| 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. |
X Demographics
The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Netherlands | 1 | 33% |
| Australia | 1 | 33% |
| Brazil | 1 | 33% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 67% |
| Scientists | 1 | 33% |
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
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.
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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.