Monday, March 5, 2018

How the public is misinformed about the outcomes of CPR

A survey of 1000 volunteer adults found 71% regularly watched medical television dramas, but only 12% said the shows “were a reliable source of health information.”

The participants were given some brief vignettes describing scenarios where CPR was administered—a 54-year-old who suffered a heart attack at home and received CPR by paramedics, an 80-year-old with a postoperative cardiac arrest in the hospital after surgery, and a post-traumatic arrest in an 8-year-old.

Those surveyed estimated CPR success rates at 57% to 72% and rates of long-term survival with neurologic recovery at 53% to 64%.

Depending on the circumstances surrounding the arrest and the baseline health status of the victim, rates of return of spontaneous circulation for CPR in cardiac arrest can be as high as 40% in one study. However according to the American Heart Association, long-term survival with intact neurologic function occurs in only about 8.3% of patients.

The survey was published ahead of print in the American Journal of Emergency Medicine. The authors noted that their survey results were similar to those of previous papers on this subject.

They pointed out that the public’s unrealistic expectations about CPR make it difficult for physicians to discuss end-of-life issues with patients and family. A previous paper found that about half of elderly patients changed their minds about requesting they be resuscitated after they found out what the true statistics were.

Not addressed in the paper, but nonetheless worth mentioning is the possibility that many of the survey’s participants did not want to admit or did not realize they considered TV dramas a reliable source of health information.

If you are on Twitter, you may be aware of a debate many of us physicians have been having with Amy Holden Jones (@aholdenj), the writer and producer of the medical TV drama “The Resident.” She claims she is exposing the dark side of medicine in the name of patient safety.

We say the glaring and sometimes laughable inaccuracies of the show create the very same unrealistic expectations the investigators found in their survey and what is worse, inflame the already rampant mistrust of doctors and medicine in general.

I would like to say that that the discussion with Ms. Jones has been productive, but I can’t. After a brief give-and-take, she has blocked every medical professional who criticized the show. The misinformation continues.

Redemption may be near. The show’s ratings are plummeting.

Click on chart to enlarge it.


artiger said...

The show's ratings are plummeting? Thank goodness.

I don't know about anyone else, but the population of patients that I deal with thinks a 10% chance is worth a shot for themselves, but not necessarily everyone else, especially when it's other people's money paying for it.

Rugger said...

I am not so sure these numbers of survival and neurologic impairment are really true in a hospital setting of CPR. At least, that is not my experience. I can definitely see it in the field though.

Skeptical Scalpel said...

Artiger, good point.

Rugger, as I said in the post, outcomes after CPR depend on the health of the patients and the circumstances of the arrest.

Lady Anne said...

As a medical hanger-on, I find those shows more a hindrance than a help in understanding "how things work". The same is true of productions such as CSI - on the show, DNA tests are instantaneous, and practically deliver a roadmap to the suspect's house.

Take 'em with a grain of salt. Or, as my German grandmother said, a dose of salts.

Skeptical Scalpel said...

Lady Anne, I agree. The unfortunate thing is many viewers think this show is exposing what's wrong with the system.

Someone on Twitter just tweeted this to me about "The Resident": "I feel showing patients a more accurate picture of what *really* happens (institutionally) when adverse events occur is valuable." I don't even know what to say to that. I tried to explain that the show doesn't depict what really happens. Then I gave up.

Anonymous said...

Survival rates vary depending on whether pt was in vfib/pulseless vtach vs asystole/PEA.

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