{"id":6459,"date":"2026-10-19T09:48:56","date_gmt":"2026-10-19T09:48:56","guid":{"rendered":"https:\/\/phd.hi.is\/doktorsvorn\/doktorsvorn-i-lydheilsuvisindum-bjorg-thorsteinsdottir\/"},"modified":"2026-10-19T09:48:56","modified_gmt":"2026-10-19T09:48:56","slug":"doktorsvorn-i-lydheilsuvisindum-bjorg-thorsteinsdottir","status":"publish","type":"phd_defence","link":"https:\/\/phd.hi.is\/en\/doktorsvorn\/doktorsvorn-i-lydheilsuvisindum-bjorg-thorsteinsdottir\/","title":{"rendered":"Doktorsv\u00f6rn \u00ed l\u00fd\u00f0heilsuv\u00edsindum – Bj\u00f6rg \u00deorsteinsd\u00f3ttir"},"content":{"rendered":"
\n
\n

\u00deri\u00f0judaginn 27. jan\u00faar ver Bj\u00f6rg \u00deorsteinsd\u00f3ttir doktorsritger\u00f0 s\u00edna \u00ed l\u00fd\u00f0heilsuv\u00edsindum vi\u00f0 L\u00e6knadeild H\u00e1sk\u00f3la \u00cdslands.<\/p>\n

Ritger\u00f0in ber heiti\u00f0: \u00der\u00f3un \u00e1kv\u00f6r\u00f0unart\u00f3lsins CKD Journeys til a\u00f0 stu\u00f0la a\u00f0 sameiginlegri \u00e1kvar\u00f0anat\u00f6ku me\u00f0al sj\u00faklinga me\u00f0 n\u00fdrnasj\u00fakd\u00f3m \u00e1 h\u00e1u stigi.\u00a0Development of the CKD Journeys Decision Aid to Promote Shared Decision Making\u00a0in Patients with Advanced Kidney Disease.<\/p>\n

Andm\u00e6lendur eru dr. Willem Jan Bos, pr\u00f3fessor vi\u00f0 Leiden University Medical Center, og dr. Andrew C. Nixon, n\u00fdrnal\u00e6knir og lei\u00f0togi stu\u00f0nings- og l\u00edknarme\u00f0fer\u00f0ar vi\u00f0 Lancashire Teaching Hospitals NHS Foundation Trust.<\/p>\n

Umsj\u00f3narkennari var Run\u00f3lfur P\u00e1lsson, pr\u00f3fessor \u00ed lyfl\u00e6knisfr\u00e6\u00f0i (n\u00fdrnasj\u00fakd\u00f3mafr\u00e6\u00f0i), lei\u00f0beinandi var dr. Jon C. Tilburt, pr\u00f3fessor vi\u00f0 Mayo Clinic Arizona, og me\u00f0lei\u00f0beinandi var Mar\u00eda Heimisd\u00f3ttir landl\u00e6knir. Auk \u00feeirra s\u00e1tu \u00ed doktorsnefnd dr. Ann M. O\u00b4Hare, pr\u00f3fessor vi\u00f0 University of Washington, Seattle, og dr. Mildred Z. Solomon, pr\u00f3fessor vi\u00f0 Harvard Medical School, Boston.<\/p>\n

S\u00e6d\u00eds S\u00e6varsd\u00f3ttir, pr\u00f3fessor og deildarforseti L\u00e6knadeildar, stj\u00f3rnar ath\u00f6fninni sem fer fram \u00ed H\u00e1t\u00ed\u00f0asal H\u00e1sk\u00f3la \u00cdslands og hefst kl. 13.00.<\/p>\n

\u00c1grip<\/strong><\/p>\n

Langvinnur n\u00fdrnasj\u00fakd\u00f3mur er sj\u00f6undi algengasti \u00e1h\u00e6ttu\u00fe\u00e1tturinn fyrir dau\u00f0a \u00e1 heimsv\u00edsu. N\u00fdrnasj\u00fakd\u00f3mur \u00e1 lokastigi hefur einkennabyr\u00f0i og d\u00e1nart\u00ed\u00f0ni sem jafnast \u00e1 vi\u00f0 langt gengi\u00f0 krabbamein. \u00d3vissa r\u00edkir um \u00fea\u00f0 hvort bl\u00f3\u00f0skilun lengi e\u00f0a b\u00e6ti l\u00edf \u00e1kve\u00f0inna sj\u00faklingah\u00f3pa umfram l\u00edknandi me\u00f0fer\u00f0. Engu a\u00f0 s\u00ed\u00f0ur telja l\u00e6knar og sj\u00faklingar sig oft ekki eiga annarra kosta v\u00f6l og notkun bl\u00f3\u00f0skilunar fer \u00fev\u00ed vaxandi, me\u00f0 auknum samf\u00e9lagskostna\u00f0i.<\/p>\n

