Evidence map›Paper›PMID 33968474›Full record

ReviewNeurology. Clinical practice2021

Munchausen Syndrome by Tissue Plasminogen Activator: Patients Seeking Thrombolytic Administration.

Rafer Willenberg, Bo Leung, Shlee Song, Oana M Dumitrascu, Konrad Schlick, Patrick Lyden

Open access · greenAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Neurology. Clinical practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.0field-weighted citation impact, top 23% 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

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Ethical Issues in Stroke Management.Neurology. Clinical practice · 2021
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Rafer WillenbergDepartment of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA.
Bo LeungDepartment of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA.
Shlee SongDepartment of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA.
Oana M DumitrascuDepartment of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA.
Konrad SchlickDepartment of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA.
Patrick LydenDepartment of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA.
Cedars-Sinai Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purpose of reviewMunchausen syndrome by tissue plasminogen activator (tPA) is a phenomenon we describe as patients exhibiting factitious symptoms to assume the role of the sick patient, desiring and received tPA, with no alternative diagnosis or secondary gain to better account for their presentation. To illustrate this phenomenon and its magnitude, we present a series of cases of Munchausen syndrome by tPA, prevalence in our stroke center, and highlight one illustrative case. RECENT

findingsOf 335 cases with tPA administration over 29 months, 10 were confirmed as Munchausen syndrome by tPA, reflecting a 3.0% prevalence in our stroke center. SUMMARY: Munchausen syndrome by tPA is an underappreciated phenomenon encountered in evaluating patients with acute stroke symptoms. Administering tPA in Munchausen syndrome poses an ethical dilemma because standard of care favors rapid tPA administration, but administration can cause harm, burdens the healthcare system, and does not treat the patient's Munchausen syndrome.

Identifiers

PMID33968474
PMCPMC8101300
OpenAlexW3010771910

What OpenQuestion holds

Textmetadata
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.