Evidence map›Paper›PMID 37455838›Full record

ArticleEJIFCC2023

Age-Stratified Lithium Therapeutic Ranges for Older Adults with Bipolar Disorder - from Awareness to an Action Plan.

Angela W S Fung, Kenneth I Shulman, Danijela Konforte, Hilde Vandenberghe, Julia Stemp, Victoria R Yuan, Paul M Yip, Lei Fu

Open access · greenAbstract read
In one paragraph

Article in EJIFCC, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 37% 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

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

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

8 authors at 3 institutions in 1 country.

Angela W S FungDepartment of Pathology and Laboratory Medicine, St. Paul's Hospital, Vancouver, BC.
Kenneth I ShulmanDepartment of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON.
Danijela KonforteLifeLabs Medical Laboratories, Toronto, ON.
Hilde VandenbergheDepartment of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON.
Julia StempInstitute for Quality Management in Healthcare, Toronto, ON.
Victoria R YuanDepartment of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON.
Paul M YipDepartment of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON.
Lei FuDepartment of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON.
University of Toronto · CAHealth Sciences Centre · CASt. Paul's Hospital · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Lithium is the first-line treatment for maintenance therapy in bipolar disorder. It is an effective mood stabilizer agent, and may have potential benefits in neuroprotection and reducing the risk of suicide. Toxicity has been a concern in recent decades, particularly in older adults (≥60 years). In 2019, the Older Adults Task Force within the International Society for Bipolar Disorder (ISBD) published recommendations for age-stratified lithium therapeutic ranges for therapy of Older Age Bipolar Disorder (OABD), namely 0.4 - 0.8 mmol/L for ages 60 to 79 and 0.4 - 0.7 mmol/L for ages 80 and above. Clinical laboratory practice surveys in Canada indicated that adoption and implementation of the proposed ranges has been limited to date. In this article, we describe the approach and steps taken to evaluate and implement recommended lithium therapeutic ranges in Ontario and other provinces in Canada for laboratory quality improvement. Sources of variation in lithium reporting practices are discussed and shared here to highlight potential barriers to implementation. The overall goal of this article is to bring attention across the global laboratory community that lower lithium therapeutic target ranges in older patients are crucial for patient safety in OABD.

Indexed as

bipolar disorderelderlylithiumtherapeutic drug monitoringtherapeutic ranges

Identifiers

PMID37455838
PMCPMC10349314
OpenAlexW4384493226

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.