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Diagnostic and ethical challenges in disorders of consciousness and locked-in syndrome: a survey of German neurologists

Overview of attention for article published in Journal of Neurology, March 2012
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (88th percentile)
  • High Attention Score compared to outputs of the same age and source (95th percentile)

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1 blog
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Citations

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77 Mendeley
Title
Diagnostic and ethical challenges in disorders of consciousness and locked-in syndrome: a survey of German neurologists
Published in
Journal of Neurology, March 2012
DOI 10.1007/s00415-012-6459-9
Pubmed ID
Authors

Katja Kuehlmeyer, Eric Racine, Nicole Palmour, Eva Hoster, Gian Domenico Borasio, Ralf J. Jox

Abstract

Diagnosis and decisions on life-sustaining treatment (LST) in disorders of consciousness, such as the vegetative state (VS) and the minimally conscious state (MCS), are challenging for neurologists. The locked-in syndrome (LiS) is sometimes confounded with these disorders by less experienced physicians. We aimed to investigate (1) the application of diagnostic knowledge, (2) attitudes concerning limitations of LST, and (3) further challenging aspects in the care of patients. A vignette-based online survey with a randomized presentation of a VS, MCS, or LiS case scenario was conducted among members of the German Society for Neurology. A sample of 503 neurologists participated (response rate 16.4%). An accurate diagnosis was given by 86% of the participants. The LiS case was diagnosed more accurately (94%) than the VS case (79%) and the MCS case (87%, p < 0.001). Limiting LST for the patient was considered by 92, 91, and 84% of the participants who accurately diagnosed the VS, LiS, and MCS case (p = 0.09). Overall, most participants agreed with limiting cardiopulmonary resuscitation; a minority considered limiting artificial nutrition and hydration. Neurologists regarded the estimation of the prognosis and determination of the patients' wishes as most challenging. The majority of German neurologists accurately applied the diagnostic categories VS, MCS, and LiS to case vignettes. Their attitudes were mostly in favor of limiting life-sustaining treatment and slightly differed for MCS as compared to VS and LiS. Attitudes toward LST strongly differed according to circumstances (e.g., patient's will opposed treatment) and treatment measures.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 77 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 2 3%
United States 2 3%
Canada 1 1%
Unknown 72 94%

Demographic breakdown

Readers by professional status Count As %
Researcher 12 16%
Student > Ph. D. Student 10 13%
Student > Bachelor 10 13%
Professor > Associate Professor 9 12%
Student > Master 9 12%
Other 14 18%
Unknown 13 17%
Readers by discipline Count As %
Medicine and Dentistry 27 35%
Psychology 9 12%
Neuroscience 7 9%
Philosophy 5 6%
Social Sciences 5 6%
Other 9 12%
Unknown 15 19%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 11. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 30 October 2018.
All research outputs
#2,996,225
of 23,520,142 outputs
Outputs from Journal of Neurology
#645
of 4,596 outputs
Outputs of similar age
#18,685
of 157,946 outputs
Outputs of similar age from Journal of Neurology
#2
of 40 outputs
Altmetric has tracked 23,520,142 research outputs across all sources so far. Compared to these this one has done well and is in the 87th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 4,596 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.2. This one has done well, scoring higher than 85% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 157,946 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 88% of its contemporaries.
We're also able to compare this research output to 40 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 95% of its contemporaries.