The prevalence of perceptions of mismatch between treatment intensity and achievable goals of care in the intensive care unit: a cross-sectional study.

Matthew H Anstey, Edward Litton, Michelle L Trevenen, Kelly Thompson, Steve Webb, Ian Seppelt, Imogen A Mitchell

Abstract read

In one paragraph

Article in Intensive care medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it

0cells of the map it votes in

3citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

Goals of Care: a framework in evolution.Internal medicine journal · 2026
Article
Families' Experiences of Surrogate Decision-Making and Challenges of Shared Decision-Making: A Cross-Sectional Study.Cureus · 2025
Article
What is appropriate care? A qualitative study into the perceptions of healthcare professionals in Flemish university hospital intensive care units.Heliyon · 2023
Article

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Matthew H AnsteyIntensive Care Department, Sir Charles Gairdner Hospital, Level 4 G Block, Hospital Ave, Nedlands, 6009, WA, Australia. matthew.anstey@health.wa.gov.au.ORCID 0000-0001-7927-524X

Edward LittonFiona Stanley Hospital, Murdoch, Australia.

Michelle L TrevenenCentre for Applied Statistics, University of Western Australia, Perth, Australia.

Kelly ThompsonThe George Institute for Global Health, Sydney, Australia.

Steve WebbSt John of God Hospital, Subiaco, Australia.

Ian SeppeltNepean Hospital, Kingswood, Australia.

Imogen A MitchellThe Canberra Hospital, Garran, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo describe the prevalence of perceptions of patients receiving a mismatch in treatment intensity, as perceived by intensive care unit (ICU) healthcare providers, and to assess the congruence of perceptions between providers.

methodsIn this cross-sectional, observational study conducted in 21 ICUs in Australia and New Zealand, patient prevalence data was linked to an ICU staff survey to describe the extent to which patient treatment intensity was matched to the perceived prognosis and patient wishes.

resultsOf the 307 study patients, 62 (20.2%) were reported to be receiving a mismatch in treatment intensity by at least one ICU healthcare professional. For reported mismatch, there was consensus amongst staff members for 52/62 (84%) of patients. Patients were significantly more likely to receive mismatched treatments if they were more severely unwell (APACHE II score > 20 vs. ≤ 20), odds ratio OR 2.35, 95% confidence interval (CI) 1.63-3.37, p < 0.0001, if they were an emergency admission (OR 3.05, CI 1.18-7.89, p = 0.0212) or if they had an advance care directive (OR 3.68, 95% CI 1.66-8.16, p = 0.0013).

conclusionsBeing more severely unwell, being an emergency admission or having an advance care directive made patients more likely to be perceived as having a mismatch between the intensity of treatments provided and either the achievable goals of care, expected prognosis or patient's wishes.

Indexed as

PerceptionAPACHEAustraliaCross-Sectional StudiesHumansIntensive Care UnitsNew ZealandOdds RatioPatient Care PlanningPrevalenceSeverity of Illness IndexSurveys and QuestionnairesTriageDecision-makingPatient outcomesTreatment intensity

Identifiers

PMID30725139

DOI10.1007/s00134-019-05543-y

What OpenQuestion holds

Textmetadata

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Registered trials

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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.