Evidence map›Paper›PMID 40147994›Full record

ArticleBMJ open2025

Clinician attitudes, opinions and practice patterns regarding inotrope use for cardiac surgery in the USA: a multicentre mixed methods study protocol.

Michael R Mathis, Kamolnat Mirizzi, Courtney J Burns, Allison M Janda, Graciela Mentz, Keith D Aaronson, Zhenke Wu, Donald S Likosky, Francis D Pagani, Sachin Kheterpal and 3 more

Abstract read
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

13 authors.

Michael R MathisDepartment of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan, USA mathism@med.umich.edu.ORCID http://orcid.org/0000-0002-9697-2212
Kamolnat MirizziDepartment of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan, USA.ORCID http://orcid.org/0000-0002-9168-1360
Courtney J BurnsDepartment of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Allison M JandaDepartment of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan, USA.ORCID http://orcid.org/0000-0001-5080-5630
Graciela MentzDepartment of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Keith D AaronsonDepartment of Internal Medicine-Cardiology, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Zhenke WuDepartment of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA.
Donald S LikoskyDepartment of Cardiac Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Francis D PaganiDepartment of Cardiac Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Sachin KheterpalDepartment of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Kamrouz GhadimiDuke University School of Medicine, Durham, North Carolina, USA.
Milisa ManojlovichSchool of Nursing, University of Michigan, Ann Arbor, Michigan, USA.
Timothy GuettermanDepartment of Family Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA.ORCID http://orcid.org/0000-0002-0093-858X

Funding

Research Training in AnesthesiaT32GM086287 · NIGMS · YALE UNIVERSITY · PI ROBERT SCHONBERGER · 2009 to 2026
$3.7M
COmparing iNoTRope prACtice variaTION in Cardiac Surgery (CONTRACTION-CS)R01HL167790 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Michael Robert Mathis · 2024 to 2026
$2.1M
PHEnylephrine versus NOrepinephrine in Major NONcardiac surgery (PHENOMeNON): Foundational Studies for a Pragmatic Randomized Clinical Trial.K23HL166685 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Allison Mary Janda · 2023 to 2026
$689k
NHLBI NIH HHS K23 HL166685NHLBI NIH HHS R01 HL167790NIGMS NIH HHS T32 GM086287
6 · The paper itself

Abstract

introductionCardiac inotrope medications administered to cardiac surgical patients carry steep risk-benefit trade-offs, yet wide inter-institutional variation exists in inotrope practices. Despite known wide variation in use of any inotrope for cardiac surgery, limited multicentre data exist regarding determinants of inotrope selection and time course for use. Additionally, the reasons that underpin how clinicians decide on inotrope usage and the factors that influence inotrope practice change are not well understood. METHODS AND ANALYSIS: This is an investigator-initiated, multicentre mixed methods study. Quantitative data will include electronic health records from an observational cohort of adult cardiac procedures within the Multicenter Perioperative Outcomes Group (MPOG) database, comprising cardiac surgical procedures from over 30 US academic and community hospitals. Additional quantitative data will be collected via surveys of clinicians involved in inotrope decision-making, contacted through an existing multicentre research and quality improvement infrastructure with engaged clinician representatives participating across MPOG hospitals. Qualitative data will be collected from open-ended questions within surveys, as well as semi-structured interviews with surveyed clinicians, sampled across approximately six institutions selected for diversity of settings and inotrope practices. An explanatory sequential mixed methods design will merge quantitative and qualitative data to develop meta-inferences explaining inotrope practices, as guided by an existing framework for characterising clinical practice variation and levers for practice change. ETHICS AND DISSEMINATION: The study is approved by the institutional review board at the University of Michigan Medical School (HUM00245353). Findings will be disseminated through peer-reviewed journals, conference proceedings and quality improvement forums. The study began in February 2025 and will continue until 2028.

Indexed as

Attitude of Health PersonnelCardiac Surgical ProceduresCardiotonic AgentsPractice Patterns, Physicians'HumansMulticenter Studies as TopicResearch DesignSurveys and QuestionnairesUnited StatesCardiotonic AgentsAdult anaesthesiaCardiac surgeryClinical ProtocolsQuality Improvement

Identifiers

PMID40147994
PMCPMC11956292

What OpenQuestion holds

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LicenceCC BY-NC
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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.