Observational studyCritical care medicine2015
An Observational Study of Decision Making by Medical Intensivists.
Observational study in Critical care medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
40 citing papers in PubMed.
- Decision volume and temporal workload structure as dissociable correlates of fatigue and mood in intensive care physicians: a real-time observational study.Critical care (London, England) · 2026Observational
- Food for thought: a mixed methods analysis of nutrition decision making during bedside rounds in the neonatal intensive care unit.Pediatric research · 2026Article
- Clinicians' decisions about antibiotic treatment in advanced dementia: an international survey.BMJ neurology open · 2026Article
- Review
- A framework for health systems to assess and prioritize participation in pragmatic clinical trials.Learning health systems · 2025Article
- Evaluating the o1 reasoning large language model for cognitive bias: a vignette study.Critical care (London, England) · 2025Article
- The Effect of Clinical Ambiguity on the Decision-Making Process Among Intensive Care Unit Providers in Northern America Using Clinical Vignettes in Mixed Methods Study.Journal of multidisciplinary healthcare · 2025Article
- Unclear Trajectory and Uncertain Benefit: Creating a Lexicon for Clinical Uncertainty in Patients with Critical or Advanced Illness Using a Delphi Consensus Process.Medical decision making : an international journal of the Society for Medical Decision Making · 2025Article
- Using Electronic Health Records to Identify the Daily Primary Provider During Hospitalization.Critical care explorations · 2024Article
- The limitations of evidence-based medicine compel the practice of personalized medicine.Intensive care medicine · 2024Article
- The Impact of Information Relevancy and Interactivity on Intensivists' Trust in a Machine Learning-Based Bacteremia Prediction System: Simulation Study.JMIR human factors · 2024Article
- The Integration of Clinical Trials With the Practice of Medicine: Repairing a House Divided.JAMA · 2024Article
- Ten misconceptions regarding decision-making in critical care.World journal of critical care medicine · 2024Review
- Enhancing post-arrest prognostication through good outcome prediction.Resuscitation · 2024Article
- A Snapshot of Chronic Critical Illness in Pediatric Intensive Care Units.Journal of pediatric intensive care · 2024Article
- Identifying the need for infection-related consultations in intensive care patients using machine learning models.Scientific reports · 2024Article
- Article
- MRI and the Critical Care Patient: Clinical, Operational, and Financial Challenges.Critical care research and practice · 2023Review
- Systematic Review of the "Pragmatism" of Pragmatic Critical Care Trials.Critical care explorations · 2022Review
- Guiding Efficient, Effective, and Patient-Oriented Electrolyte Replacement in Critical Care: An Artificial Intelligence Reinforcement Learning Approach.Journal of personalized medicine · 2022Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
objectivesThe ICU is a place of frequent, high-stakes decision making. However, the number and types of decisions made by intensivists have not been well characterized. We sought to describe intensivist decision making and determine how the number and types of decisions are affected by patient, provider, and systems factors.
designDirect observation of intensivist decision making during patient rounds.
settingTwenty-four-bed academic medical ICU. SUBJECTS: Medical intensivists leading patient care rounds.
interventionNone. MEASUREMENTS AND MAIN
resultsDuring 920 observed patient rounds on 374 unique patients, intensivists made 8,174 critical care decisions (mean, 8.9 decisions per patient daily, 102.2 total decisions daily) over a mean of 3.7 hours. Patient factors associated with increased numbers of decisions included a shorter time since ICU admission and an earlier slot in rounding order (both p < 0.05). Intensivist identity explained the greatest proportion of variance in number of decisions per patient even when controlling for all other factors significant in bivariable regression. A given intensivist made more decisions per patient during days later in the 14-day rotation (p < 0.05). Female intensivists made significantly more decisions than male intensivists (p < 0.05).
conclusionsIntensivists made over 100 daily critical care decisions during rounds. The number of decisions was influenced by a variety of patient- and system-related factors and was highly variable among intensivists. Future work is needed to explore effects of the decision-making burden on providers' choices and on patient outcomes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.