Our mission is to improve clinical outcomes by finding and delivering medical evidence to anyone wanting to make an informed medical decision. We do this by making medical evidence more accessible, relevant and readable (in the context of existing data) for both consumers and professionals.

Doctor Evidence translates and delivers medical data from clinical studies into “distributive databases.” Physicians, payers, policy makers, researchers, patients and others use this database of evidence to make informed healthcare decisions. Doctor Evidence applies extreme rigor in translating clinical evidence from published studies into a database format that enables clinicians to:

• View clinical studies in a more specific, dynamic fashion
• Compare outcomes against standard-of-care, usual practice or a competitive product
• Generate an industry compliant meta-analysis of evidence
• Connect clinical evidence to individual patient profiles

Brain monitoring and assessing depth of anesthesia

Brain monitoring devices (also called brain function monitors, consciousness monitors or depth of anesthesia monitors) provide anesthesia professionals a method to assess patient responses during surgery. These devices have become quite prevalent in the United States – nearly 60% of operating rooms now have a brain monitor available for use. During procedures performed under general anesthesia, anesthesiologists and nurse anesthetists frequently use these devices in addition to observation of clinical signs and conventional monitoring of vital signs provide. According to recent surveys, about 45% of anesthesia professionals use these monitors during the care of some of their patients.

The American Society of Anesthesiologists has produced a practice document to provide guidance on the use of brain monitor devices to prevent a rare complication of anesthesia – intraoperative awareness. However, brain monitoring devices have a much greater extent of patient benefit than just avoiding awareness. To this end, Doctor Evidence searched, extracted and created a database to display the available data of patient outcomes when anesthesia care is guided by the use of a brain monitor compared to standard practice.

The ASA Practice Advisory discussed 7 different brain monitoring devices. This Doctor Evidence Brain Monitoring database searched for the available clinically significant evidence (as of 12/2008) on the same seven brain monitoring technologies:

• AEP Monitor™ (Danmeter)
• BIS™ Monitors/Modules (Aspect Medical Systems)
• Cerebral State Monitor™ (Danmeter)
• Narcotrend™ Monitor(Schiller)
• Patient State Monitor (Hospira)
• SNAP™ Monitor (Stryker)
• Entropy Modules (GE Healthcare)

The ASA Practice Advisory states: “It is the consensus of the Task Force that the decision to use a brain function monitor should be made on a case-by-case basis by the individual practioner of selected patients (e.g, light anesthesia).” The following database of the clinical evidence regarding brain monitors and their efficacy will allow anesthesia professionals to make an informed medical decision powered by evidence.

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