Evidence map›Paper›PMID 31801541›Full record

Observational studyBMC medical ethics2019

Are physicians on the same page about do-not-resuscitate? To examine individual physicians' influence on do-not-resuscitate decision-making: a retrospective and observational study.

Yen-Yuan Chen, Melany Su, Shu-Chien Huang, Tzong-Shinn Chu, Ming-Tsan Lin, Yu-Chun Chiu, Kuan-Han Lin

Abstract readObservational Study
In one paragraph

Observational study in BMC medical ethics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
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

7 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Article
  5. Article
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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

7 authors.

Yen-Yuan ChenDepartment of Medical Education, Graduate Institute of Medical Education & Bioethics, National Taiwan University College of Medicine, National Taiwan University Hospital, #1, Rd. Ren-Ai sec. 1, Chong-Cheng District, Taipei, 10051, Taiwan.
Melany SuNew York University School of Medicine, #550 1st Avenue, New York, NY, 10016, USA.
Shu-Chien HuangDepartment of Surgery, National Taiwan University Hospital, #7 Rd. Chong-Shan S, Taipei, 10002, Taiwan.
Tzong-Shinn ChuGraduate Institute of Medical Education & Bioethics, National Taiwan University College of Medicine, #1 Rd. Ren-Ai sec. 1, Chong-Cheng District, Taipei, 10051, Taiwan.
Ming-Tsan LinDepartment of Surgery, National Taiwan University College of Medicine, #1, Rd. Ren-Ai sec. 1, Chong-Cheng District, Taipei, 10051, Taiwan.
Yu-Chun ChiuDepartment of Medical Education, National Taiwan University Hospital, #7, Rd. Chong-Shan S., Chong-Cheng District, Taipei, 10002, Taiwan. clairrychun@gmail.com.
Kuan-Han LinDepartment of Healthcare Administration, Asia University, #500, Lioufeng Rd., Wufeng, Taichung, 41354, Taiwan. okonkwolin@gmail.com.ORCID 0000-0003-2047-6025

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIndividual physicians and physician-associated factors may influence patients'/surrogates' autonomous decision-making, thus influencing the practice of do-not-resuscitate (DNR) orders. The objective of this study was to examine the influence of individual attending physicians on signing a DNR order.

methodsThis study was conducted in closed model, surgical intensive care units in a university-affiliated teaching hospital located in Northern Taiwan. The medical records of patients, admitted to the surgical intensive care units for the first time between June 1, 2011 and December 31, 2013 were reviewed and data collected. We used Kaplan-Meier survival curves with log-rank test and multivariate Cox proportional hazards models to compare the time from surgical intensive care unit admission to do-not-resuscitate orders written for patients for each individual physician. The outcome variable was the time from surgical ICU admission to signing a DNR order.

resultsWe found that each individual attending physician's likelihood of signing do-not-resuscitate orders for their patients was significantly different from each other. Some attending physicians were more likely to write do-not-resuscitate orders for their patients, and other attending physicians were less likely to do so.

conclusionOur study reported that individual attending physicians had influence on patients'/surrogates' do-not-resuscitate decision-making. Future studies may be focused on examining the reasons associated with the difference of each individual physician in the likelihood of signing a do-not-resuscitate order.

Indexed as

Resuscitation OrdersAdultAgedAged, 80 and overAge FactorsDecision MakingFemaleHospitals, UniversityHumansIntensive Care UnitsKaplan-Meier EstimateMaleMiddle AgedPhysiciansPhysician's RolePractice Patterns, Physicians'Decision-makingDo-not-resuscitateIntensive care

Identifiers

PMID31801541
PMCPMC6894148

What OpenQuestion holds

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Registered trials

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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.