Observational studyNature medicine2024
Multimodal assessment improves neuroprognosis performance in clinically unresponsive critical-care patients with brain injury.
Observational study in Nature medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04534777 (Multimodal Neuroprognostication in Disorders of Consciousness), which is not on this map. Cited by 36 papers.
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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.
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.
Multimodal Neuroprognostication in Disorders of Consciousness
Who cites it
36 citing papers in PubMed.
- Unreactive EEG Background Is Associated With Unfavorable Outcome in Patients With Disorders of Consciousness of Various Etiologies: An Adult Cohort Study.European journal of neurology · 2025Trial
- Variation in capability, organisational structure, and treatment processes for critically ill adults with moderate-to-severe traumatic brain injury in Australia and New Zealand.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026Article
- Impact of a Specialized Care Pathway for ICU Patients With Disorders of Consciousness: Observational Insights From an Expert Center.European journal of neurology · 2026Observational
- EEG functional connectivity measures for differentiating 6-month consciousness-related outcome after brain injury.BMC medical imaging · 2026Article
- Auditory Stimuli Most Effective in Eliciting Reactivity in Critically Ill Patients with an Impaired Consciousness.Neurocritical care · 2026Article
- Early Identification of Recovery Potential After Acute Brain Injury Using Functional Near-Infrared Spectroscopy.Neurocritical care · 2026Article
- Between Patterns and Predictions: Interpretable Latent EEG Representations for Clinical Insights.medRxiv : the preprint server for health sciences · 2026Article
- Clinically translatable ultrasound localization microscopy reveals cerebrovascular remodelling and prognosis in patients with traumatic brain injury.Nature biomedical engineering · 2026Article
- Neurological Outcome Beyond the ICU in Patients with Severe Acute Brain Injury: A Knowledge gap for ICU Teams.Journal of intensive care medicine · 2026Observational
- Exploring pathways leading to drug-resistant epilepsy for patients with cryptogenic new onset refractory status epilepticus.Epilepsia · 2026Article
- EEG for bedside monitoring: the intensivist's point of view.Critical care (London, England) · 2026Review
- Multimodal multicentre investigation of diagnostic and prognostic markers in disorders of consciousness.Brain : a journal of neurology · 2026Article
- Practicalities of noninvasive neuromonitoring in intensive care.Neurocritical care · 2026Article
- Multimodal contrastive prognostication framework for early neurological outcome prediction in post-cardiac arrest patients.Scientific reports · 2026Article
- Article
- Deep white matter MRI predicts outcomes in coma of various etiologies: a cohort study.Critical care (London, England) · 2026Article
- Surrogate decision-making for people with disorders of consciousness: considering the control-preferences of informal caregivers before implementing multimodal testing.BMC medical ethics · 2026Article
- Disorders of consciousness diagnosis, interventions, and prognostication for the intensivist: Report of the 2025 ISICEM roundtable.Intensive care medicine · 2026Review
- Longitudinal assessment of automated gray-white matter ratio for outcome prediction after cardiac arrest.Critical care (London, England) · 2025Article
- Computational whole-body-exposome models for global precision brain health.Nature communications · 2025Article
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Authors and funding
29 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Accurately predicting functional outcomes for unresponsive patients with acute brain injury is a medical, scientific and ethical challenge. This prospective study assesses how a multimodal approach combining various numbers of behavioral, neuroimaging and electrophysiological markers affects the performance of outcome predictions. We analyzed data from 349 patients admitted to a tertiary neurointensive care unit between 2009 and 2021, categorizing prognoses as good, uncertain or poor, and compared these predictions with observed outcomes using the Glasgow Outcome Scale-Extended (GOS-E, levels ranging from 1 to 8, with higher levels indicating better outcomes). After excluding cases with life-sustaining therapy withdrawal to mitigate the self-fulfilling prophecy bias, our findings reveal that a good prognosis, compared with a poor or uncertain one, is associated with better one-year functional outcomes (common odds ratio (95% CI) for higher GOS-E: OR = 14.57 (5.70-40.32), P < 0.001; and 2.9 (1.56-5.45), P < 0.001, respectively). Moreover, increasing the number of assessment modalities decreased uncertainty (OR = 0.35 (0.21-0.59), P < 0.001) and improved prognostic accuracy (OR = 2.72 (1.18-6.47), P = 0.011). Our results underscore the value of multimodal assessment in refining neuroprognostic precision, thereby offering a robust foundation for clinical decision-making processes for acutely brain-injured patients. ClinicalTrials.gov registration: NCT04534777 .
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