{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T13:33:10Z","timestamp":1783344790277,"version":"3.54.6"},"reference-count":42,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2022YFC3601200"],"award-info":[{"award-number":["2022YFC3601200"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Neurol Disord"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec><jats:title>Background:<\/jats:title><jats:p> The diagnosis of and life-sustaining treatment (LST) for patients with disorders of consciousness (DoC) and locked-in syndrome (LIS) have been the subject of intense debate. <\/jats:p><\/jats:sec><jats:sec><jats:title>Objective:<\/jats:title><jats:p> We aim to investigate the application of diagnostic knowledge, opinions about the administration of LST, and ethical challenges related to DoC and LIS. <\/jats:p><\/jats:sec><jats:sec><jats:title>Design:<\/jats:title><jats:p> A cross-sectional study. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p> A survey was conducted among Chinese neurologists. Questionnaires included three vignettes (unresponsive wakefulness syndrome (UWS); minimally conscious state (MCS), and LIS). They were randomly distributed among neurologists from August 2018 to December 2019. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> A sample of 360 questionnaires was included (response rate: 78%). Overall, 63% of the participants chose the correct diagnostic category. The neurologists who received the MCS case chose the category more accurately than the neurologists with the UWS ( p\u2009&lt;\u20090.001) and LIS case ( p\u2009=\u20090.002). Most neurologists preferred never to limit LST for their patients (47%, 63%, and 67% in UWS, MCS, and LIS groups, p\u2009=\u20090.052). A large group of neurologists believed UWS patients could feel pain (73%), with no difference from MCS and LIS patients ( p\u2009&gt;\u20090.05). Deciding for patients in the absence of surrogates was rated extremely challenging. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion:<\/jats:title><jats:p> A large proportion of Chinese neurologists in our study didn\u2019t apply the accurate diagnostic categories to the description of DoC and LIS patients. This calls for more education and training. Most Chinese neurologists were reluctant to limit LST for patients. This may indicate that there may be a need to emphasize the allocation of more resources toward long-term care in China. <\/jats:p><\/jats:sec>","DOI":"10.1177\/17562864241283328","type":"journal-article","created":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T01:17:17Z","timestamp":1728523037000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical and ethical challenges in decision-making for patients with disorders of consciousness and locked-in syndrome from Chinese neurologists\u2019 perspectives"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7616-5875","authenticated-orcid":false,"given":"Meiqi","family":"Li","sequence":"first","affiliation":[{"name":"International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China"},{"name":"Intensive Care Unit, Hangzhou First People\u2019s Hospital, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifan","family":"Yan","sequence":"additional","affiliation":[{"name":"International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China"},{"name":"School of Public Health, Zhejiang University, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katja","family":"Kuehlmeyer","sequence":"additional","affiliation":[{"name":"Institute of Ethics, History and Theory of Medicine, LMU Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5496-9920","authenticated-orcid":false,"given":"Wangshan","family":"Huang","sequence":"additional","affiliation":[{"name":"International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Laureys","sequence":"additional","affiliation":[{"name":"Coma Science Group, GIGA-Consciousness, University of Li\u00e8ge, Li\u00e8ge, Belgium"},{"name":"Centre du Cerveau2, University Hospital of Li\u00e8ge, Li\u00e8ge, Belgium"},{"name":"Joint International Research Unit on Consciousness, CERVO Brain Research Centre, Laval University, Qu\u00e9bec, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haibo","family":"Di","sequence":"additional","affiliation":[{"name":"International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China"},{"name":"School of Basic Medicine, Hangzhou Normal University, Hangzhou 311121, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,10,9]]},"reference":[{"key":"bibr1-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.med.60.060107.091250"},{"key":"bibr2-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-8-68"},{"key":"bibr3-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.58.3.349"},{"key":"bibr4-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(95)80031-X"},{"key":"bibr5-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1007\/s12264-018-0263-1"},{"key":"bibr6-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-020-01924-9"},{"key":"bibr7-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-9-35"},{"key":"bibr8-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1093\/jmp\/jhq046"},{"key":"bibr9-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-010-2124-x"},{"key":"bibr10-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awae060"},{"key":"bibr11-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)32136-1"},{"key":"bibr12-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1097\/HTR.0000000000000058"},{"key":"bibr13-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-010-5882-z"},{"key":"bibr14-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1007\/s12152-011-9149-x"},{"key":"bibr15-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-011-2132-5"},{"key":"bibr16-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)02030-2"},{"key":"bibr17-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-012-6459-9"},{"key":"bibr18-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(14)70030-4"},{"key":"bibr19-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003138"},{"key":"bibr20-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-14-119"},{"key":"bibr21-17562864241283328","unstructured":"World Health Organization (WHO). Process of translation and adaptation of instruments. http:\/\/www.who.int\/substance_abuse\/research_tools\/translation\/en\/. (accessed 14 November 2011)."},{"key":"bibr22-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(20)30182-4"},{"key":"bibr23-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-023-07072-1"},{"key":"bibr24-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2021.0199"},{"key":"bibr25-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(14)70152-8"},{"key":"bibr26-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1080\/02699052.2019.1566832"},{"key":"bibr27-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2004.02.033"},{"key":"bibr28-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1016\/j.rehab.2020.09.001"},{"key":"bibr29-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1016\/j.rehab.2023.101764"},{"key":"bibr30-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1097\/CM9.0000000000000806"},{"key":"bibr31-17562864241283328","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2019.01184"},{"key":"bibr32-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000207067"},{"key":"bibr33-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-018-8849-0"},{"key":"bibr34-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-012-6821-y"},{"key":"bibr35-17562864241283328","volume":"7","author":"Schnakers C","year":"2015","journal-title":"Pm&R"},{"key":"bibr36-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-510X(03)00106-0"},{"key":"bibr37-17562864241283328","doi-asserted-by":"publisher","DOI":"10.3109\/02699052.2013.775507"},{"key":"bibr38-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000002367"},{"key":"bibr39-17562864241283328","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics12030769"},{"key":"bibr40-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1016\/j.rehab.2019.09.011"},{"key":"bibr41-17562864241283328","unstructured":"Shenzhen special economic zone medical regulations, http:\/\/www.szrd.gov.cn\/rdlv\/chwgg\/content\/post_826158.html. (2022, accessed 5 July 2022)."},{"key":"bibr42-17562864241283328","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-016-4347-y"}],"container-title":["Therapeutic Advances in Neurological Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17562864241283328","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17562864241283328","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17562864241283328","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T19:25:13Z","timestamp":1741116313000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17562864241283328"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":42,"alternative-id":["10.1177\/17562864241283328"],"URL":"https:\/\/doi.org\/10.1177\/17562864241283328","relation":{},"ISSN":["1756-2864","1756-2864"],"issn-type":[{"value":"1756-2864","type":"print"},{"value":"1756-2864","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]},"article-number":"17562864241283328"}}