Doktorsverkefni\u00f0 mi\u00f0a\u00f0i a\u00f0 \u00fev\u00ed a\u00f0 b\u00e6ta sameiginlega \u00e1kvar\u00f0anat\u00f6ku eldri sj\u00faklinga me\u00f0 langt genginn n\u00fdrnasj\u00fakd\u00f3m og l\u00e6kna \u00feeirra me\u00f0 \u00fer\u00f3un gagnvirks samskiptaverkf\u00e6ris, CKD Journeys, sem ber saman me\u00f0fer\u00f0ar\u00farr\u00e6\u00f0i. Afsta\u00f0a og \u00f3skir sj\u00faklinga voru lag\u00f0ar til grundvallar.<\/p>\n

Ni\u00f0urst\u00f6\u00f0ur safngreininga s\u00fdndu fram \u00e1 skort \u00e1 \u00e1rei\u00f0anlegum sp\u00e1t\u00e6kjum og samskiptaverkf\u00e6rum til a\u00f0 a\u00f0sto\u00f0a sj\u00faklinga vi\u00f0 val \u00e1 me\u00f0fer\u00f0. Samanbur\u00f0argreining \u00e1 lifsl\u00edkum s\u00fdndi h\u00f3flegan lifunar\u00e1vinning af skilunarme\u00f0fer\u00f0, jafnvel fyrir elstu sj\u00faklingana. \u00de\u00f3 nokkur breytileiki fannst \u00ed \u00f3skum sj\u00faklinga um a\u00f0 f\u00e1 uppl\u00fdsingar um horfur. Fleiri h\u00f6f\u00f0u \u00e1huga \u00e1 a\u00f0 vera uppl\u00fdstir um \u00e1h\u00e6ttu s\u00edna \u00e1 lokastigsn\u00fdrnabilun en heildarlifun og vildu a\u00f0 \u00feessum uppl\u00fdsingum yr\u00f0i deilt snemma \u00ed sj\u00fakd\u00f3msferlinu. Flestir s\u00e6ttu sig vi\u00f0 \u00f3vissu \u00ed forsp\u00e1rgildum.<\/p>\n

CKD Journeys varpar lj\u00f3si \u00e1 \u00e1h\u00e6ttu sj\u00faklings \u00e1 a\u00f0 f\u00e1 lokastigsn\u00fdrnabilun og samanbur\u00f0arlifun fyrir mismunandi me\u00f0fer\u00f0ar\u00farr\u00e6\u00f0i, auk \u00e1hrifa \u00e1 a\u00f0ra \u00fe\u00e6tti sem eru sj\u00faklingum mikilv\u00e6gir.<\/p>\n

Abstract<\/strong><\/p>\n

The prevalence of end stage kidney disease (ESKD) and the use of hemodialysis treatment has been increasing beyond population growth, contributing to unsustainable health care spending. \u00a0ESKD carries a symptom burden and mortality risk rivaling advanced cancer. For certain high-risk groups, there is equipoise about whether dialysis will extend or improve life compared with supportive care without dialysis. Nonetheless, many physicians perceive the initiation of dialysis as an imperative, and patients do not feel that they have a choice but to start dialysis.<\/p>\n

The overall goal of this doctoral research was to promote choice awareness and shared decision making around treatment options in older adults with ESKD, for both patients and clinicians, through the development of CKD Journeys, an interactive decision aid (DA), for use in the clinical encounter. A patient and user centered approach was used.\u00a0<\/p>\n

Systematic reviews of prognostic indices demonstrated a lack of both reliable mortality indices and comprehensive validated DAs. A propensity-matched comparative survival analysis showed dialysis initiation to be associated with a consistent, albeit modest, survival benefit compared with no dialysis, even for the oldest patients. The qualitative analysis highlighted variability in patients\u2019 desire for prognostic information. More patients were interested in understanding whether or not they might reach ESKD, than in knowing how long they might live. Patients wanted prognostic information shared early in the course of their illness and most were accepting of uncertainty.<\/p>\n

CKD Journeys presents individualized estimates for ESKD risk, the competing risk of death and comparative survival for different treatment options, as well as other outcomes known to be important to ESKD patients.<\/p>\n

