Doctors and nurses subjective predictions of 6-month outcome compared to actual 6-month outcome for adult patients with spontaneous intracerebral haemorrhage (ICH) in neurocritical care: An observational study.

Journal article


McLernon, S., Frings, D., Terry, L., Simister, R., Browning, S., Burgess, H., Chua, J., Reddy, U. and Werring, D.J. (2023). Doctors and nurses subjective predictions of 6-month outcome compared to actual 6-month outcome for adult patients with spontaneous intracerebral haemorrhage (ICH) in neurocritical care: An observational study. eNeurologicalSci. 34, p. 100491. https://doi.org/10.1016/j.ensci.2023.100491
AuthorsMcLernon, S., Frings, D., Terry, L., Simister, R., Browning, S., Burgess, H., Chua, J., Reddy, U. and Werring, D.J.
AbstractAcute spontaneous intracerebral haemorrhage is a devastating form of stroke. Prognostication after ICH may be influenced by clinicians' subjective opinions. To evaluate subjective predictions of 6-month outcome by clinicians' for ICH patients in a neurocritical care using the modified Rankin Scale (mRS) and compare these to actual 6-month outcome. We included clinicians' predictions of 6-month outcome in the first 48 h for 52 adults with ICH and compared to actual 6-month outcome using descriptive statistics and multilevel binomial logistic regression. 35/52 patients (66%) had a poor 6-month outcome (mRS 4-6); 19/52 (36%) had died. 324 predictions were included. For good (mRS 0-3) versus poor (mRS 4-6), outcome, accuracy of predictions was 68% and exact agreement 29%. mRS 6 and mRS 4 received the most correct predictions. Comparing job roles, predictions of death were underestimated, by doctors (12%) and nurses (13%) compared with actual mortality (36%). Predictions of vital status showed no significant difference between doctors and nurses: OR = 1.24 {CI; 0.50-3.05}; (  = 0.64) or good versus poor outcome: OR = 1.65 {CI; 0.98-2.79}; (  = 0.06). When predicted and actual 6-month outcome were compared, job role did not significantly relate to correct predictions of good versus poor outcome: OR = 1.13 {CI;0.67-1.90}; (  = 0.65) or for vital status: OR = 1.11 {CI; 0.47-2.61};  = 0.81). Early prognostication is challenging. Doctors and nurses were most likely to correctly predict poor outcome but tended to err on the side of optimism for mortality, suggesting an absence of clinical nihilism in relation to ICH. [Abstract copyright: © 2024 The Authors. Published by Elsevier B.V.]
KeywordsNeurocritical care predictions; Modified Rankin Scale (mRS); Outcome; Spontaneous intracerebral haemorrhage; Prognostication
Year2023
JournaleNeurologicalSci
Journal citation34, p. 100491
PublisherElsevier
ISSN2405-6502
Digital Object Identifier (DOI)https://doi.org/10.1016/j.ensci.2023.100491
https://doi.org/S2405-6502(23)00049-7
Publication dates
Online22 Dec 2023
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Accepted18 Dec 2023
Deposited08 Feb 2024
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Almalkawi, I, Jester, R and Terry, LM (2018). Exploring mentors’ interpretation of terminology and levels of competence when assessing nursing students: an integrative review. Nurse Education Today. 69, pp. 95-103. https://doi.org/10.1016/j.nedt.2018.07.003
Messages matter: The Tobacco Products Directive nicotine addiction health warning versus an alternative relative risk message on smokers' willingness to use and purchase an electronic cigarette
Cox, S, Frings, D., Ahmed, R and Dawkins, L. (2018). Messages matter: The Tobacco Products Directive nicotine addiction health warning versus an alternative relative risk message on smokers' willingness to use and purchase an electronic cigarette. Addictive Behaviors Reports. 8, pp. 136-139. https://doi.org/10.1016/j.abrep.2018.09.006
Nurses as role models in health promotion: piloting the acceptability of a social marketing campaign.
