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Text
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<a href="http://doi.org/10.1136/jme.2002.001537" target="_blank" rel="noreferrer">http://doi.org/10.1136/jme.2002.001537</a>
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Title
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Certainty and mortality prediction in critically ill children.
Publisher
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Journal Of Medical Ethics
Date
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2004
Subject
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Child; Humans; Intensive Care Units; Medical Staff; Hospital Mortality; Prognosis; Prospective Studies; Clinical Competence; Longitudinal Studies; Risk Assessment; Pediatric; Empirical Approach; Professional Patient Relationship; Death and Euthanasia; Hospital; Health Care and Public Health; Critical Illness/mortality
Creator
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Marcin JP; Pretzlaff RK; Pollack MM; Patel KM; Ruttimann UE
Description
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OBJECTIVES: The objective of this study is to investigate the relationship between a physician's subjective mortality prediction and the level of confidence with which that mortality prediction is made. DESIGN AND PARTICIPANTS: The study is a prospective cohort of patients less than 18 years of age admitted to a tertiary Paediatric Intensive Care Unit (ICU) at a University Children's Hospital with a minimum length of ICU stay of 10 h. Paediatric ICU attending physicians and fellows provided mortality risk predictions and the level of confidence associated with these predictions on consecutive patients at the time of multidisciplinary rounds within 24 hours of admission to the paediatric ICU. Median confidence levels were compared across different ranges of mortality risk predictions. RESULTS: Data were collected on 642 of 713 eligible patients (36 deaths, 5.6%). Mortality predictions greater than 5% and less than 95% were made with significantly less confidence than those predictions 95%. Experience was associated with greater confidence in prognostication. CONCLUSIONS: We conclude that a physician's subjective mortality prediction may be dependent on the level of confidence in the prognosis; that is, a physician less confident in his or her prognosis is more likely to state an intermediate survival prediction. Measuring the level of confidence associated with mortality risk predictions (or any prognostic assessment) may therefore be important because different levels of confidence may translate into differences in a physician's therapeutic plans and their assessment of the patient's future.
2004
Identifier
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<a href="http://doi.org/10.1136/jme.2002.001537" target="_blank" rel="noreferrer">10.1136/jme.2002.001537</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
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Journal Article
2004
Backlog
Child
Clinical Competence
Critical Illness/mortality
Death and Euthanasia
Empirical Approach
Health Care and Public Health
Hospital
Hospital Mortality
Humans
Intensive Care Units
Journal Article
Journal of Medical Ethics
Longitudinal Studies
Marcin JP
Medical Staff
Patel KM
Pediatric
Pollack MM
Pretzlaff RK
Professional Patient Relationship
Prognosis
Prospective Studies
Risk Assessment
Ruttimann UE