Um doktorsefni\u00f0<\/strong><\/p>\n

Bj\u00f6rg \u00deorsteinsd\u00f3ttir er f\u00e6dd \u00e1ri\u00f0 1972 \u00ed Reykjav\u00edk. H\u00fan lauk st\u00fadentspr\u00f3fi fr\u00e1 e\u00f0lisfr\u00e6\u00f0ideild Menntask\u00f3lans \u00ed Reykjav\u00edk og s\u00ed\u00f0an emb\u00e6ttispr\u00f3fi \u00ed l\u00e6knisfr\u00e6\u00f0i 1999. H\u00fan sinnti emb\u00e6tti forseta al\u00fej\u00f3\u00f0asamtaka l\u00e6knanema, IFMSA, sk\u00f3la\u00e1ri\u00f0 1997-1998, samhli\u00f0a n\u00e1mi. A\u00f0 loknu kand\u00eddats\u00e1ri starfa\u00f0i Bj\u00f6rg sem deildarl\u00e6knir \u00e1 \u00fdmsum deildum Landsp\u00edtala \u00e1\u00f0ur en h\u00fan h\u00e9lt utan til s\u00e9rn\u00e1ms. H\u00fan lauk s\u00e9rmenntun \u00ed almennum lyfl\u00e6kningum \u00e1 Mayo Clinic \u00ed Minnesota \u00e1ri\u00f0 2005. \u00de\u00e1 lauk h\u00fan vi\u00f0b\u00f3tarn\u00e1mi \u00ed l\u00edfsi\u00f0fr\u00e6\u00f0i vi\u00f0 Harvard Medical School 2008. Bj\u00f6rg starfa\u00f0i \u00e1 hag- og uppl\u00fdsingadeild og l\u00edknardeild Landspitalans 2008-2011. H\u00fan lauk s\u00e9rfr\u00e6\u00f0ipr\u00f3fi \u00ed l\u00edknarme\u00f0fer\u00f0 2012. S\u00ed\u00f0an 2011 hefur Bj\u00f6rg starfa\u00f0 sem almennur lyfl\u00e6knir og vi\u00f0 l\u00edknarme\u00f0fer\u00f0 \u00e1 Mayo Clinic, \u00fear sem h\u00fan hefur einnig kennt og lagt stund \u00e1 ranns\u00f3knir. Doktorsverkefni\u00f0 var styrkt af Satellite Healthcare, National Institute on Ageing og Mayo Clinic. Foreldrar Bjargar eru \u00deorsteinn T\u00f3masson pl\u00f6ntuerf\u00f0afr\u00e6\u00f0ingur og Sophie Kofoed Hansen s\u00e9rkennari. Eiginma\u00f0ur Bjargar er Bo Enemark Madsen br\u00e1\u00f0al\u00e6knir og b\u00f6rn \u00feeirra eru J\u00f3hannes, Harald, Sophie og Kirsten.<\/p>\n<\/div><\/div>","protected":false},"featured_media":5877,"template":"","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"_phd_date_start":"2026-01-27T13:00:00+00:00","_phd_date_end":"2026-01-27T16:00:00+00:00","_phd_location":"A\u00f0albygging H\u00e1t\u00ed\u00f0asalur","_phd_admission":"A\u00f0gangur \u00f3keypis","_phd_thesis_title":"\u00der\u00f3un \u00e1kv\u00f6r\u00f0unart\u00f3lsins CKD Journeys til a\u00f0 stu\u00f0la a\u00f0 sameiginlegri \u00e1kvar\u00f0anat\u00f6ku me\u00f0al sj\u00faklinga me\u00f0 n\u00fdrnasj\u00fakd\u00f3m \u00e1 h\u00e1u stigi. Development of the CKD Journeys Decision Aid to Promote Shared Decision Making in Patients with Advanced Kidney Disease","_phd_source_url":"https:\/\/gamli.hi.is\/vidburdir\/doktorsvorn_i_lydheilsuvisindum_bjorg_thorsteinsdottir","_phd_source_node_id":"443163","_phd_source_type":"vidburdir","_phd_member_id":1001,"footnotes":""},"phd_school":[60,67],"phd_discipline":[120],"class_list":["post-6459","phd_defence","type-phd_defence","status-publish","has-post-thumbnail","hentry","phd_school-heilbrigdisvisindasvid","phd_school-laeknadeild","phd_discipline-phd-i-lydheilsuvisindum"],"_links":{"self":[{"href":"https:\/\/phd.hi.is\/en\/wp-json\/wp\/v2\/phd_defence\/6459","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/phd.hi.is\/en\/wp-json\/wp\/v2\/phd_defence"}],"about":[{"href":"https:\/\/phd.hi.is\/en\/wp-json\/wp\/v2\/types\/phd_defence"}],"version-history":[{"count":0,"href":"https:\/\/phd.hi.is\/en\/wp-json\/wp\/v2\/phd_defence\/6459\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/phd.hi.is\/en\/wp-json\/wp\/v2\/media\/5877"}],"wp:attachment":[{"href":"https:\/\/phd.hi.is\/en\/wp-json\/wp\/v2\/media?parent=6459"}],"wp:term":[{"taxonomy":"phd_school","embeddable":true,"href":"https:\/\/phd.hi.is\/en\/wp-json\/wp\/v2\/phd_school?post=6459"},{"taxonomy":"phd_discipline","embeddable":true,"href":"https:\/\/phd.hi.is\/en\/wp-json\/wp\/v2\/phd_discipline?post=6459"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}