An Evidence Map of Pupillary Assessment in a Preselected Acute-Care Literature Archive

Background/Objectives: We examined clinical purpose and acquisition method in a preselected acute-care archive of unknown representativeness. Methods: We reconciled 871 historical records using numerical adult-age evidence. Historical dual-human review, investigator-adopted dispositions for 325 unresolved records, a separate 100-record human-verified audit, and source reconciliation were distinguished. Six mapping domains and a scenario adding 274 age-unverified reports were analyzed. Results: The archive contained 355 core reports, 15 noncore records, 497 eligibility exclusions, three unresolved sources and one duplicate. Acquisition remained unestablished in 237/355 reports (66.8%): 38 remained unresolved after targeted source reconciliation, and 199 were not sampled for that acquisition audit. Any automated component was documented in 17/39 cardiac-arrest reports (43.6%), 15/27 mixed neurological/trauma reports (55.6%), and 6/116 trauma reports (5.2%). Diagnostic/physiological questions predominated in ocular and toxicological reports; neurological prognosis predominated after cardiac arrest. Adding age-unverified reports increased trauma representation from 32.7% to 39.9%. Conclusions: Clinical questions and documented acquisition profiles differ within this archive, while the numerical-age rule changes case mix. Unestablished acquisition and unequal verification limit comparisons of documented assessment methods across clinical groups. These findings do not establish field-wide coverage, clinical adoption, or comparative effectiveness.