Wills, J, Kelly, M and Frings, D (2018). Nurses as role models in health promotion: piloting the acceptability of a social marketing campaign. Journal of Advanced Nursing. 75 (2), pp. 423-431. https://doi.org/10.1111/jan.13874
Patients’ and healthcare professionals’ experiences and perceptions of physiotherapy services in the emergency department: A qualitative systematic review
Barrett, R and Terry, L (2018). Patients’ and healthcare professionals’ experiences and perceptions of physiotherapy services in the emergency department: A qualitative systematic review. International Journal of Emergency Medicine. 11 (1). https://doi.org/10.1186/s12245-018-0201-z
The effects of the European E-cigarette health warning and comparative health messages on non-smokers' and smokers' risk perceptions and behavioural intentions: study protocol
Kimber, C, Frings, D, Cox, S, Albery, I and Dawkins, L (2018). The effects of the European E-cigarette health warning and comparative health messages on non-smokers' and smokers' risk perceptions and behavioural intentions: study protocol. BMC Public Health. 18 (1259). https://doi.org/10.1186/s12889-018-6161-7
Helping you helps me: Giving and receiving social support in recovery groups for problem gamblers
Hutchison, P, Cox, S and Frings, DJ (2018). Helping you helps me: Giving and receiving social support in recovery groups for problem gamblers. Group Dynamics: Theory, Research, and Practice. 22 (4), pp. 187-199. https://doi.org/10.1037/gdn0000090
Online and face-to-face extended brief interventions for harmful alcohol use: client characteristics, attendance and treatment outcomes
Frings, Daniel, Hogan, Cassandra J., Jn-Pierre, Kerlin H., Wood, K., Holmes, Mark and Albery, Ian P. (2018). Online and face-to-face extended brief interventions for harmful alcohol use: client characteristics, attendance and treatment outcomes. Counselling Psychology Quarterly. 33 (3), pp. 415-426. https://doi.org/10.1080/09515070.2018.1555516
Supporting people with learning disabilities to make and maintain intimate relationships
Bates, C, Terry, LM and Popple, K (2017). Supporting people with learning disabilities to make and maintain intimate relationships. Tizard Learning Disability Review. 22 (1), pp. 16-23. https://doi.org/10.1108/TLDR-03-2016-0009
A moral profession: Nurse educators’ selected narratives of care and compassion
Newham, R, Terry, LM, Atherley, S, Hahessy, S, Babenko-Mould, Y, Evans, M, Ferguson, K, Carr, G and Cedar, SH (2017). A moral profession: Nurse educators’ selected narratives of care and compassion. Nursing Ethics. 26 (1), pp. 105-115. https://doi.org/10.1177/0969733016687163
An adaptable Discourse Analysis instrument and method to explore Caring and Compassion
Terry, LM and Newham, R (2017). An adaptable Discourse Analysis instrument and method to explore Caring and Compassion. Nurse Researcher. 24 (2), pp. 8-12. https://doi.org/10.7748/nr.2017.e1451
Exploring senior nurses' understanding of compassionate leadership in the community
Ali, S. and Terry, L.M. (2017). Exploring senior nurses' understanding of compassionate leadership in the community. British Journal of Community Nursing. 22 (2). https://doi.org/10.12968/bjcn.2017.22.2.77
The whys and the hows of psychosocial approaches to addiction
Frings, D, Albery, IP and Monk, RL (2017). The whys and the hows of psychosocial approaches to addiction. Journal of Applied Social Psychology. 47 (3), pp. 115-117. https://doi.org/10.1111/jasp.12440
A longitudinal, mixed methods investigation of newly qualified nurses’ workplace stressors and stress experiences during transition
Halpin, Y, Terry, LM and Curzio, J (2017). A longitudinal, mixed methods investigation of newly qualified nurses’ workplace stressors and stress experiences during transition. Journal of Advanced Nursing. 73 (11), pp. 2577-2586. https://doi.org/10.1111/jan.13344
The Effect of E-Cigarette Advertisements and Anti-Smoking Messages on Explicit and Implicit Attitudes towards Tobacco and E-Cigarette Smoking in 18-65 Year Olds: A Randomised Controlled Study Protocol
Booth, P, Albery, IP and Frings, D (2017). The Effect of E-Cigarette Advertisements and Anti-Smoking Messages on Explicit and Implicit Attitudes towards Tobacco and E-Cigarette Smoking in 18-65 Year Olds: A Randomised Controlled Study Protocol. BMJ Open. https://doi.org/10.1136/bmjopen-2016-014361
Understanding and applying the precautionary principle
Terry, LM (2017). Understanding and applying the precautionary principle. Family Law. 47 (11), pp. 1210-1215.
