Evidence map›Paper›PMID 34184130›Full record

Trial reportSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2021

Association among rescue neuroleptic use, agitation, and perceived comfort: secondary analysis of a randomized clinical trial on agitated delirium.

Michael Tang, Minxing Chen, Eduardo Bruera, David Hui

Open access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 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
0.7field-weighted citation impact, top 31% 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, 7 citations in OpenAlex.

  1. Review
  2. 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

4 authors at 1 institution in 1 country.

Michael TangDepartment of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1414, Houston, TX, 77030, USA. MJTang@mdanderson.org.
Minxing ChenDepartment of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Eduardo BrueraDepartment of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1414, Houston, TX, 77030, USA.
David HuiDepartment of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1414, Houston, TX, 77030, USA.
The University of Texas MD Anderson Cancer Center · US

Funding

Efficacy and Safety of Rapid-Onset Opioids for Exertional Dyspnea in Cancer PatientsR01CA231471 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI HUI, DAVID · 2020 to 2024
$1.9M
Strategies for Persistent Agitated Delirium in Palliative CareR01CA225701 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI HUI, DAVID · 2019 to 2022
$1.9M
A Randomized Controlled Trial of Dexamethasone for Dyspnea in Cancer PatientsR01CA214960 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI HUI, DAVID · 2017 to 2020
$1.6M
Palliative Therapies for Refractory Delirium in Advanced CancerR21NR016736 · NINR · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI HUI, DAVID · 2017 to 2018
$455k
Adjuvant Lorazepam for Agitated Delirium in the Palliative Care UnitR21CA186000 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI HUI, DAVID · 2015 to 2016
$399k
American Cancer Society R21CA186000-01A1NCI NIH HHS R01 CA214960NCI NIH HHS R01CA214960-01A1NCI NIH HHS R01 CA225701NCI NIH HHS R01CA225701-01A1NCI NIH HHS R01 CA231471NCI NIH HHS R01CA231471-01A1NCI NIH HHS R21 CA186000NCI NIH HHS R21CA186000-01A1NINR NIH HHS 1R21NR016736-01NINR NIH HHS R21 NR016736
6 · The paper itself

Abstract

backgroundFew studies have examined how the use of rescue medications could be used to inform on the efficacy of interventions in delirium clinical trials. The objective of this study was to determine the association among rescue medication use, Richmond Agitation-Sedation Scale (RASS), and perceived comfort by the nurses and caregivers.

methodsThis was a pre-planned secondary analysis of a double-blind, randomized clinical trial comparing the use of a single dose of lorazepam plus haloperidol versus placebo plus haloperidol in patients with agitated delirium. Rescue medications were considered the gold standard for this analysis. The optimal cutoff for RASS analysis was calculated by using general linear regression models and determining the area of the curve and using the top left approach. We used 2 × 2 tables to examine the association between rescue medication use and perceived comfort.

resultsFifty-eight patients received the study medications and 52 (89%) completed the 8-h observation period. There were 26 (50%) patients in each arm. The lorazepam/haloperidol arm required fewer rescue doses (4/26 (15%)) vs. 16/26 (62%), p = 0.004). Patients with a greater initial RASS reduction required fewer rescue doses. The cutoff value for RASS improvement was 4 points, area under the curve (AUC) 0.64 (95% CI 0.49-0.79) for those who required no rescue doses, and 3 points, AUC 0.74 (95% CI 0.52-0.96) for those who required more than one rescue dose.

conclusionsRescue medication use was responsive to change and associated with both RASS scores and perceived patient comfort by the nurse and caregiver.

Indexed as

Antipsychotic AgentsDeliriumDouble-Blind MethodHaloperidolHumansLorazepamPsychomotor AgitationAntipsychotic AgentsHaloperidolLorazepamAgitated deliriumComfortPalliative medicineRASSRescue medication

Identifiers

PMID34184130
PMCPMC8641064
OpenAlexW3176152861

What OpenQuestion holds

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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.