Evidence map›Paper›PMID 35241303›Full record

ArticleSurgery2022

The choices we make: Ethical challenges in trauma surgery.

Pranit N Chotai, Marie D Kuzemchak, Mayur B Patel, Catherine Hammack-Aviran, Bradley M Dennis, Stephen P Gondek, Oscar D Guillamondegui, Keith G Meador, Kenneth A Wallston, Heidi Chen and 1 more

Open access · greenAbstract read
In one paragraph

Article in Surgery, 2022. 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
1.7field-weighted citation impact, top 16% 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, 6 citations in OpenAlex.

  1. Ethics in Clinical Orthopedic Surgery.Indian journal of orthopaedics · 2023
    Review
  2. Article
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

11 authors at 2 institutions in 1 country.

Pranit N ChotaiDepartment of General Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN; Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, TN; Division of Transplantation, Department of General Surgery, The Ohio State University Wexner Medical Center, Columbus, OH; Division of Trauma and Surgical Critical Care, Vanderbilt University Medical Center, Nashville, TN. Electronic address: https://twitter.com/txpchotai.
Marie D KuzemchakCenter for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, TN; Vanderbilt University School of Medicine, Nashville, TN.
Mayur B PatelDepartment of General Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN; Division of Trauma and Surgical Critical Care, Vanderbilt University Medical Center, Nashville, TN; Vanderbilt University School of Medicine, Nashville, TN; Surgical Services, Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN; Center for Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt Center for Health Services Research, Nashville, TN.
Catherine Hammack-AviranCenter for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, TN.
Bradley M DennisDepartment of General Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN; Division of Trauma and Surgical Critical Care, Vanderbilt University Medical Center, Nashville, TN; Vanderbilt University School of Medicine, Nashville, TN.
Stephen P GondekDepartment of General Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN; Division of Trauma and Surgical Critical Care, Vanderbilt University Medical Center, Nashville, TN; Vanderbilt University School of Medicine, Nashville, TN.
Oscar D GuillamondeguiDepartment of General Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN; Division of Trauma and Surgical Critical Care, Vanderbilt University Medical Center, Nashville, TN; Vanderbilt University School of Medicine, Nashville, TN.
Keith G MeadorCenter for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, TN; Department of Psychiatry and Behavior Sciences, Vanderbilt University Medical Center, Nashville, TN; Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN; Ethics and Society, Vanderbilt Divinity School, Nashville, TN.
Kenneth A WallstonInstitute of Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN.
Heidi ChenDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, TN.
Allan B PeetzDepartment of General Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN; Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, TN; Division of Trauma and Surgical Critical Care, Vanderbilt University Medical Center, Nashville, TN; Vanderbilt University School of Medicine, Nashville, TN; Surgical Services, Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN. Electronic address: allan.b.peetz@vumc.org.
Vanderbilt University Medical Center · USNational Academy of Medicine · US

Funding

Vanderbilt Institute for Clinical and Translational Research (VICTR) -Identifying correlates of functional immunity in SARS-CoV-2 convalescent plasmaUL1TR002243 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Paul A. Harris, Wesley H Self · 2017 to 2026
$130.7M
BRAIN-ICU-2 Study: Bringing to Light the Risk Factors And Incidence of Neuropsychological Dysfunction (Dementia) in ICU Survivors, 2nd StudyR01AG058639 · NIA · VANDERBILT UNIVERSITY MEDICAL CENTER · PI ELY, E WESLEY, JEFFERSON, ANGELA L. · 2019 to 2024
$18.3M
The INSIGHT-ICU Study: Illuminating Neuropsychological dysfunction and Systemic Inflammatory mechanisms Gleaned after Hospitalization in Trauma-ICU StudyR01GM120484 · NIGMS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI PATEL, MAYUR B · 2017 to 2021
$3.0M
Returning to Everyday Tasks Utilizing Rehabilitation Networks-III Pilot Randomized Clinical Trial (RETURN-III Pilot RCT)I01RX002992 · VA · VETERANS HEALTH ADMINISTRATION · PI ELY, E WESLEY, PATEL, MAYUR B · 2020 to 2025
–
NCATS NIH HHS UL1 TR002243NIA NIH HHS R01 AG058639NIGMS NIH HHS R01 GM120484RRD VA I01 RX002992
6 · The paper itself

Abstract

backgroundEthical issues in trauma surgery are commonplace but scarcely studied. We aim to characterize the ethical dilemmas trauma surgeons encounter in clinical practice and describe perceptions about the ability to manage these dilemmas and strategies they use to address them.

methodsMembers of a U.S. trauma society were electronically surveyed on handling ethically challenging scenarios. The survey instrument was developed using published ethics literature and iterative cognitive interviews. Domains included perceived frequency of encountering and self-efficacy of managing ethical situations in trauma surgery. Common situations were defined as those encountered monthly or weekly. Ethical problems were categorized within 7 larger categories: general ethics, autonomy, communication, justice, end-of-life, conflict, and other. Descriptive analyses were performed; group comparisons were analyzed using analysis of variance.

resultsOf 1,748 surveyed, 548 responded (30.6%) and 154 (28%) were female. Most were White, under 55 years age, had completed fellowship training, and were practicing at a level I or II trauma center. The most encountered ethical categories were generic ethics and communication (79%). Issues involving conflict were least frequent (21%). Respondents felt most uncomfortable with autonomy topics. Respondents with high self-efficacy in handling ethical situations were older, in practice ≥15 years, served on an ethics committee, and/or frequently experienced ethical challenges.

conclusionMost trauma surgeons regularly encounter ethical challenges, especially those related to communication. Trauma surgeons encounter ethical issues involving conflict least often, and lowest self-efficacy scores with issues involving autonomy. Experienced trauma surgeons reported higher self-efficacy scores in managing ethical issues. Future work should examine how self-efficacy translates to observed behavior, and how trauma surgeons build and enhance their ethical skillsets in the care of the injured patient.

Indexed as

Fellowships and ScholarshipsFemaleHumansMaleSurveys and Questionnaires

Identifiers

PMID35241303
PMCPMC9811627
OpenAlexW4220775578

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.