Evidence map›Paper›PMID 39443437›Full record

Observational studyNeurocritical care2025

A Survey of Surrogates and Health Care Professionals Indicates Support of Cognitive Motor Dissociation-Assisted Prognostication.

Gregory A Heinonen, Jerina C Carmona, Lauren Grobois, Lucie S Kruger, Angela Velazquez, Athina Vrosgou, Vedant B Kansara, Qi Shen, Satoshi Egawa, Lizbeth Cespedes and 11 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Neurocritical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Review
  2. Article
  3. 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

21 authors.

Gregory A Heinonen *Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA.
Jerina C Carmona *Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA.
Lauren GroboisDepartment of Neurology, Columbia University Irving Medical Center, New York, NY, USA.
Lucie S KrugerDepartment of Neurology, Columbia University Irving Medical Center, New York, NY, USA.
Angela VelazquezDepartment of Neurology, Columbia University Irving Medical Center, New York, NY, USA.
Athina VrosgouDepartment of Neurology, Columbia University Irving Medical Center, New York, NY, USA.
Vedant B KansaraDepartment of Neurology, Columbia University Irving Medical Center, New York, NY, USA.
Qi ShenDepartment of Neurology, Columbia University Irving Medical Center, New York, NY, USA.
Satoshi EgawaDepartment of Neurology, Columbia University Irving Medical Center, New York, NY, USA.
Lizbeth CespedesNewYork-Presbyterian Hospital, New York, NY, USA.
Mariam YazdiNewYork-Presbyterian Hospital, New York, NY, USA.
Danielle BassDepartment of Neurology, University of Miami, Miami, FL, USA.
Ana Bolanos SaavedraDepartment of Neurology, University of Miami, Miami, FL, USA.
Daniel SamanoDepartment of Neurology, University of Miami, Miami, FL, USA.
Shivani GhoshalDepartment of Neurology, Columbia University Irving Medical Center, New York, NY, USA.
David RohDepartment of Neurology, Columbia University Irving Medical Center, New York, NY, USA.
Sachin AgarwalDepartment of Neurology, Columbia University Irving Medical Center, New York, NY, USA.
Soojin ParkDepartment of Neurology, Columbia University Irving Medical Center, New York, NY, USA.
Ayham AlkhachroumDepartment of Neurology, University of Miami, Miami, FL, USA.
Lydia DugdaleDepartment of Medicine, Columbia University Irving Medical Center, New York, NY, USA.
Jan ClaassenDepartment of Neurology, Columbia University Irving Medical Center, New York, NY, USA. jc1439@cumc.columbia.edu.ORCID 0000-0002-5893-8531

Funding

Clinical and Translational Science AwardUL1TR001873 · NCATS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI REILLY, MUREDACH P · 2016 to 2025
$99.0M
RECONFIG - REcovery of CONsciousness Following Intracerebral hemorrhaGeR01NS106014 · NINDS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI CLAASSEN, JAN · 2019 to 2023
$3.6M
BIGDATA: Causal Inference in Large-Scale Time Series with Rare and Latent EventsR01LM011826 · NLM · THE TRUSTEES OF THE STEVENS INSTITUTE OF TECHNOLOGY · PI KLEINBERG, SAMANTHA · 2013 to 2024
$3.3M
Clinical and Translational Science Awards UL1TR001873 from NCATS/NIHNCATS NIH HHS UL1 TR001873NINDS NIH HHS NS106014NINDS NIH HHS R01 NS106014NLM NIH HHS R01 LM011826U.S. National Library of Medicine LM011826
6 · The paper itself

Abstract

backgroundPrognostication of patients with acute disorders of consciousness is imprecise but more accurate technology-supported predictions, such as cognitive motor dissociation (CMD), are emerging. CMD refers to the detection of willful brain activation following motor commands using functional magnetic resonance imaging or machine learning-supported analysis of the electroencephalogram in clinically unresponsive patients. CMD is associated with long-term recovery, but acceptance by surrogates and health care professionals is uncertain. The objective of this study was to determine receptiveness for CMD to inform goals of care (GoC) decisions and research participation among health care professionals and surrogates of behaviorally unresponsive patients.

methodsThis was a two-center study of surrogates of and health care professionals caring for unconscious patients with severe neurological injury who were enrolled in two prospective US-based studies. Participants completed a 13-item survey to assess demographics, religiosity, minimal acceptable level of recovery, enthusiasm for research participation, and receptiveness for CMD to support GoC decisions.

resultsCompleted surveys were obtained from 196 participants (133 health care professionals and 63 surrogates). Across all respondents, 93% indicated that they would want their loved one or the patient they cared for to participate in a research study that supports recovery of consciousness if CMD were detected, compared to 58% if CMD were not detected. Health care professionals were more likely than surrogates to change GoC with a positive (78% vs. 59%, p = 0.005) or negative (83% vs. 59%, p = 0.0002) CMD result. Participants who reported religion was the most important part of their life were least likely to change GoC with or without CMD. Participants who identified as Black (odds ratio [OR] 0.12, 95% confidence interval [CI] 0.04-0.36) or Hispanic/Latino (OR 0.39, 95% CI 0.2-0.75) and those for whom religion was the most important part of their life (OR 0.18, 95% CI 0.05-0.64) were more likely to accept a lower minimum level of recovery.

conclusionsTechnology-supported prognostication and enthusiasm for clinical trial participation was supported across a diverse spectrum of health care professionals and surrogate decision-makers. Education for surrogates and health care professionals should accompany integration of technology-supported prognostication.

Indexed as

Attitude of Health PersonnelHealth PersonnelPersistent Vegetative StateAdultAgedElectroencephalographyFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedPrognosisProspective StudiesBrain computer interfaceComaDisorders of consciousnessEthics surveyLong-term recoveryOutcomesPerceptions of care

Identifiers

PMID39443437
PMCPMC13157124

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

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 Socratic graph.