ArticleExperimental physiology2024
Myths and methodologies: Assessment of dynamic cerebral autoregulation by the mean flow index.
Article in Experimental physiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
What it found
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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.
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Who cites it
9 citing papers in PubMed.
- Time-resolved laser speckle contrast imaging (TR-LSCI) of cerebral blood flow response to intracranial pressure elevation.Journal of biomedical optics · 2026Article
- Time-Resolved Laser Speckle Contrast Imaging (TR-LSCI) of Cerebral Blood Flow Response to Intracranial Pressure Elevation.bioRxiv : the preprint server for biology · 2026Article
- Mean flow index (Mxa) algorithm option can influence cerebral autoregulation classification in critically ill septic patients.Journal of clinical monitoring and computing · 2026Article
- Status quo of Experimental Physiology - Anno 2025: What's in a name?Experimental physiology · 2026Article
- Spinal cord vascular autoregulation: key concepts and opportunities to improve management.Spinal cord · 2026Review
- What we talk about when we talk about reliability: Comment on 'Intra- and inter-session reliability and repeatability ofExperimental physiology · 2025Article
- Myths and methodologies: Assessment of dynamic cerebral autoregulation by the mean flow index.Experimental physiology · 2024Article
- Unveiling the enigma from sick to beauty: Hungry to standardize metrics for dynamic cerebral autoregulation.Experimental physiology · 2024Article
- Observational
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
The mean flow index-usually referred to as Mx-has been used for assessing dynamic cerebral autoregulation (dCA) for almost 30 years. However, concerns have arisen regarding methodological consistency, construct and criterion validity, and test-retest reliability. Methodological nuances, such as choice of input (cerebral perfusion pressure, invasive or non-invasive arterial pressure), pre-processing approach and artefact handling, significantly influence mean flow index values, and previous studies correlating mean flow index with other established dCA metrics are confounded by inherent methodological flaws like heteroscedasticity, while the mean flow index also fails to discriminate individuals with presumed intact versus impaired dCA (discriminatory validity), and its prognostic performance (predictive validity) across various conditions remains inconsistent. The test-retest reliability, both within and between days, is generally poor. At present, no single approach for data collection or pre-processing has proven superior for obtaining the mean flow index, and caution is advised in the further use of mean flow index-based measures for assessing dCA, as current evidence does not support their clinical application.
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Registered trials
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.