Epidemiology and prognosis of coma in daytime television dramas

BMJ 2005; 331 doi: http://dx.doi.org/10.1136/bmj.331.7531.1537 (Published 22 December 2005)
Cite this as: BMJ 2005;331:1537

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  1. David Casarett, assistant professor (casarett{at}mail.med.upenn.edu)1,
  2. Jessica M Fishman, faculty fellow2,
  3. Holly Jo MacMoran, research coordinator3,
  4. Amy Pickard, research coordinator3,
  5. David A Asch, professor1
  1. 1Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, 9 East, 3900 Woodland Avenue, Philadelphia, PA 19104-4155, USA
  2. 2Center for Clinical Epidemiology and Biostatistics, 113 Blockley Hall, 423 Guardian Drive, University of Pennsylvania, Philadelphia, PA 19104-6021
  3. 3Division of Geriatric Medicine, University of Pennsylvania, 3615 Chestnut Street, Suite 312, Philadelphia, PA 19104
  1. Correspondence to: D Casarett
  • Accepted 8 November 2005

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.

Footnotes

  • Contributors DC, JMF, HJMacM, AP, and DAA all contributed to the design of this research, the analysis and interpretation of the data, and the drafting and revising of the article. All have provided final approval. James Tulsky contributed comments on a previous version of this manuscript. DC is the guarantor.

  • Funding DC is the recipient of an advanced research career development award from the Department of Veterans Affairs, and a Paul Beeson Physician Faculty scholars award.

  • Competing interests None declared.

  • Ethical approval Not needed.

  • Accepted 8 November 2005

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