ArticleAnnals of internal medicine2020
Ventilator Triage Policies During the COVID-19 Pandemic at U.S. Hospitals Associated With Members of the Association of Bioethics Program Directors.
Article in Annals of internal medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04373135 (A Study to Evaluate Health Behavior and Access Impacts Due to COVID-19 and for Community Engagement of Stakeholders Surrounding Scarce Resource Allocation Policy.), which is not on this map. Cited by 82 papers, 1 of them a synthesis that pooled it.
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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.
A Study to Evaluate Health Behavior and Access Impacts Due to COVID-19 and for Community Engagement of Stakeholders Surrounding Scarce Resource Allocation Policy.
Who cites it
82 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Crisis Standards of Care in the USA: A Systematic Review and Implications for Equity Amidst COVID-19.Journal of racial and ethnic health disparities · 2021Pooled it
- Simulating crisis triage: a methodological framework for evaluating ventilator allocation under crisis standards of care.BMC medical research methodology · 2026Article
- Ethical Prioritization of Healthcare Access During Pandemics in Jordan: A Cross-Sectional Study of Physician Awareness, Confidence in Ethical Decision-Making and the Role of COVID-19-Specific Training.Journal of healthcare leadership · 2026Article
- A transfer triage tool for COVID-19 mass critical care surges.Scientific reports · 2025Observational
- The psychosocial effects of the COVID-19 pandemic on Turkish older adults: is there a difference between males and females?BMC geriatrics · 2024Article
- [Ethical boundary decisions in intensive care medicine].Innere Medizin (Heidelberg, Germany) · 2024Article
- Social Disparities and Critical Illness during the Coronavirus Disease 2019 Pandemic: A Narrative Review.Critical care clinics · 2024Review
- COVID-19 critical care triage across Canada: a narrative synthesis and ethical analysis of early provincial triage protocols.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2024Article
- Hospital Policy Variation in Addressing Decisions to Withhold and Withdraw Life-Sustaining Treatment.Chest · 2024Article
- SOFA score performs worse than age for predicting mortality in patients with COVID-19.PloS one · 2024Article
- Article
- Simulation of New York City's Ventilator Allocation Guideline During the Spring 2020 COVID-19 Surge.JAMA network open · 2023Article
- Serial laboratory biomarkers are associated with ICU outcomes in patients hospitalized with COVID-19.PloS one · 2023Article
- Preparing for the Worst-Case Scenario in a Pandemic: Intensivists Simulate Prioritization and Triage of Scarce ICU Resources.Critical care medicine · 2022Article
- Anxiety among older adults during the COVID-19 pandemic.Journal of anxiety disorders · 2022Article
- Development and Internal Validation of a New Prognostic Model Powered to Predict 28-Day All-Cause Mortality in ICU COVID-19 Patients-The COVID-SOFA Score.Journal of clinical medicine · 2022Article
- How Common SOFA and Ventilator Time Trial Criteria Would Have Performed During the COVID-19 Pandemic: An Observational Simulated Cohort Study.Disaster medicine and public health preparedness · 2022Observational
- Ethical Guidance for Hard Decisions: A Critical Review of Early International COVID-19 ICU Triage Guidelines.Health care analysis : HCA : journal of health philosophy and policy · 2022Review
- We Should Not Use Randomization Procedures to Allocate Scarce Life-Saving Resources.Public health ethics · 2022Article
- Perspectives of Triage Team Members Participating in Statewide Triage Simulations for Scarce Resource Allocation During the COVID-19 Pandemic in Washington State.JAMA network open · 2022Article
22 more citing papers are in PubMed but not listed here.
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe coronavirus disease 2019 pandemic has or threatens to overwhelm health care systems. Many institutions are developing ventilator triage policies.
objectiveTo characterize the development of ventilator triage policies and compare policy content.
designSurvey and mixed-methods content analysis.
settingNorth American hospitals associated with members of the Association of Bioethics Program Directors.
participantsProgram directors. MEASUREMENTS: Characteristics of institutions and policies, including triage criteria and triage committee membership.
resultsSixty-seven program directors responded (response rate, 91.8%); 36 (53.7%) hospitals did not yet have a policy, and 7 (10.4%) hospitals' policies could not be shared. The 29 institutions providing policies were relatively evenly distributed among the 4 U.S. geographic regions (range, 5 to 9 policies per region). Among the 26 unique policies analyzed, 3 (11.3%) were produced by state health departments. The most frequently cited triage criteria were benefit (25 policies [96.2%]), need (14 [53.8%]), age (13 [50.0%]), conservation of resources (10 [38.5%]), and lottery (9 [34.6%]). Twenty-one (80.8%) policies use scoring systems, and 20 of these (95.2%) use a version of the Sequential Organ Failure Assessment score. Among the policies that specify the triage team's composition (23 [88.5%]), all require or recommend a physician member, 20 (87.0%) a nurse, 16 (69.6%) an ethicist, 8 (34.8%) a chaplain, and 8 (34.8%) a respiratory therapist. Thirteen (50.0% of all policies) require or recommend that those making triage decisions not be involved in direct patient care, but only 2 (7.7%) require that their decisions be blinded to ethically irrelevant considerations. LIMITATION: The results may not be generalizable to institutions without academic bioethics programs.
conclusionOver one half of respondents did not have ventilator triage policies. Policies have substantial heterogeneity, and many omit guidance on fair implementation. PRIMARY FUNDING SOURCE: None.
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