Evidence map›Paper›PMID 40162593›Full record

ArticleInternal medicine journal2025

Current practice and attitudes in emergency department management of primary spontaneous pneumothorax in Australia and New Zealand: a scenario-based/survey.

Anne-Maree Kelly, Sanjeevan Muruganandan, Peter Jones, Gerben Keijzers, Fran Kinnear, Peter Cameron, Arash Badiei, Yc Gary Lee, Julian A Smith, Emma Ball and 3 more

Abstract read
In one paragraph

Article in Internal medicine journal, 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. Observational
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.

Anne-Maree KellyJoseph Epstein Centre for Emergency Medicine Research at Western Health, Sunshine Hospital, St Albans, Victoria, Australia.ORCID 0000-0002-4655-5023
Sanjeevan MuruganandanDepartment of Respiratory Medicine, Northern Health, Melbourne, Victoria, Australia.
Peter JonesFaculty of Health and Medical Sciences, University of Auckland, Auckland, New Zealand.
Gerben KeijzersDepartment of Emergency Medicine, Gold Coast Hospital and Health Service, Southport, Queensland, Australia.ORCID 0000-0003-1100-4552
Fran KinnearEmergency and Children's Services, The Prince Charles Hospital, Brisbane, Queensland, Australia.
Peter CameronMonash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia.
Arash BadieiDepartment of Thoracic Medicine, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Yc Gary LeePleural Medicine Unit, Institute for Respiratory Health, Perth, Western Australia, Australia.
Julian A SmithDepartment of Surgery (School of Clinical Sciences at Monash Health), Monash University, Clayton, Victoria, Australia.
Emma BallDepartment of Respiratory Medicine, Royal Hobart Hospital, Hobart, Tasmania, Australia.
Ethan BaconConsumer representative, Melbourne, Victoria, Australia.
Roland BammerDepartment of Radiology and Radiological Sciences, Monash University, Australia.
Diana Egerton-WarburtonSchool of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundManagement of primary spontaneous pneumothorax (PSP) has long been contentious.

aimsTo identify the factors influencing interventional versus conservative management and to assess current practice patterns for moderate-to-large PSP in emergency department (ED) patients.

methodsAnonymous online survey of emergency medicine, respiratory medicine and thoracic surgery specialists and trainees in Australia and New Zealand. Data collected included rating the decision-making importance of potential drivers of interventional versus conservative management for PSP, initial management preference for stable patients with moderate-large PSP based on three X-ray-based scenarios (one moderate-large, one almost total collapse without mediastinal shift and one large with mediastinal shift) and awareness of evidence and current guidelines for the management of PSP.

resultsThere were 456 responses; 85.5% were from Australia. The most commonly reported factors influencing treatment decision-making were vital signs (96.7%) and patient-reported dyspnoea (84.3%). There was variation between specialty groups in initial treatment preference for all scenarios (P < 0.001) and a reduction in preference for conservative treatment as the magnitude of radiological features increased (93.8% vs 61.5% vs 32.1% respectively). Guideline recommendation awareness was low except for the 2023 British Thoracic Society guideline (60.4%).

conclusionThis study demonstrates variation of opinion regarding the initial management of stable patients with moderate to large PSP and an increasing preference for intervention as the magnitude of radiological features increases. Guideline awareness was low, highlighting the need for an evidence-based approach to PSP management in the ED that is widely understood and accepted across speciality groups and that prioritises patient symptoms over X-ray findings.

Indexed as

Attitude of Health PersonnelEmergency Service, HospitalPneumothoraxPractice Patterns, Physicians'AdultAustraliaConservative TreatmentDisease ManagementFemaleHumansMaleMiddle AgedNew ZealandSurveys and Questionnairesemergency departmentguidelinespleural diseasepneumothorax

Identifiers

PMID40162593
PMCPMC12155077

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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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.