Comment on “Can Quantitative Pupillometry be used to Screen for Elevated Intracranial Pressure? A Retrospective Cohort Study”

In the current issue of Neurocritical Care, Pansell and colleagues [1] present findings from a cross-sectional study comparing the use of direct intracranial pressure (ICP) measurements with the use of the neurological pupil index (NPi), a quantitative measurement of the pupillary light reflex obtai...

Full description

Saved in:
Bibliographic Details
Published in:Neurocritical care 2022-10, Vol.37 (2), p.597-598
Main Authors: Maas, Matthew B., Naidech, Andrew M., Batra, Ayush, Chou, Sherry H.-Y., Bleck, Thomas P.
Format: Article
Language:English
Subjects:
Cohort analysis
Critical Care Medicine
Diagnostic tests
Intensive
Internal Medicine
Intracranial pressure
Letters to the Editor
Medicine
Medicine & Public Health
Neurology
Neurosurgery
Traumatic brain injury
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:In the current issue of Neurocritical Care, Pansell and colleagues [1] present findings from a cross-sectional study comparing the use of direct intracranial pressure (ICP) measurements with the use of the neurological pupil index (NPi), a quantitative measurement of the pupillary light reflex obtained by automated pupillometry. If one were to have walked into the room of a patient and flipped a fair coin instead of performing a pupillometry measurement, the negative predictive value of a coin toss test would be 93%—the overall rate of normal ICP in the study population. A diagnostic test that yields a 3.7% absolute improvement over a coin toss in differentiating elevated and normal ICP in the relevant population while producing manyfold false positive results for every true positive is not suitable for informing high-stake clinical decisions.
ISSN:1541-6933
1556-0961
DOI:10.1007/s12028-022-01549-5