Comparing neonatal morbidity and mortality estimates across specialty in periviable counseling

Objective: To describe and compare estimates of neonatal morbidity and mortality communicated by neonatologists and obstetricians in simulated periviable counseling encounters. Methods: A simulation-based study of 16 obstetricians (OBs) and 15 neonatologists counseling standardized patients portrayi...

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Bibliographic Details
Published in:The journal of maternal-fetal & neonatal medicine 2015-12, Vol.28 (18), p.2145-2149
Main Authors: Tucker Edmonds, Brownsyne, McKenzie, Fatima, Panoch, Janet E., Frankel, Richard M.
Format: Article
Language:English
Subjects:
Adult
Aged
Clinical Competence - statistics & numerical data
Counseling - methods
Counseling - standards
Doctor-patient communication
extreme prematurity
Female
Fetal Membranes, Premature Rupture
Fetal Viability
Humans
Indiana
Infant
Infant Mortality
Infant, Newborn
Infant, Newborn, Diseases - epidemiology
Infant, Newborn, Diseases - etiology
Male
Middle Aged
Neonatology
Obstetrics
Patient Simulation
periviability
Physician-Patient Relations
Practice Patterns, Physicians' - statistics & numerical data
Pregnancy
Prenatal Care - methods
Prenatal Care - standards
Risk Assessment
risk-communication
Truth Disclosure
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Summary:Objective: To describe and compare estimates of neonatal morbidity and mortality communicated by neonatologists and obstetricians in simulated periviable counseling encounters. Methods: A simulation-based study of 16 obstetricians (OBs) and 15 neonatologists counseling standardized patients portraying pregnant women with ruptured membranes at 23 weeks gestation. Two investigators tabulated all instances of numerically-described risk estimates across individuals and by specialty. Results: Overall, 12/15 (80%) neonatologists utilized numeric estimates of survival; 6/16 (38%) OBs did. OBs frequently deferred the discussion of "exact numbers" to neonatologists. The 12 neonatologists provided 13 unique numeric estimates, ranging from 3% to 50% survival. Half of those neonatologists provided two to three different estimates in a single encounter. By comparison, six OBs provided four unique survival estimates ("50%", "30-40%", "1/3-1/2", "
ISSN:1476-7058
1476-4954
DOI:10.3109/14767058.2014.981807