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DTSTAMP:20241017T183511Z
LOCATION:Harbor Ballrooms D-I
DTSTART;TZID=America/Los_Angeles:20241016T094500
DTEND;TZID=America/Los_Angeles:20241016T100500
UID:ncs_NCS 2024_sess117_ccrnt113@linklings.com
SUMMARY:Mitigating Self-Fulfilling Prophecies in Neurocritical Care Resear
 ch
DESCRIPTION:Breakout Session\n\nJonathan Elmer (University of Pittsburgh)\
 n\nThe goal of much clinical research (both trials and observational) is t
 o estimate the relationship between one or more clinical characteristics o
 r intervention with patients' outcomes.  Unfortunately, we make these esti
 mates from data contaminated by myriad treatment decisions.  In randomized
  trials, these include post-randomization interventions that by definition
  cannot be balanced by us of prior randomization as an instrument. Risks o
 f bias are even greater in observational studies.  Traditional methods to 
 make unbiased causal estimates (e.g., causal inference methods or randomiz
 ation) cannot be used when an intervention is deterministic of outcome (e.
 g., withdrawal of life-sustaining therapies (WLST)).  This creates a ubiqu
 itous risk of self-fulfilling prophecies to which our neurocritically ill 
 patients are uniquely vulnerable.\n\nSupported by NINDS, we will present i
 nterim results from an R01 (R01NS124642) that aims to innovate novel metho
 ds that mitigate the risk of self-fulfilling prophecies by incorporating e
 xpert knowledge into prediction models.  We reviewed >1,400 cases from com
 atose patients resuscitated from cardiac arrest who died after WLST with a
  pool of 35 international experts (3-5 experts per case, ~1,500 total expe
 rt-hours). Together with analytical colleagues, we developed multiple intu
 itive statistical approaches to infuse this expert knowledge into predicti
 ve models.  We believe our work and results are of interest and broadly re
 levant to neurocritical care researchers and NCS conference-goers.\n\nTrac
 k: Science of Neurocritical Care\n\nFocus Area: Basic/Neurocritical Care 1
 01, General Critical Care, Intracerebral Hemorrhage, Multimodal Neuromonit
 oring (invasive/non-invasive), Nursing Pharmacology, Pharmacist Practice, 
 Stroke, Subarachnoid Hemorrhage, Traumatic Brain Injury\n\nTarget Audience
 : Intermediate\n\nSession Chair: Sherif Mahmoud (University of Alberta, Sc
 hool of Public Health)
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