BMJ  2005;331:1537-1539 (24 December), doi:10.1136/bmj.331.7531.1537

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Epidemiology and prognosis of coma in daytime television dramas

¹ Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, 9 East, 3900 Woodland Avenue, Philadelphia, PA 19104-4155, USA, ² Center for Clinical Epidemiology and Biostatistics, 113 Blockley Hall, 423 Guardian Drive, University of Pennsylvania, Philadelphia, PA 19104-6021, ³ Division of Geriatric Medicine, University of Pennsylvania, 3615 Chestnut Street, Suite 312, Philadelphia, PA 19104

Abstract

Objective To determine how soap operas portray, and possibly misrepresent, the likelihood of recovery for patients in coma.

Design Retrospective cohort study.

Setting Nine soap operas in the United States reviewed between 1 January 1995 and 15 May 2005.

Subjects 64 characters who experienced a period of unconsciousness lasting at least 24 hours. Their final status at the end of the follow-up period was compared with pooled data from a meta-analysis.

Results Comas lasted a median of 13 days (interquartile range 7-25 days). Fifty seven (89%) patients recovered fully, five (8%) died, and two (3%) remained in a vegetative state. Mortality for non-traumatic and traumatic coma was significantly lower than would be predicted from the meta-analysis data (non-traumatic 4% v 53%; traumatic 6% v 67%; Fisher's exact test both P < 0.001). On the day that patients regained consciousness, most (49/57; 86%) had no evidence of limited function, cognitive deficit, or residual disability needing rehabilitation. Compared with meta-analysis data, patients in this sample had a much better than expected chance of returning to normal function (non-traumatic 91% v 1%; traumatic 89% v 7%; both P < 0.001).

Conclusions The portrayal of coma in soap operas is overly optimistic. Although these programmes are presented as fiction, they may contribute to unrealistic expectations of recovery.

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