1. Eligibility for Cisplatin Therapy with Race-free eGFR vs. CKD-EPI 2009 in Black Patients with Bladder Cancer:

   Eligibility for cisplatin therapy may vary depending on the method used to calculate eGFR (estimated glomerular filtration rate), an important measure of kidney function. The use of a race-free eGFR method might eliminate certain biases, allowing more individuals to be eligible for treatment compared to when CKD-EPI 2009 (which might include race as a factor) is used.

2. Impact on Incidence of Adverse Outcomes and Long-term Clinical Outcomes:

   The method used to assess eligibility may have varying impacts on adverse outcomes and long-term clinical outcomes. If race-free eGFR allows for more inclusive treatment access, it may enable more effective therapy for a broader population, possibly improving overall outcomes. Conversely, it could lead to overtreatment in some cases, increasing the risk of adverse effects.

3. Comparison with White Patients with Bladder Cancer:

   The difference in eligibility criteria may indeed have different implications for white patients, given that racial factors can impact eGFR calculations. An analysis would need to examine the specific parameters and potential biases in the models used to make a definitive comparison.

4. Revised Sentence:

   “When evaluating eligibility for cisplatin therapy in black patients with bladder cancer, the use of a race-free eGFR may yield different odds compared to the CKD-EPI 2009 method, potentially impacting both the incidence of adverse outcomes and long-term clinical results. This discrepancy in eligibility criteria may also manifest differently in white patients, emphasizing the need for careful consideration of the methods used to assess treatment suitability.”

digraph G {
    
    label = "\n\n Figure 1. Odds of eligibility for cisplatin in black patients with bladder cancer when race-free eGFR is used";
    rankdir = "TB";

    // Graph layout parameters
    graph [splines=polyline, nodesep=1];
    edge [dir=none, color="black"];
    node [shape=box, style="rounded, filled"];

    // Define nodes
    Bladder_Cancer [label="Bladder Cancer", pos="0,2.5!"];
    eligibility [shape=point, width=0, height=0, pos="0,2!"];
    eGFR_greater_than_60 [label="eGFR>60ml/min", fillcolor="honeydew", pos="0,0!"]
    invis1 [shape=point, width=0, height=0, pos="-2.5,0!"];
    invis2 [shape=point, width=0, height=0, pos="2.5,0!"];
    invis3 [shape=point, width=0, height=0, pos="-4,-2.5!"];
    invis4 [shape=point, width=0, height=0, pos="-1,-2.5!"];
    CKD_EPI_2021 [label="CKD-EPI 2021", fillcolor="lightblue", pos="-2.5,-2.5!"];
    CKD_EPI_2009 [label="CKD-EPI 2009", fillcolor="lightpink", pos="2.5,-2.5!"];
    invis5 [shape=point, width=0, height=0, pos="1,-2.5!"];
    invis6 [shape=point, width=0, height=0, pos="4,-2.5!"];
    Cisplatin_Positive1 [label="Cisplatin+", fillcolor="lightyellow", pos="-4,-5!"];
    Cisplatin_Negative1 [label="Cisplatin-", fillcolor="lightcoral", pos="-1,-5!"];
    Cisplatin_Positive2 [label="Cisplatin+", fillcolor="lightyellow", pos="1,-5!"];
    Cisplatin_Negative2 [label="Cisplatin-", fillcolor="lightcoral", pos="4,-5!"];

    // Define edges
    Bladder_Cancer -> eligibility;
    eligibility -> eGFR_greater_than_60;
    eGFR_greater_than_60 -> invis1;
    eGFR_greater_than_60 -> invis2;
    invis1 -> CKD_EPI_2021;
    CKD_EPI_2021 -> invis3;
    CKD_EPI_2021 -> invis4;
    invis2 -> CKD_EPI_2009;
    CKD_EPI_2009 -> invis5;
    CKD_EPI_2009 -> invis6;
    invis3 -> Cisplatin_Positive1;
    invis4 -> Cisplatin_Negative1;
    invis5 -> Cisplatin_Positive2;
    invis6 -> Cisplatin_Negative2;

    // Same level definition
    {
        rank=same;
        invis2;
        invis1;
        eGFR_greater_than_60; // Centered random node
    }
}

neato -Tpng fig1.dot -o fig1_cisplatin.png