A research-based mantra for compassionate caring
Terry, LM, Newham, R, Hahessy, S, Atherley, S, Babenko-Mould, Y, Evans, M, Ferguson, K, Carr, G and Cedar, SH (2017). A research-based mantra for compassionate caring. Nurse Education Today. 58, pp. 1-11. https://doi.org/10.1016/j.nedt.2017.07.012
The iNEAR programme: an existential positive psychology intervention for resilience and emotional wellbeing
Tunariu, A, Tribe, R, Frings, D and Albery, IP (2017). The iNEAR programme: an existential positive psychology intervention for resilience and emotional wellbeing. International Review of Psychiatry. 29 (4), pp. 362-372. https://doi.org/10.1080/09540261.2017.1343531
Environmental context influences visual attention to responsible drinking messages
Frings, D, Moss, AC, Albery, IP, Eskisan, G, Wilcockson, TDW and Marchant, A (2017). Environmental context influences visual attention to responsible drinking messages. Alcohol and Alcoholism. https://doi.org/10.1093/alcalc/agx076
Understanding and meeting your legal responsibilities as a nurse
Terry, LM, Carr, G and Halpin, Y (2017). Understanding and meeting your legal responsibilities as a nurse. Nursing Standard. https://doi.org/10.7748/ns.2017.e11015
Study protocol for a randomised controlled trial of Allen Carr’s Easyway programme versus Lambeth and Southwark NHS service for smoking cessation.
Wood, KV, Albery, IP, Moss, AC, White, S and Frings, D (2017). Study protocol for a randomised controlled trial of Allen Carr’s Easyway programme versus Lambeth and Southwark NHS service for smoking cessation. BMJ Open. 7 (12), p. e016867. https://doi.org/10.1136/bmjopen-2017-016867
Partner Selection for People with Intellectual Disabilities.
Bates, C, Terry, LM and Popple, K (2016). Partner Selection for People with Intellectual Disabilities. Journal of Applied Research in Intellectual Disabilities. 30 (4), pp. 602-611. https://doi.org/10.1111/jar.12254
Implicit and explicit drinker identities interactively predict in-the-moment alcohol placebo consumption
Frings, D, Melichar, L and Albery, IP (2016). Implicit and explicit drinker identities interactively predict in-the-moment alcohol placebo consumption. Addictive Behaviors Reports. 3, pp. 86-91. https://doi.org/10.1016/j.abrep.2016.04.002
A test of the Social Identity Model of Cessation Maintenance: The content and role of social control
Frings, D, Collins, M, Long, G, Pinto, IR and Albery, IP (2016). A test of the Social Identity Model of Cessation Maintenance: The content and role of social control. Addictive Behaviors Reports. 3, pp. 77-85. https://doi.org/10.1016/j.abrep.2016.02.003
Modeling the contribution of personality, social identity and social norms to problematic Facebook use in adolescents.
Marino, C, Vieno, A, Pastore, M, Albery, IP, Frings, D and Spada, MM (2016). Modeling the contribution of personality, social identity and social norms to problematic Facebook use in adolescents. Addictive Behaviors. 63 (Dec), pp. 51 - 56. https://doi.org/10.1016/j.addbeh.2016.07.001
Expert nurses' perceptions of the relevance of Carper's patterns of knowing to junior nurses.
