Evidence map›Paper›PMID 39978834›Full record

ArticleWorld journal of surgery2025

A T2 Translational Science Modified Delphi Study: The Ethical Triage and Treatment of Entrapped and Mangled Extremities in Resource-Scarce Environments.

Eric S Weinstein, Zachary Gilbert, James Gosney, Brielle Weinstein, Hannah B Wild, Joseph Cuthbertson, Melissa Leming, Rachel Semmons, Dónal O'Mathúna, Carl Montan and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in World journal of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

12 authors.

Eric S WeinsteinDepartment of Emergency Medicine-Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.ORCID 0000-0002-1147-5656
Zachary GilbertDepartment of Emergency Medicine-Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.ORCID 0009-0009-6171-5345
James GosneyEmergency Rehabilitation Committee, International Society of Physical and Rehabilitation Medicine, Milan, Italy.ORCID 0009-0003-1274-3637
Brielle WeinsteinDepartment of Plastic Surgery Morsani College of Medicine University of South Florida, Tampa, Florida, USA.ORCID 0000-0001-6131-2583
Hannah B WildDepartment of Surgery, University of Washington, Seattle, Washington, USA.ORCID 0000-0003-0974-0956
Joseph CuthbertsonCRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, Novara, Italy.ORCID 0000-0003-3210-8115
Melissa LemingDepartment of Emergency Medicine-Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
Rachel SemmonsDepartment of Emergency Medicine-Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.ORCID 0009-0003-3952-7205
Dónal O'MathúnaCollege of Nursing and the Center for Bioethics and Medical Humanities, The Ohio State University, Columbus, Ohio, USA.ORCID 0000-0001-5331-3340
Carl MontanDepartment of Molecular Medicine and Surgery, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0002-1572-3979
Richard GosselinOrthopedic Surgery, Institute for Global Orthopaedics and Traumatology, University of California at San Francisco, El Granada, California, USA.ORCID 0000-0001-5977-6573
Frederick Skip BurkleGlobal Scholar Woodrow Wilson International Center for Scholars, Washington, DC, USA.ORCID 0000-0002-5110-7284

Funding

Research Mentoring and Building Capacity of underrepresented Minority Research Scientists in India.D43TW010540 · FIC · YALE UNIVERSITY · PI MICHELE BARRY, Eva Harris · 2017 to 2026
$15.5M
FIC NIH HHS D43 TW010540
6 · The paper itself

Abstract

backgroundThere is a lack of ethical triage and treatment guidelines for the entrapped and mangled extremity (E&ME) in resource-scarce environments (RSE): mass casualty incidents, low- to middle-income countries, complex humanitarian emergencies including conflict, and prolonged transport times (RSE). The aim of this study is to use a modified Delphi (mD) approach to produce statements to develop treatment guidelines of the E&ME in RSE.

methodExperts rated their agreement with each statement on a 7-point linear numeric scale. Consensus amongst experts was defined as a standard deviation ≤ 1. Statements attaining consensus after the first round moved to the final report. Those not attaining consensus moved to the second round in which experts were shown the mean response of the expert panel and their own response for the opportunity to reconsider their rating for that round. Statements attaining consensus after the second round moved to the final report. This process was repeated in the third round. Statements attaining consensus were moved to the final report. The remaining statements did not attain consensus.

resultsSeventy-seven experts participated in the first, 75 in the second, and 74 in the third round. Twenty-three statements attained consensus. Twenty-one statements did not attain consensus.

conclusionA modified Delphi technique was used to establish consensus regarding the numerous complex factors influencing treatment of the E&ME in RSEs. Twenty-three statements attained consensus and can be incorporated into guidelines to advance the ethical treatment of the E&ME in RSEs.

Indexed as

Mass Casualty IncidentsTriageConsensusDelphi TechniqueDeveloping CountriesHumansPractice Guidelines as TopicTranslational Research, Biomedicalclinical practice guidelinesDelphi studyentrapped extremitymangled extremityresource‐scarce environmenttranslational science

Identifiers

PMID39978834
PMCPMC11994154

What OpenQuestion holds

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LicenceCC BY
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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.