningful deviations in other effect modifiers remained in both study types. Non\u2010US samples also showed limited representativeness.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>RCTs and RWE studies demonstrate limited representativeness, underscoring the need to validate and adapt evidence before clinical application.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jebm.70194","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T08:44:31Z","timestamp":1789461871000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Population Representativeness of Randomized Controlled Trials and Real\u2010World Evidence Studies for Patients With End\u2010Stage Kidney Disease in the United States"],"prefix":"10.1111","volume":"19","author":[{"given":"Zhuotong","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Biostatistics Southern Medical University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiling","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of Groningen, University Medical Center Groningen  Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Southern Medical University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinuo","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Southern Medical University  Guangzhou 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