Terry, LM, Carr, G and Curzio, J (2016). Expert nurses' perceptions of the relevance of Carper's patterns of knowing to junior nurses. Advances in Nursing Science. 40 (1), pp. 85-102. https://doi.org/10.1097/ANS.0000000000000142
Examining the relationship between selective attentional bias for food- and body-related stimuli and purging behaviour in bulimia nervosa
Albery, IP, Wilcockson, TDW, Frings, D, Moss, AC, Caselli, G and Spada, MM (2016). Examining the relationship between selective attentional bias for food- and body-related stimuli and purging behaviour in bulimia nervosa. Appetite. 107 (Dec), pp. 208 - 212. https://doi.org/10.1016/j.appet.2016.08.006
Exploring the Relationship between Sexual Compulsivity and Attentional Bias to Sex-Related Words in a Cohort of Sexually Active Individuals.
Albery, IP, Lowry, J, Frings, D, Johnson, HL, Hogan, C and Moss, AC (2016). Exploring the Relationship between Sexual Compulsivity and Attentional Bias to Sex-Related Words in a Cohort of Sexually Active Individuals. European Addiction Research. 23 (1), pp. 1 - 6. https://doi.org/10.1159/000448732
Impact of alcohol promoting and alcohol warning advertisements on alcohol consumption, affect, and implicit cognition in heavy drinking young adults: a laboratory-based randomized controlled trial
Stautz, K, Albery, IP, Frings, D, Moss, AC and Marteau, T (2016). Impact of alcohol promoting and alcohol warning advertisements on alcohol consumption, affect, and implicit cognition in heavy drinking young adults: a laboratory-based randomized controlled trial. British Journal of Health Psychology. 22 (1), pp. 128-150. https://doi.org/10.1111/bjhp.12221
Dyads experience over confidence in hand-eye coordination skills after placebo alcohol
Frings, D, Albery, IP, Rolph, K, Leczfalvy, A, Smaczny, S and Moss, AC (2016). Dyads experience over confidence in hand-eye coordination skills after placebo alcohol. Journal of Applied Social Psychology. 3 (47), pp. 148-157. https://doi.org/10.1111/jasp.12418
Crime Victims’ Demographics Inconsistently Relate to Self-Reported Vulnerability
Aihio, N, Frings, D, Wilcock, R and Burrell, P (2016). Crime Victims’ Demographics Inconsistently Relate to Self-Reported Vulnerability. Psychiatry, Psychology and Law. 24 (3), pp. 379-391. https://doi.org/10.1080/13218719.2016.1247418
The Importance of Romantic Love to People with Learning Disabilities
Bates, C, Terry, LM and Popple, K (2016). The Importance of Romantic Love to People with Learning Disabilities. British Journal of Learning Disabilities. 45 (1), pp. 64-72. https://doi.org/10.1111/bld.12177
Testing a frequency of exposure hypothesis in attentional bias for alcohol-related stimuli amongst social drinkers
Albery, I., Sharma, D., Noyce, S., Frings, D. and Moss, A. (2015). Testing a frequency of exposure hypothesis in attentional bias for alcohol-related stimuli amongst social drinkers. Addictive Behaviors Reports. 1, pp. 68-72. https://doi.org/10.1016/j.abrep.2015.05.001
The effects of responsible drinking messages on attentional allocation and drinking behaviour.
Moss, AC, Albery, IP, Dyer, KR, Frings, D, Humphreys, K, Inkelaar, T, Harding, E and Speller, A (2015). The effects of responsible drinking messages on attentional allocation and drinking behaviour. Addictive Behaviors. 44, pp. 94 - 101. https://doi.org/10.1016/j.addbeh.2014.11.035
The role of group membership continuity and multiple memberships on mental well-being amongst post-operative stoma patients
Bule, B and Frings, D (2015). The role of group membership continuity and multiple memberships on mental well-being amongst post-operative stoma patients. Psychooncology. 25 (6), pp. 726 - 728. https://doi.org/10.1002/pon.4006