Evidence map›Paper›PMID 39363334›Full record

ArticleCritical care (London, England)2024

Consensus statements for the establishment of medical intensive care in low-resource settings: international study using modified Delphi methodology.

Pedja Kovacevic, Jadranka Vidovic, Boris Tomic, Jihad Mallat, Ali Ait Hssain, Muyiwa Rotimi, Owoniya Temitope Akindele, Kent Doi, Rajesh Mishra, F Joachim Meyer and 5 more

Abstract readConsensus Statement
In one paragraph

Article in Critical care (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. 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

15 authors.

Pedja KovacevicMedical Intensive Care Unit, University Clinical Centre of the Republic of Srpska, 78000, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina. pedja.kovacevic@med.unibl.org.
Jadranka VidovicMedical Intensive Care Unit, University Clinical Centre of the Republic of Srpska, 78000, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina.
Boris TomicMedical Intensive Care Unit, University Clinical Centre of the Republic of Srpska, 78000, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina.
Jihad MallatDepartment of Critical Care Medicine, Critical Care Institute, Cleveland Clinic Abu Dhabi, Al Maryah Island, Abu Dhabi, United Arab Emirates.
Ali Ait HssainMedical Intensive Care Unit, Department of Medicine, Hamad General Hospital, Weill Cornell Medical College, ESICM International Representative for Middle East, Doha, Qatar.
Muyiwa RotimiDepartment of Anaesthesia, Lagos University Teaching Hospital, Idi-Araba, Lagos State, Nigeria.
Owoniya Temitope AkindeleDepartment of Anaesthesia and Intensive Care Unit, Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife, Nigeria.
Kent DoiDepartment of Emergency and Critical Care Medicine, University of Tokyo, ESICM International Representative for Asia-Pacific, Tokyo, 113-8655, Japan.
Rajesh MishraCritical Care, Shaibya Comprehensive Care Clinic, ESICM National Representative of India, Ahmedabad, Gujarat, India.
F Joachim MeyerMünchen Klinik gGmbH and Medical Faculty, Lung Center Munich, University of Heidelberg, Heidelberg, Germany.
Ivan PalibrkDepartment of Anesthesiology, Reanimatology and Intensive Care, Clinic for Abdominal Surgery, University Clinical Centre of Serbia, 11000, Belgrade, Serbia.
Ranko SkrbicFaculty of Medicine, University of Banja Luka, Dvanaest Beba Bb, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina.
Enrique BoloñaClínica Guayaquil, Guayaquil, Ecuador.
Oguz KilickayaDepartment of Medicine, Division of Pulmonary and Critical Care Medicine Mayo Clinic, Rochester, MN, USA.
Ognjen GajicDepartment of Medicine, Division of Pulmonary and Critical Care Medicine Mayo Clinic, Rochester, MN, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe inadequacy of intensive care medicine in low-resource settings (LRS) has become significantly more visible after the COVID-19 pandemic. Recommendations for establishing medical critical care are scarce and rarely include expert clinicians from LRS.

methodsIn December 2023, the National Association of Intensivists from Bosnia and Herzegovina organized a hybrid international conference on the topic of organizational structure of medical critical care in LRS. The conference proceedings and literature review informed expert statements across several domains. Following the conference, the statements were distributed via an online survey to conference participants and their wider professional network using a modified Delphi methodology. An agreement of ≥ 80% was required to reach a consensus on a statement.

resultsOut of the 48 invited clinicians, 43 agreed to participate. The study participants came from 20 countries and included clinician representatives from different base specialties and health authorities. After the two rounds, consensus was reached for 13 out of 16 statements across 3 domains: organizational structure, staffing, and education. The participants favored multispecialty medical intensive care units run by a medical team with formal intensive care training. Recognition and support by health care authorities was deemed critical and the panel underscored the important roles of professional organizations, clinician educators trained in high-income countries, and novel technologies such as tele-medicine and tele-education.

conclusionDelphi process identified a set of consensus-based statements on how to create a sustainable patient-centered medical intensive care in LRS.

Indexed as

Critical CareDelphi TechniqueCOVID-19Developing CountriesHealth ResourcesHumansIntensive Care UnitsConsensusDevelopmentIntensive care medicineMICU

Identifiers

PMID39363334
PMCPMC11451122

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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.