ArticleNeurocritical care2019
Withdrawal of Life-Sustaining Treatments in Perceived Devastating Brain Injury: The Key Role of Uncertainty.
Article in Neurocritical care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis 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
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 73 citations in OpenAlex.
- European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2025: post-resuscitation care.Intensive care medicine · 2025Guideline
- Racial and Ethnic Differences in Withdrawal of Life-Sustaining Treatment and Hospice Referral in Severe Traumatic Brain Injury.Journal of racial and ethnic health disparities · 2026Article
- Treatment-Limiting Decisions in Neurointensive Care: Withholding or Withdrawal of Life-Sustaining Measures.Acta anaesthesiologica Scandinavica · 2026Observational
- Association of the ICH Score With Withdrawal of Life-Sustaining Treatment Over a 10-Year Period.Annals of clinical and translational neurology · 2025Article
- Equity in Clinical Care and Research Involving Persons with Disorders of Consciousness.Neurocritical care · 2024Review
- Limitation of life sustaining therapy in disorders of consciousness: ethics and practice.Brain : a journal of neurology · 2024Review
- Characterizing coma in large vessel occlusion stroke.Journal of neurology · 2024Article
- Disorders of Consciousness Rehabilitation: Ethical Dimensions and Epistemic Dilemmas.Physical medicine and rehabilitation clinics of North America · 2024Review
- Covert cortical processing: a diagnosis in search of a definition.Neuroscience of consciousness · 2024Article
- Treatment-limiting decisions in patients with severe traumatic brain injury in the Netherlands.Brain & spine · 2024Article
- Disambiguating Consciousness in Clinical Settings.Neurology · 2023Article
- Prognostic Language in Critical Neurologic Illness: A Multicenter Mixed-Methods Study.Neurology · 2023Article
- Predictors and Temporal Trends of Withdrawal of Life-Sustaining Therapy After Acute Stroke in the Florida Stroke Registry.Critical care explorations · 2023Article
- Traumatic brain injury: progress and challenges in prevention, clinical care, and research.The Lancet. Neurology · 2022Review
- Neuroethics across the Disorders of Consciousness Care Continuum.Seminars in neurology · 2022Review
- Association of Acute Alteration of Consciousness in Patients With Acute Ischemic Stroke With Outcomes and Early Withdrawal of Care.Neurology · 2022Article
- The neuroethics of disorders of consciousness: a brief history of evolving ideas.Brain : a journal of neurology · 2021Article
- Article
- Not Always a Nail in the Coffin! Brainstem Lesions After Traumatic Brain Injury.Neurocritical care · 2021Article
- Proceedings of the First Curing Coma Campaign NIH Symposium: Challenging the Future of Research for Coma and Disorders of Consciousness.Neurocritical care · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWithdrawal of life-sustaining treatment (WOLST) is the leading proximate cause of death in patients with perceived devastating brain injury (PDBI). There are reasons to believe that a potentially significant proportion of WOLST decisions, in this setting, are premature and guided by a number of assumptions that falsely confer a sense of certainty.
methodThis manuscript proposes that these assumptions face serious challenges, and that we should replace unwarranted certainty with an appreciation for the great degree of multi-dimensional uncertainty involved. The article proceeds by offering a taxonomy of uncertainty in PDBI and explores the key role that uncertainty as a cognitive state, may play into how WOLST decisions are reached.
conclusionIn order to properly share decision-making with families and surrogates of patients with PDBI, we will have to acknowledge, understand, and be able to communicate the great degree of uncertainty involved.
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Registered trials
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.