SynthesisJournal of racial and ethnic health disparities2021
Crisis Standards of Care in the USA: A Systematic Review and Implications for Equity Amidst COVID-19.
Synthesis in Journal of racial and ethnic health disparities, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 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
41 citing papers in PubMed, 1 synthesis or guideline pooled it, 76 citations in OpenAlex.
- Part 3: Ethics: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.Circulation · 2025Guideline
- Bolstering agreement with scarce resource allocation policy using education: a post hoc analysis of a randomized controlled trial.BMC health services research · 2025Trial
- The Impact of State COVID-19 Responses on People With Intellectual and Developmental Disabilities.Inclusion (Washington, D.C.) · 2025Article
- Minnesota Hospitals' Plans for Implementing Statewide Guidance on Allocation of Scarce Critical Care Resources During the COVID-19 Pandemic.Mayo Clinic proceedings. Innovations, quality & outcomes · 2024Article
- Social Disparities and Critical Illness during the Coronavirus Disease 2019 Pandemic: A Narrative Review.Critical care clinics · 2024Review
- Article
- Health Professional vs Layperson Values and Preferences on Scarce Resource Allocation.JAMA network open · 2024Article
- Comparative Effectiveness of Virtual Versus In-person Visits for Abdominal Pain During the COVID-19 Pandemic.Digestive diseases and sciences · 2024Article
- Utilization of Hospital Do-Not-Resuscitate Orders in Older Adults During COVID-19 Surges in 2020.Journal of palliative medicine · 2024Article
- Estimating population impact of state triage policies restricting healthcare access for older adults with chronic conditions.Journal of the American Geriatrics Society · 2024Article
- Article
- Psychedelic-Assisted Therapy in Military and Veterans Healthcare Systems: Clinical, Legal, and Implementation Considerations.Current psychiatry reports · 2023Review
- Triage Procedures for Critical Care Resource Allocation During Scarcity.JAMA network open · 2023Article
- "A Community-Engaged Approach to Address Collateral Findings in Embedded Research".The American journal of bioethics : AJOB · 2023Article
- Extracorporeal Membrane Oxygenation Then and Now; Broadening Indications and Availability.Critical care clinics · 2023Review
- Nurses' Perceptions of Ethical Conflicts When Caring for Patients with COVID-19.International journal of environmental research and public health · 2023Article
- Public voices on tie-breaking criteria and underlying values in COVID-19 triage protocols to access critical care: a scoping review.Discover health systems · 2023Article
- "Community engagement via restorative justice to build equity-oriented crisis standards of care".Journal of the National Medical Association · 2022Article
- Who is essential in care? Reflections from the pandemic's backstage.Nursing ethics · 2022Article
- How Common SOFA and Ventilator Time Trial Criteria Would Have Performed During the COVID-19 Pandemic: An Observational Simulated Cohort Study.Disaster medicine and public health preparedness · 2022Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCrisis Standards of Care (CSC) provide a framework for the fair allocation of scarce resources during emergencies. The novel coronavirus disease (COVID-19) has disproportionately affected Black and Latinx populations in the USA. No literature exists comparing state-level CSC. It is unknown how equitably CSC would allocate resources.
methodsThe authors identified all publicly available state-level CSC through online searches and communication with state governments. Publicly available CSC were systematically reviewed for content including ethical framework and prioritization strategy.
resultsCSC were identified for 29 states. Ethical principles were explicitly stated in 23 (79.3%). Equity was listed as a guiding ethical principle in 15 (51.7%); 19 (65.5%) said decisions should not factor in race, ethnicity, disability, and other identity-based factors. Ten states (34.4%) allowed for consideration of societal value, which could lead to prioritization of health care workers and other essential personnel. Twenty-one (72.4%) CSC provided a specific strategy for prioritizing patients for critical care resources, e.g., ventilators. All incorporated Sequential Organ Failure Assessment scores; 15 (71.4%) of these specific CSC considered comorbid conditions (e.g., cardiac disease, renal failure, malignancy) in resource allocation decisions.
conclusionThere is wide variability in the existence and specificity of CSC across the USA. CSC may disproportionately impact disadvantaged populations due to inequities in comorbid condition prevalence, expected lifespan, and other effects of systemic racism.
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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.