ASSIST-CKD FAQs
Common Errors
ASSIST-CKD Version 4
General Support Topics
Common Errors
Problem Occurred During Upload
- "String or Binary Data Would be Truncated"
- This error indicates that some field(s) within the batch were too long for the database to accept. This will be specific to text fields, most commonly affecting the ckd_gfr "location" field.
- "Error Converting nvarchar to numeric"
- This error occurs when a text value is given in place of a numeric value. This can only occur with a few specific fields throughout all application database tables. A common cause of this is fields being "out of sync" with the expected layout - usually too many fields within a single row causing a text value to be incorrectly interpreted in place of a numeric field.
- "Check Constraint Failed"
- This rare error will be caused by some row including an illegal value for ckd_gfr "location type" or "sex" fields. Support values for location types are "I", "O", "R", "X", or any user-mapped types; supported values for sex are "M", "F" and "U".
Failed to Connect to Database
Slow Operation on Analyse or Graph Screens
Application Failed to Install
ASSIST-CKD Version 4
How do I Reset the Application Config?
In some circumstances it can be useful to reset the application to “factory settings”, effectively undoing any configuration including application settings, database connection details and email server details.
To reset the config, simply delete the contents of the Config Directory (see "where is the application installed?").
Note that the Config Directory also contains the application’s activity/error logs - you may wish to retain these specific files across a config reset by making backups of them.
Note that if you selected the wrong database type on initial setup, or you need to change your database connection details for any reason, a config reset will be necessary.
Where is the Application Installed?
The application has two key directories after installation - the installation directory (where the application itself resides) and the config directory (the location of error logs, application settings, and upload error details).
Installation: C:\Users\{your-username}\AppData\Local\AssistCKD Config: C:\Users\{your-username}\AppData\Roaming\AssistCKDThe main configuration files, storing your database and email server connection details, are located in the config directory: [config-directory]\assist-ckd-config.json and [config-directory]\assist-ckd-email-config-email.json
What do I do if I get an error message?
The application creates a log of all its activities at the following location:
C:\Users\{your-username}\AppData\Roaming\AssistCKD\log.log
If you encounter a critical error (application freezes, error message box pops up, or other unexpected / blocking behaviour), most commonly the log will contain information about what went wrong. It is recommended to either open a support ticket at https://assist-ckd.org or email support@assist-ckd.org with your log file attached, as well as a description of the problem you encountered and any screenshots you can gather surrounding it.
Please note: the log file will contain copies of all data you upload to the database, which will include confidential patient data. It is vital that you modify the file to remove this data before sending it to the support team.
Sometimes the application will need to skip some data within a given file due to one or more fields being invalid. If this occurs, you will receive a non-blocking error once upload has completed, detailing how many rows were skipped.
Information about these skipped rows can be found by clicking the link to the file provided; situated here:
C:\Users\{your-username}\AppData\Roaming\AssistCKD\errors.csv
In these cases, data must be modified to fit the schema of the target table and re-uploaded, if you don’t want to skip the rows and leave them out.
See the FAQ's section "Common Error Messages" for more information.Is the patient data secure?
The application does not perform any encryption of patient data. It is up to the individual Trusts to ensure that the way the patient records are stored is compliant. If using SQLIte as a storage mechanism it is recommend that the hard drive the database file is installed on is encrypted. The application will restrict sending emails to addresses that end with valid NHS extensions. It is the Trust IT department's responsibility to ensure that emails are sent securely end-to-end.
How do I Test the Application is Working?
For testing and verification, we recommend using the application’s “SQLite” database option for quick independent setup. The application comes with some valid eGFR Control Data to facilitate the testing of basic upload and analysis functionality within your site. This can be found at the following location, after installation:
C:\Users\{your-username}\AppData\Local\AssistCKD\app-{version}\resources\app\docs\ckdtest-valid-gfr.csv There is also a file named "ckdtest-valid-gfr-large.csv" at the same location, to use for testing large uploads which may take longer and incur a higher risk of errors.General Support Topics
What will I need from my Trust IT department?
"We use our integration engine (Rhapsody) to pick up files from our Pathology system, which filters out the relevant Biochemistry results and feeds them into a new "CKD" route within Rhapsody. This new route picks out any results with an eGFR and then from those, picks out the useful information (e.g. report data and demographics), as well as bringing in any useful supporting information (e.g. practice details) from our patient master index, before using all this gathered data and writing that to the CKD tables (which bits it uses depends on whether it's inserting or updating tables).”As an external body we are unable to advise on how to configure your LIMS system to automate this process. This is something you would need to request and resolve internally.
What is Assist CKD?
ASSIST-CKD is an intervention to improve the care of people with kidney disease. It is based around a piece of software which enables laboratory staff (or other trained members of the healthcare team) to review patients eGFR test results in graphical form. This helps to assess trends in kidney function. When viewing each graph the reviewer decides whether the patient should be "marked". Marking a patient means that a report is sent to their GP highlighting the fact that their kidney function has deteriorated over time.
Task List for Individual Running Graphing Software and Reviewing Graphs
These tasks should be performed on a weekly basis
- Run the enquiry to produce the weekly eGFR data extract from the laboratory LIMS. This step will not be necessary for those sites where this process is automated.
- Login to the Graphing Software system.
- Load data into SQL database as described in CKD User Guide.
- Select the date from which to review the patient data – usually one week back from today’s date.
- Select ‘other’ (GPs) and set the age range, one of which is for 65 and under with an eGFR cut-off of 50; the second is for over 65s with an eGFR of 40. It is possible to also select ‘outpatients’; however we recommend that this option is not used, as it will result in GPs being informed about tests that they did not request (and may not have a record of).
- Once the list is generated, sort by location so all the practices are grouped together and then generate the graphs for review.
- While reviewing the graphs, select ‘Inform Clinician’ for those patients whose eGFR is declining. The links to the screencasts below give advice on how to assess and review graphs.
- The system records those patients who have already been flagged with their clinician. The results since that referral will inform the decision whether or not to inform the clinician again.
- Repeat steps 5-8 for over 65s.
- Once all the graphs have been reviewed, re-filter the graphs according to those that have been selected under ‘Inform Clinician’.
- There are two further optional steps that are performed in Birmingham: a. Reviewthepathologysystemanddeterminewhetherthepatienthas had a repeat eGFR request since and if function has improved (however this is unlikely unless there’s been a delay reviewing the graphs). b. Determine whether the patient is under active review with a renal physician (this is likely to be difficult for most sites; an alternative is to amend the standard free text on the eGFR graph reports to reflect local practice. This is described in the CKD User Guide).
- Delete the graphs of those who have been excluded if step 11 has been performed.
- Print a list of those to be flagged with the clinician and file this list (paper and electronically) securely. A list of flagged patients needs to be sent securely to the UK Renal Registry at the end of each year.
- Distribute the graphs of the flagged patients to the referring clinician. This can be done electronically via secure email, or by saving a copy of the graphs to the desktop and printing hard copies.