Evidence map›Paper›PMID 26067402›Full record

ArticleJournal of clinical monitoring and computing2016

Intraoperative blood glucose management: impact of a real-time decision support system on adherence to institutional protocol.

Bala G Nair, Katherine Grunzweig, Gene N Peterson, Mayumi Horibe, Moni B Neradilek, Shu-Fang Newman, Gail Van Norman, Howard A Schwid, Wei Hao, Irl B Hirsch and 1 more

Abstract read
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In one paragraph

Article in Journal of clinical monitoring and computing, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 2 pooled it
3.1field-weighted citation impact, top 8% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 41 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Intraoperative glycemic protocol calculator: automation in the OR.Journal of clinical monitoring and computing · 2025
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  5. Review
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  12. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 1 country.

Bala G NairDepartment of Anesthesiology and Pain Medicine, University of Washington, BB-1469 Health Sciences Bldg, 1959 NE Pacific Street, Mail Box: 356540, Seattle, WA, 98195, USA. nairbg@uw.edu.
Katherine GrunzweigSchool of Medicine, University of Washington, Seattle, WA, USA.
Gene N PetersonDepartment of Anesthesiology, Virginia Commonwealth University, Richmond, VA, USA.
Mayumi HoribeDepartment of Anesthesiology and Pain Medicine, University of Washington, BB-1469 Health Sciences Bldg, 1959 NE Pacific Street, Mail Box: 356540, Seattle, WA, 98195, USA.
Moni B NeradilekThe-Mountain-Whisper-Light Statistics, Seattle, WA, USA.
Shu-Fang NewmanDepartment of Anesthesiology and Pain Medicine, University of Washington, BB-1469 Health Sciences Bldg, 1959 NE Pacific Street, Mail Box: 356540, Seattle, WA, 98195, USA.
Gail Van NormanDepartment of Anesthesiology and Pain Medicine, University of Washington, BB-1469 Health Sciences Bldg, 1959 NE Pacific Street, Mail Box: 356540, Seattle, WA, 98195, USA.
Howard A SchwidDepartment of Anesthesiology and Perioperative Care, University of California, Irvine, CA, USA.
Wei HaoDivision of Metabolism, Department of Medicine, University of Washington, Seattle, WA, USA.
Irl B HirschDivision of Metabolism, Department of Medicine, University of Washington, Seattle, WA, USA.
E Patchen DellingerDivision of General Surgery, Department of Surgery, University of Washington, Seattle, WA, USA.
University of Washington · USThe Mountain Institute · USUniversity of California, Irvine · USVirginia Commonwealth University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Poor perioperative glycemic management can lead to negative surgical outcome. Improved compliance to glucose control protocol could lead to better glucose management. An Anesthesia Information Management System based decision support system-Smart Anesthesia Manager™ (SAM) was used to generate real-time reminders to the anesthesia providers to closely adhere to our institutional glucose management protocol. Compliance to hourly glucose measurements and correct insulin dose adjustments was compared for the baseline period (12 months) without SAM and the intervention period (12 months) with SAM decision support. Additionally, glucose management parameters were compared for the baseline and intervention periods. A total of 1587 cases during baseline and 1997 cases during intervention met the criteria for glucose management (diabetic patients or non-diabetic patients with glucose level >140 mg/dL). Among the intervention cases anesthesia providers chose to use SAM reminders 48.7 % of the time primarily for patients who had diabetes, higher HbA1C or body mass index, while disabling the system for the remaining cases. Compliance to hourly glucose measurement and correct insulin doses increased significantly during the intervention period when compared with the baseline (from 52.6 to 71.2 % and from 13.5 to 24.4 %, respectively). In spite of improved compliance to institutional protocol, the mean glucose levels and other glycemic management parameters did not show significant improvement with SAM reminders. Real-time electronic reminders improved intraoperative compliance to institutional glucose management protocol though glycemic parameters did not improve even when there was greater compliance to the protocol.

Indexed as

Decision Support Systems, ClinicalAdultAgedBlood GlucoseComputer SystemsDiabetes MellitusFemaleHumansHyperglycemiaInfusions, IntravenousInsulinIntraoperative ComplicationsMaleMiddle AgedMonitoring, IntraoperativePoint-of-Care SystemsBlood GlucoseInsulinAnesthesiaBlood glucoseDecision support systemsGuideline adherenceSurgery

Identifiers

PMID26067402
OpenAlexW626730138

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.