Evidence map›Paper›PMID 34376239›Full record

Observational studyCritical care (London, England)2021

Intensive care doctors and nurses personal preferences for Intensive Care, as compared to the general population: a discrete choice experiment.

Matthew H Anstey, Imogen A Mitchell, Charlie Corke, Lauren Murray, Marion Mitchell, Andrew Udy, Vineet Sarode, Nhi Nguyen, Oliver Flower, Kwok M Ho and 3 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Critical care (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. 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

13 authors.

Matthew H AnsteyIntensive Care Department, Sir Charles Gairdner Hospital, Level 4 G Block, Hospital Ave, Nedlands, Perth, WA, 6009, Australia. matthew.anstey@health.wa.gov.au.ORCID 0000-0001-7927-524X
Imogen A MitchellAustralian National University, Canberra, Australia.
Charlie CorkeUniversity Hospital Geelong, Geelong, Australia.
Lauren MurraySunshine Coast University Hospital, Birtinya, QLD, Australia.
Marion MitchellGriffith University, Griffith, QLD, Australia.
Andrew UdyAlfred Hospital, Melbourne, Australia.
Vineet SarodeMonash University, Melbourne, Australia.
Nhi NguyenNepean Hospital, Kingswood, NSW, Australia.
Oliver FlowerRoyal North Shore Hospital, Sydney, Australia.
Kwok M HoSchool of Medicine, University of Western Australia, Crawley, Australia.
Edward LittonSchool of Medicine, University of Western Australia, Crawley, Australia.
Bradley WibrowIntensive Care Department, Sir Charles Gairdner Hospital, Level 4 G Block, Hospital Ave, Nedlands, Perth, WA, 6009, Australia.
Richard NormanSchool of Population Health, Curtin University, Bentley, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo test the hypothesis that Intensive Care Unit (ICU) doctors and nurses differ in their personal preferences for treatment from the general population, and whether doctors and nurses make different choices when thinking about themselves, as compared to when they are treating a patient.

methodsCross sectional, observational study conducted in 13 ICUs in Australia in 2017 using a discrete choice experiment survey. Respondents completed a series of choice sets, based on hypothetical situations which varied in the severity or likelihood of: death, cognitive impairment, need for prolonged treatment, need for assistance with care or requiring residential care.

resultsA total of 980 ICU staff (233 doctors and 747 nurses) participated in the study. ICU staff place the highest value on avoiding ending up in a dependent state. The ICU staff were more likely to choose to discontinue therapy when the prognosis was worse, compared with the general population. There was consensus between ICU staff personal views and the treatment pathway likely to be followed in 69% of the choices considered by nurses and 70% of those faced by doctors. In 27% (1614/5945 responses) of the nurses and 23% of the doctors (435/1870 responses), they felt that aggressive treatment would be continued for the hypothetical patient but they would not want that for themselves.

conclusionThe likelihood of returning to independence (or not requiring care assistance) was reported as the most important factor for ICU staff (and the general population) in deciding whether to receive ongoing treatments. Goals of care discussions should focus on this, over likelihood of survival.

Indexed as

Consumer BehaviorAdultAttitude of Health PersonnelAustraliaChi-Square DistributionCritical CareCross-Sectional StudiesFemaleHealth PersonnelHumansIntensive Care UnitsMaleMiddle AgedNursesOdds RatioPhysiciansAttitude to deathDecision makingDiscrete choice experimentIntensive care units

Identifiers

PMID34376239
PMCPMC8353726

What OpenQuestion holds

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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.