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Using incentives to recruit physicians into behavioral trials: lessons learned from four studies

Objective To describe lessons learned from the use of different strategies for recruiting physicians responsible for trauma triage, we summarize recruitment data from four behavioral trials run in the United States between 2010 and 2016. Results We ran a series of behavioral trials with the primary objective of understanding the influence of heuristics on physician decision...

Precision medicine for all? Challenges and opportunities for a precision medicine approach to critical illness

All of medicine aspires to be precise, where a greater understanding of individual data will lead to personalized treatment and improved outcomes. Prompted by specific examples in oncology, the field of critical care may be tempted to envision that complex, acute syndromes could bend to a similar reductionist philosophy—where single mutations could identify and target our...

Omega-3 supplementation in patients with sepsis: a systematic review and meta-analysis of randomized trials

Evans Saleh Almenawer Lori Leduc 0 Derek C. Angus Waleed Alhazzani 0 0 St. Joseph's Healthcare Hamilton , 50 Charlton Avenue, L8N 4A6 Hamilton, ON , Canada Background: Nutritional supplementation of

Recovery after critical illness: putting the puzzle together—a consensus of 29

In this review, we seek to highlight how critical illness and critical care affect longer-term outcomes, to underline the contribution of ICU delirium to cognitive dysfunction several months after ICU discharge, to give new insights into ICU acquired weakness, to emphasize the importance of value-based healthcare, and to delineate the elements of family-centered care. This...

Recovery after critical illness: putting the puzzle together—a consensus of 29

In this review, we seek to highlight how critical illness and critical care affect longer-term outcomes, to underline the contribution of ICU delirium to cognitive dysfunction several months after ICU discharge, to give new insights into ICU acquired weakness, to emphasize the importance of value-based healthcare, and to delineate the elements of family-centered care. This...

Recovery after critical illness: putting the puzzle together—a consensus of 29

In this review, we seek to highlight how critical illness and critical care affect longer-term outcomes, to underline the contribution of ICU delirium to cognitive dysfunction several months after ICU discharge, to give new insights into ICU acquired weakness, to emphasize the importance of value-based healthcare, and to delineate the elements of family-centered care. This...

Drotrecogin alfa (activated) ... a sad final fizzle to a roller-coaster party

Following the failure of PROWESS-SHOCK to demonstrate efficacy, Eli Lilly and Company withdrew drotrecogin alfa (activated) from the worldwide market. Drotrecogin was initially approved after the original trial, PROWESS, was stopped early for overwhelming efficacy. These events prompt consideration of both the initial approval decision and the later decision to withdraw. It is...

A Comparison of Free-Standing versus Co-Located Long-Term Acute Care Hospitals

Background Long-term acute care hospitals (LTACs) provide specialized treatment for patients with chronic critical illness. Increasingly LTACs are co-located within traditional short-stay hospitals rather than operated as free-standing facilities, which may affect LTAC utilization patterns and outcomes. Methods We compared free-standing and co-located LTACs using 2005 data from...

Assessing the Validity of Using Serious Game Technology to Analyze Physician Decision Making

Background Physician non-compliance with clinical practice guidelines remains a critical barrier to high quality care. Serious games (using gaming technology for serious purposes) have emerged as a method of studying physician decision making. However, little is known about their validity. Methods We created a serious game and evaluated its construct validity. We used the...

The puzzle of long-term morbidity after critical illness

Data continue to emerge demonstrating the poor quality of life of ICU survivors in the months and years following critical illness. In this issue of Critical Care, Cuthbertson and colleagues present new data on quality of life from a cohort of ICU survivors who were followed for 5 years. They found that survivors had poor physical quality of life and low quality adjusted life...

Prehospital intravenous access and fluid resuscitation in severe sepsis: an observational cohort study

Clifton W Callaway 4 Christian Martin-Gill 4 Donald M Yealy 4 Thomas D Rea 8 9 Derek C Angus 0 3 0 Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Center , 3550 Terrace

Revisiting Mars and Venus: understanding gender differences in critical illness

Understanding the nature and biological basis of gender-determined differences in risk of and outcome from infection might identify new therapeutic targets, allow more individualised treatment, and facilitate better risk prediction and application of healthcare resources. Gender differences in behaviours, comorbidities, access to healthcare and biology may result in differences...

The challenge of admitting the very elderly to intensive care

Yn-Lan Nguyen 0 Derek C Angus Ariane Boumendil Bertrand Guidet 0 Centre d'Epidmiologie Clinique , Hpital Htel-Dieu, Assistance Publique des Hpitaux de Paris, Paris, France The aging of the

Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016

Antonelli Ricard Ferrer Anand Kumar Jonathan E. Sevransky Charles L. Sprung Mark E. Nunnally Bram Rochwerg Gordon D. Rubenfeld Derek C. Angus Djillali Annane Richard J. Beale Geoffrey J. Bellinghan Gordon R

Sources of non-compliance with clinical practice guidelines in trauma triage: a decision science study

Fischhoff 4 Derek C Angus 1 Amber E Barnato 3 0 Department of Surgery, University of Pittsburgh , F1266, 200 Lothrop Street, Pittsburgh, PA , USA 1 Department of Critical Care Medicine, The CRISMA Center

Geographic Access to High Capability Severe Acute Respiratory Failure Centers in the United States

Objective Optimal care of adults with severe acute respiratory failure requires specific resources and expertise. We sought to measure geographic access to these centers in the United States. Design Cross-sectional analysis of geographic access to high capability severe acute respiratory failure centers in the United States. We defined high capability centers using two criteria...

Effects of intra-abdominal sepsis on atherosclerosis in mice

Shanmugam Nagarajan 4 Steven D Shapiro 4 Derek C Angus 0 1 0 Department of Critical Care Medicine, University of Pittsburgh , Pittsburgh, PA , USA 1 The Clinical Research, Investigation, and Systems Modeling

Light and the outcome of the critically ill: an observational cohort study

Introduction Light before and during acute illness has been associated with both benefit and harm in animal models and small human studies. Our objective was to determine the associations of light duration (photoperiod) and intensity (insolation) before and during critical illness with hospital mortality in ICU patients. Based on the 'winter immunoenhancement' theory, we tested...