Evidence map›Paper›PMID 28558697›Full record

Trial reportBMC anesthesiology2017

Does an electronic cognitive aid have an effect on the management of severe gynaecological TURP syndrome? A prospective, randomised simulation study.

Michael St Pierre, Georg Breuer, Dieter Strembski, Christopher Schmitt, Bjoern Luetcke

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMC anesthesiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.6field-weighted citation impact, top 16% 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

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Article
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

5 authors at 1 institution in 1 country.

Michael St PierreAnästhesiologische Klinik, Universitätsklinikum Erlangen, Krankenhaustrasse 12, 91054, Erlangen, Germany. michael.st.pierre@kfa.imed.uni-erlangen.de.ORCID 0000-0001-6263-5261
Georg BreuerAnästhesiologische Klinik, Universitätsklinikum Erlangen, Krankenhaustrasse 12, 91054, Erlangen, Germany.
Dieter StrembskiAnästhesiologische Klinik, Universitätsklinikum Erlangen, Krankenhaustrasse 12, 91054, Erlangen, Germany.
Christopher SchmittAnästhesiologische Klinik, Universitätsklinikum Erlangen, Krankenhaustrasse 12, 91054, Erlangen, Germany.
Bjoern LuetckeAnästhesiologische Klinik, Universitätsklinikum Erlangen, Krankenhaustrasse 12, 91054, Erlangen, Germany.
Universitätsklinikum Erlangen · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLack of familiarity with the content of current guidelines is a major factor associated with non-compliance by clinicians. It is conceivable that cognitive aids with regularly updated medical content can guide clinicians' task performance by evidence-based practices, even if they are unfamiliar with the actual guideline. Acute hyponatraemia as a consequence of TURP syndrome is a rare intraoperative event, and current practice guidelines have changed from slow correction to rapid correction of serum sodium levels. The primary objective of this study was to compare the management of a simulated severe gynaecological transurethral resection of the prostate (TURP) syndrome under spinal anaesthesia with either: an electronic cognitive aid, or with management from memory alone. The secondary objective was to assess the clinical relevance and participant perception of the usefulness of the cognitive aid.

methodsAnaesthetic teams were allocated to control (no cognitive aid; n = 10) or intervention (cognitive aid provided; n = 10) groups. We identified eight evidence-based management tasks for severe TURP syndrome from current guidelines and subdivided them into acute heart failure (AHF)/pulmonary oedema tasks (5) and acute hyponatraemia tasks (3). Implementation of the treatment steps was measured by scoring task items in a binary fashion (yes/no). To assess whether or not the cognitive aid had prompted a treatment step, participants from the cognitive aid group were questioned during debriefing on every single treatment step. At the end of the simulation, session participants were asked to complete a survey.

resultsTeams in the cognitive aid group considered evidence-based treatment steps significantly more often than teams of the control group (96% vs. 50% for 'AHF/pulmonary oedema' p < 0.001; 79% vs. 12% for 'acute hyponatraemia' p < 0.001). Without the cognitive aid, performance would have been comparable across both groups. Nurses, trainees, and consultants derived equal benefit from the cognitive aid.

conclusionsThe cognitive aid improved the implementation of evidence-based practices in a simulated intraoperative scenario. Cognitive aids with current medical content could help to close the translational gap between guideline publication and implementation in acute patient care. It is important that the cognitive aid should be familiar, in a format that has been used in practice and training.

Indexed as

Decision Support Systems, ClinicalDecision Support TechniquesEmergenciesAnesthesia, SpinalCesarean SectionHumansHyponatremiaIntraoperative ComplicationsPractice Guidelines as TopicProspective StudiesSimulation TrainingSingle-Blind MethodAcute hyponatraemiaChecklistGuidelinesSimulationTURP syndrome

Identifiers

PMID28558697
PMCPMC5450103
OpenAlexW2619648772

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.