Evidence map›Paper›PMID 37611734›Full record

Observational studyThe Journal of pediatrics2023

Prognostic Discordance Among Parents and Physicians Caring for Infants with Neurologic Conditions.

Sarah M Bernstein, Mary C Barks, Peter A Ubel, Kevin Weinfurt, Margaret H Barlet, Samantha Farley, Megan G Jiao, Simran Bansal, Kimberley Fisher, Monica E Lemmon

Open access · greenAbstract readObservational Study
In one paragraph

Observational study in The Journal of pediatrics, 2023. 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
2.9field-weighted citation impact, top 9% 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, 5 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Sarah M BernsteinUniversity of Utah School of Medicine, Salt Lake City, UT; Duke University Medical Center, Durham, NC. Electronic address: sarahbernsteinmd@gmail.com.
Mary C BarksDuke Margolis Center for Health Policy, Durham, NC.
Peter A UbelDuke University Medical Center, Durham, NC.
Kevin WeinfurtDuke University Medical Center, Durham, NC.
Margaret H BarletDuke University Medical Center, Durham, NC.
Samantha FarleyDuke Margolis Center for Health Policy, Durham, NC.
Megan G JiaoDuke Margolis Center for Health Policy, Durham, NC.
Simran BansalDuke University Medical Center, Durham, NC.
Kimberley FisherDuke University Medical Center, Durham, NC.
Monica E LemmonDuke University Medical Center, Durham, NC; Duke Margolis Center for Health Policy, Durham, NC.
Duke Medical Center · USDuke Institute for Health Innovation · USDuke University · US

Funding

Child Neurologist Career Development Program (CNCDP)K12NS098482 · NINDS · HUGO W. MOSER RES INST KENNEDY KRIEGER · PI SCHLAGGAR, BRADLEY L · 2016 to 2025
$26.2M
Decision Making for Infants with Neurologic ConditionsK23NS116453 · NINDS · DUKE UNIVERSITY · PI LEMMON, MONICA · 2020 to 2024
$942k
NINDS NIH HHS K12 NS098482NINDS NIH HHS K23 NS116453
6 · The paper itself

Abstract

objectiveTo determine the frequency, degree, and nature of prognostic discordance between parents and physicians caring for infants with neurologic conditions. STUDY

designIn this observational cohort study, we enrolled parents and physicians caring for infants with neurologic conditions in advance of a family conference. Parent-physician dyads completed a postconference survey targeting expected neurologic outcomes across 3 domains (motor, speech, and cognition) using a 6-point scale. Prognostic discordance was defined as a difference of ≥2 response options and was considered moderate (difference of 2-3 response options) or high (difference of 4-5 response options). Responses were categorized as differences in belief and/or differences in understanding using an existing paradigm.

resultsForty parent-physician dyads of 28 infants completed surveys. Parent-physician discordance about prognosis occurred in ≥1 domain in the majority of dyads (n = 28/40, 70%). Discordance was generally moderate in degree (n = 23/28, 82%) and occurred with similar frequency across all domains. Of parent-physician dyads with discordance, the majority contained a difference in understanding in at least 1 domain (n = 25/28, 89%), while a minority contained a difference of belief (n = 6/28, 21%). When discordance was present, parents were typically more optimistic in their predictions compared with physicians (n = 25/28, 89%).

conclusionsDiffering perceptions about the prognosis of critically ill infants are common and due to differences in both understanding and belief. These findings can be used to develop targeted interventions to improve prognostic communication.

Indexed as

PhysiciansCohort StudiesCommunicationHumansInfantParentsPrognosis

Identifiers

PMID37611734
PMCPMC10841319
OpenAlexW4386033878

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.