Evidence map›Paper›PMID 38039068›Full record

ArticleJMIR perioperative medicine2023

Survey of the Impact of Decision Support in Preoperative Management of Anemia (i-Anemia): Survey Study.

Gaëtan Mignanelli, Richard Boyer, Nicolas Bonifas, Emmanuel Rineau, Yassine Moussali, Morgan Le Guen

Open access · diamondAbstract read
In one paragraph

Article in JMIR perioperative medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.2field-weighted citation impact, top 55% 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

3 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Article
  3. Management and perceptions of anemia and iron deficiency prior to cardiac surgery.Archivos peruanos de cardiologia y cirugia cardiovascular
    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

6 authors at 6 institutions in 2 countries.

Gaëtan Mignanelli *Department of Anesthesia and Pain Medicine, Hôpital Foch, Université Versailles Saint Quentin, Neuilly sur Seine, France.ORCID https://orcid.org/0000-0002-8507-7992
Richard Boyer *Department of Anesthesiology, Weill Cornell Medical College, New York, NY, United States.ORCID https://orcid.org/0000-0001-9318-3747
Nicolas Bonifas *Ecole Polytechnique, Palaiseau, France.ORCID https://orcid.org/0000-0002-9260-683X
Emmanuel Rineau *Department of Anesthesia and Critical Care, Angers University Hospital, University of Angers, Angers, France.ORCID https://orcid.org/0000-0003-1293-1120
Yassine Moussali *Department of Anaesthesia, Claude Galien Clinic, Quincy-sous-Sénart, France.ORCID https://orcid.org/0000-0003-4949-8930
Morgan Le Guen *Department of Anesthesia and Pain Medicine, Hôpital Foch, Université Versailles Saint Quentin, Suresnes, France.ORCID https://orcid.org/0000-0002-6789-1237
Clinique Claude-Bernard · FRCornell University · USÉcole Polytechnique · FRHôpital Foch · FRUniversité d'Angers · FRUniversité de Versailles Saint-Quentin-en-Yvelines · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMajor surgery on patients with anemia has demonstrated an increased risk of perioperative blood transfusions and postoperative morbidity and mortality. Recent studies have shown that integrating preoperative anemia treatment as a component of perioperative blood management may reduce blood product utilization and improve outcomes in both cardiac and noncardiac surgery. However, outpatient management of anemia falls outside of daily practice for most anesthesiologists and is probably weakly understood.

objectiveWe conducted a simulated case survey with anesthesiologists to accomplish the following aims: (1) evaluate the baseline knowledge of the preoperative optimization of anemia and (2) determine the impact of real-time clinical decision support on anemia management.

methodsWe sent a digital survey (i-Anemia) to members of the French Society of Anaesthesia and Critical Care. The i-Anemia survey contained 7 simulated case vignettes, each describing a patient's brief clinical history and containing up to 3 multiple-choice questions related to preoperative anemia management (12 questions in total). The cases concerned potential situations of preoperative anemia and were created and validated with a committee of patient blood management experts. Correct answers were determined by the current guidelines or by expert consensus. Eligible participants were randomly assigned to control or decision support groups. In the decision support group, the primary outcome measured was the correct response rate.

resultsOverall, 1123 participants were enrolled and randomly divided into control (n=568) and decision support (n=555) groups. Among them, 763 participants fully responded to the survey. We obtained a complete response rate of 65.6% (n=364) in the group receiving cognitive aid and 70.2% (n=399) in the group without assistance. The mean duration of response was 10.2 (SD 6.8) minutes versus 7.8 (SD 5) minutes for the decision support and control groups, respectively (P<.001). The score significantly improved with cognitive aid (mean 10.3 out of 12, SD 2.1) in comparison to standard care (mean 6.2 out of 12, SD 2.1; P<.001).

conclusionsManagement strategies to optimize preoperative anemia are not fully known and applied by anesthesiologists in daily practice despite their clinical importance. However, adding a decision support tool can significantly improve patient care by reminding practitioners of current recommendations.

Indexed as

anemiaanesthesiaanesthesiologistanesthesiologistsanesthesiologybloodcasedecision supportdigital healthpatient blood managementperioperativepreoperativepreoperative optimizationprofessional developmentrandomizedsurgerysurveytransfusion

Identifiers

PMID38039068
PMCPMC10724811
OpenAlexW4388381022

What OpenQuestion holds

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Registered trials

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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.