Evidence map›Paper›PMID 30902688›Full record

ArticleResuscitation2019

Prognostication after cardiac arrest: Results of an international, multi-professional survey.

Alexis Steinberg, Clifton W Callaway, Robert M Arnold, Tobias Cronberg, Hiromichi Naito, Koral Dadon, Minjung Kathy Chae, Jonathan Elmer

Open access · greenAbstract readMulticenter Study
In one paragraph

Article in Resuscitation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 3 pooled it
7.5field-weighted citation impact, top 2% 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

24 citing papers in PubMed, 3 syntheses or guidelines pooled it, 58 citations in OpenAlex.

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  18. Prognostication in Acute Neurological Emergencies.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2022
    Article
  19. Article
  20. Novel approaches to prediction in severe brain injury.Current opinion in neurology · 2020
    Review
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

8 authors at 5 institutions in 5 countries.

Alexis SteinbergDepartment of Critical Care Medicine, Univsersity of Pittsburgh, Pittsburgh, PA, United States; Department of Neurology, University of Pittsburgh, Pittsburgh, PA, United States.
Clifton W CallawayDepartment of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, United States.
Robert M ArnoldDepartment of Medicine, Section of Palliative Care and Medical Ethics, University of Pittsburgh, Pittsburgh, PA, United States.
Tobias CronbergDepartment of Clinical Sciences, Neurology, Lund University, Skane University Hospital, Lund, Sweden.
Hiromichi NaitoDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University, Okayama, Japan.
Koral DadonTechnion Israel Institute of Technology, Haifa, Israel.
Minjung Kathy ChaeDepartment of Emergency Medicine, Ajou University Medical Center, Republic of Korea.
Jonathan ElmerDepartment of Critical Care Medicine, Univsersity of Pittsburgh, Pittsburgh, PA, United States; Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, United States; Department of Neurology, University of Pittsburgh, Pittsburgh, PA, United States. Electronic address: elmerjp@upmc.edu.
University of Pittsburgh · USAjou University · KRLund University · SEOkayama University · JPTechnion – Israel Institute of Technology · IL

Funding

Quantitative electroencephalography after cardiac arrestK23NS097629 · NINDS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI ELMER, JONATHAN · 2017 to 2021
$945k
NINDS NIH HHS K23 NS097629
6 · The paper itself

Abstract

aimWe explored preferences for prognostic test performance characteristics and error tolerance in decisions regarding withdrawal or continuation of life-sustaining therapy (LST) after cardiac arrest in a diverse cohort of medical providers. METHODOLOGY: We distributed a survey through professional societies and research networks. We asked demographic characteristics, preferences for prognostic test performance characteristics and views on acceptable false positive rates for decisions about LST after cardiac arrest.

resultsOverall, 640 respondents participated in our survey. Most respondents were attending physicians (74%) with >10 years of experience (59%) and practiced at academic centers (77%). Common specialties were neurology (22%), neuro- or general critical care (24%) and palliative care (31%). The majority (56%) felt an acceptable FPR for withdrawal of LST from patients who might otherwise have recovered was ≤0.1%. Acceptable FPRs for continuing LST in patients with unrecognized irrecoverable injury was higher, with 59% choosing a threshold ≤1%. Compared to providers with >10 years of experience, those with <5 years thought lower FPRs were acceptable (P < 0.001 for both). Palliative care providers accepted significantly higher FPRs for withdrawal of LST (P < 0.0001), and critical care providers accepted significantly higher FPRs for provision of long-term LST (P = 0.02). With regard to test performance characteristics, providers favored accuracy over timeliness, and prefer tests be optimized to predictrather than favorable outcomes.

conclusionMedical providers are comfortable with low acceptable FPR for withdrawal (≤0.1%) and continuation (≤1%) of LST after cardiac arrest. These FPRs may be lower than can be achieved with current prognostic modalities.

Indexed as

Attitude of Health PersonnelDecision MakingFemaleHeart ArrestHumansLife Support CareMalePhysiciansPrognosisRetrospective StudiesSurveys and QuestionnairesWithholding TreatmentCardiac arrestComaCritical careError in medicinePrognosis

Identifiers

PMID30902688
PMCPMC6504567
OpenAlexW2924405005

What OpenQuestion holds

Textmetadata
LicenceTDM
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.