SynthesisDeutsches Arzteblatt international2015
Persistent vegetative state and minimally conscious state: a systematic review and meta-analysis of diagnostic procedures.
Synthesis in Deutsches Arzteblatt international, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 4 syntheses or guidelines pooled it, 69 citations in OpenAlex.
- Clinical neuromodulatory effects of deep brain stimulation in disorder of consciousness: A literature review.CNS neuroscience & therapeutics · 2024Pooled it
- Predicting outcome in disorders of consciousness: A mega-analysis.Annals of clinical and translational neurology · 2024Pooled it
- Meta-analysis of the diagnostic value of functional magnetic resonance imaging for distinguishing unresponsive wakefulness syndrome/vegetative state and minimally conscious state.Frontiers in neuroscience · 2024Pooled it
- Correlations between diffusion tensor imaging and levels of consciousness in patients with traumatic brain injury: a systematic review and meta-analysis.Scientific reports · 2017Pooled it
- Neuroprognostication after cardiac arrest in patients without withdrawal of life-sustaining therapy: a prospective observational multicenter study.Critical care (London, England) · 2026Observational
- Transcranial temporal interference stimulation of the thalamus in a patient with disorders of consciousness: a case report.Frontiers in human neuroscience · 2026Article
- The Role of [Diagnostics (Basel, Switzerland) · 2025Review
- A Review of Advances in Multimodal Treatment Strategies for Chronic Disorders of Consciousness Following Severe Traumatic Brain Injury.International journal of general medicine · 2025Review
- Altered Mental Status at the Extreme: Behavioral Evaluation of Disorders of Consciousness.Seminars in neurology · 2024Review
- Article
- End-of-Life Care of a Patient With Pontine Stroke and Prolonged Hospitalization: A Case Report.Cureus · 2024Article
- Covert Tracking to Immersive Stimuli in Traumatic Brain Injury Subjects With Disorders of Consciousness.Journal of neurotrauma · 2024Article
- Behavioral scales variability in patients with prolonged disorders of consciousness.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2023Article
- Transcranial Magnetic Stimulation in Disorders of Consciousness: An Update and Perspectives.Aging and disease · 2023Review
- Opioid-induced short-term consciousness improvement in patients with disorders of consciousness.Frontiers in neuroscience · 2023Article
- Article
- Stimulation-related modifications of evolving functional brain networks in unresponsive wakefulness.Scientific reports · 2022Article
- Effects of Acupuncture on Cortical Activation in Patients with Disorders of Consciousness: A Functional Near-Infrared Spectroscopy Study.Evidence-based complementary and alternative medicine : eCAM · 2022Article
- Informal Caregivers of Patients with Disorders of Consciousness: a Qualitative Study of Communication Experiences and Information Needs with Physicians.Neuroethics · 2022Article
- Residual Cognitive Capacities in Patients With Cognitive Motor Dissociation, and Their Implications for Well-Being.The Journal of medicine and philosophy · 2021Article
Corrections and comments
- Commented on byAdditions.2015
- Commented on byIn Reply.2015
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute brain damage can cause major disturbances of consciousness, ranging all the way to the persistent vegetative state (PVS), which is also known as "unresponsive wakefulness syndrome". PVS can be hard to distinguish from a state of minimal preserved consciousness ("minimally conscious state," MCS); the rate of misdiagnosis is high and has been estimated at 37-43%. In contrast, PVS is easily distinguished from brain death. We discuss the various diagnostic techniques that can be used to determine whether a patient is minimally conscious or in a persistent vegetative state.
methodsThis article is based on a systematic review of pertinent literature and on a quantitative meta-analysis of the sensitivity and specificity of new diagnostic methods for the minimally conscious state.
resultsWe identified and evaluated 20 clinical studies involving a total of 906 patients with either PVS or MCS. The reported sensitivities and specificities of the various techniques used to diagnose MCS vary widely. The sensitivity and specificity of functional MRI-based techniques are 44% and 67%, respectively (with corresponding 95% confidence intervals of 19%-72% and 55%-77%); those of quantitative EEG are 90% and 80%, respectively (95% CI, 69%-97% and 66%-90%). EEG, event-related potentials, and imaging studies can also aid in prognostication. Contrary to prior assumptions, 10% to 24% of patients in PVS can regain consciousness, sometimes years after the event, but only with marked functional impairment.
conclusionThe basic diagnostic evaluation for differentiating PVS from MCS consists of a standardized clinical examination. In the future, modern diagnostic techniques may help identify patients who are in a subclinical minimally conscious state.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.