Do not attempt cardiopulmonary resuscitation (DNACPR) decisions in people admitted with suspected COVID-19: Secondary analysis of the PRIEST observational cohort study

  1. Laura Sutton
  2. Steve Goodacre
  3. Ben Thomas
  4. Sarah Connelly

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Abstract

No abstract available

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  1. Version published to 10.1016/j.resuscitation.2021.04.028
  2. Version published to 10.1101/2021.01.23.21249978v2 on medRxiv
  3. ScreenIT

    SciScore for 10.1101/2021.01.23.21249978: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: We did not seek consent to collect data but information about the study was provided in the ED and patients could withdraw their data at their request.
    IRB: Ethical approval: The North West - Haydock Research Ethics Committee (REC) gave a favourable opinion on the PAINTED study on 25 June 2012 (reference 12/NW/0303) and on the updated PRIEST study on 23rd March 2020.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Data were analysed using SAS v9.4.
    SAS
    suggested: (SASqPCR, RRID:SCR_003056)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This study was based on a large representative sample of adults admitted with suspected COVID-19, but has a number of limitations. DNAR decisions were recorded to facilitate subgroup analyses addressing the primary purpose of the study rather than addressing the aims of this secondary analysis. We were unable to include 1249/13997 (9%) cases because data were missing or uncertain regarding the use or timing for DNAR. Our categorisation on the basis of timing of DNAR decision and assumption that later DNAR decisions are qualitatively different to early decisions could be challenged. We did not collect any detailed data to allow us to explore the reasons behind DNAR decisions, so we are unable to offer explanations for the associations identified in our analysis. Our suggestion that the ReSPECT process could explain the use of invasive interventions in people with a DNAR decision is based on informal contacts and requires further research. The use of the ReSPECT process could also undermine our rationale for categorising DNAR decisions as early versus late or no decision, and suggests a complex relationship between DNAR decisions and subsequent interventions. In conclusion, we found that many patients with an early DNAR decision went on to receive life-saving interventions and most survived to 30 days. Early DNAR decisions were associated with older age, lower performance status, active malignancy, chronic lung disease and severe illness, as indicated by physiological parameter...

    Results from TrialIdentifier: We found the following clinical trial numbers in your paper:

    IdentifierStatusTitle
    ISRCTN28342533NANA

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  4. Version published to 10.1101/2021.01.23.21249978v1 on medRxiv