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Conundrums in neurology: diagnosing serotonin syndrome – a meta-analysis of cases

Overview of attention for article published in BMC Neurology, July 2016
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (88th percentile)
  • High Attention Score compared to outputs of the same age and source (87th percentile)

Mentioned by

news
1 news outlet
twitter
4 tweeters
wikipedia
1 Wikipedia page
reddit
1 Redditor

Citations

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60 Dimensions

Readers on

mendeley
121 Mendeley
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Title
Conundrums in neurology: diagnosing serotonin syndrome – a meta-analysis of cases
Published in
BMC Neurology, July 2016
DOI 10.1186/s12883-016-0616-1
Pubmed ID
Authors

Ursula Werneke, Fariba Jamshidi, David M. Taylor, Michael Ott

Abstract

Serotonin syndrome is a toxic state, caused by serotonin (5HT) excess in the central nervous system. Serotonin syndrome's main feature is neuro-muscular hyperexcitability, which in many cases is mild but in some cases can become life-threatening. The diagnosis of serotonin syndrome remains challenging since it can only be made on clinical grounds. Three diagnostic criteria systems, Sternbach, Radomski and Hunter classifications, are available. Here we test the validity of four assumptions that have become widely accepted: (1) The Hunter classification performs clinically better than the Sternbach and Radomski criteria; (2) in contrast to neuroleptic malignant syndrome, the onset of serotonin syndrome is usually rapid; (3) hyperthermia is a hallmark of severe serotonin syndrome; and (4) serotonin syndrome can readily be distinguished from neuroleptic malignant syndrome on clinical grounds and on the basis of medication history. Systematic review and meta-analysis of all cases of serotonin syndrome and toxicity published between 2004 and 2014, using PubMed and Web of Science. Two of the four assumptions (1 and 2) are based on only one published study each and have not been independently validated. There is little agreement between current criteria systems for the diagnosis of serotonin syndrome. Although frequently thought to be the gold standard for the diagnosis of the serotonin syndrome, the Hunter criteria did not perform better than the Sternbach and Radomski criteria. Not all cases seem to be of rapid onset and only relatively few cases may present with hyperthermia. The 0 differential diagnosis between serotonin syndrome and neuroleptic malignant syndrome is not always clear-cut. Our findings challenge four commonly made assumptions about serotonin syndrome. We propose our meta-analysis of cases (MAC) method as a new way to systematically pool and interpret anecdotal but important clinical information concerning uncommon or emergent phenomena that cannot be captured in any other way but through case reports.

Twitter Demographics

The data shown below were collected from the profiles of 4 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 121 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Japan 1 <1%
Unknown 120 99%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 18 15%
Student > Master 17 14%
Student > Postgraduate 13 11%
Other 11 9%
Researcher 8 7%
Other 24 20%
Unknown 30 25%
Readers by discipline Count As %
Medicine and Dentistry 47 39%
Pharmacology, Toxicology and Pharmaceutical Science 15 12%
Unspecified 7 6%
Psychology 6 5%
Neuroscience 4 3%
Other 9 7%
Unknown 33 27%

Attention Score in Context

This research output has an Altmetric Attention Score of 15. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 February 2022.
All research outputs
#2,083,618
of 22,880,691 outputs
Outputs from BMC Neurology
#194
of 2,440 outputs
Outputs of similar age
#39,924
of 354,435 outputs
Outputs of similar age from BMC Neurology
#7
of 57 outputs
Altmetric has tracked 22,880,691 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 90th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,440 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.7. This one has done particularly well, scoring higher than 92% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 354,435 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 88% of its contemporaries.
We're also able to compare this research output to 57 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 87% of its contemporaries.