ReviewThe Lancet. Respiratory medicine2025
Evidence-based personalised medicine in critical care: a framework for quantifying and applying individualised treatment effects in patients who are critically ill.
Abstract readReview
In one paragraph
Review in The Lancet. Respiratory medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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
26 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Sodium bicarbonate therapy in severe metabolic acidemia: an individual patient data meta-analysis of the BICAR-ICU and BICAR-ICU2 trials.Critical care (London, England) · 2026Pooled it
- Ketamine or Etomidate for Tracheal Intubation of Critically Ill Adults.The New England journal of medicine · 2026Trial
- Article
- The Acute Respiratory Distress Syndrome (ARDS): epidemiology, etiology, molecular mechanisms, diagnosis and therapeutic strategies.Molecular biomedicine · 2026Review
- Beyond Berlin: The multidimensional evolution of ARDS in the era of precision critical care.Journal of intensive medicine · 2026Article
- From physiological innovation to clinical precision: defining the right target for diaphragm neurostimulation.Journal of thoracic disease · 2026Article
- An automated, digital immunoassay on a microfluidic cartridge for on-demand cytokine profiling.Microsystems & nanoengineering · 2026Article
- Consistent analgesic effect of intravenous dexamethasone on rebound pain after brachial plexus block: a causal machine learning approach.The Korean journal of pain · 2026Article
- Interpreting protein dose trials in critical illness: a guide for the bedside clinician.Critical care (London, England) · 2026Review
- The evolution of sepsis care: from protocol-driven management to personalized intensive care.Infection · 2026Review
- Evaluating possible treatment effect heterogeneity in a randomized trial of milrinone versus dobutamine in cardiogenic shock.Critical care (London, England) · 2026Article
- The heterogeneous treatment effect of adjuvant therapy with corticosteroids in patients with Community-Acquired Pneumonia: a review.Pneumonia (Nathan Qld.) · 2026Review
- Machine learning in ARDS: an intensivist's guide to artificial intelligence applications.Critical care (London, England) · 2026Review
- Beyond one-size-fits-all: Addressing patient heterogeneity through precision-based oxygen therapy research in critical care.Journal of intensive medicine · 2026Article
- Bridging practice and evidence: insights from the Scandinavian Society of Anaesthesiology and Intensive Care Medicine and Saudi Critical Care Society Guidelines on trauma-related VTE.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Review
- Morphological subphenotypes of acute pancreatitis-related acute respiratory distress syndrome.Critical care (London, England) · 2026Article
- Breaking the Stalemate: Advancing Sepsis Therapeutics Beyond Supportive Care.Public health reports (Washington, D.C. : 1974) · 2026Article
- Artificial Intelligence- and Machine Learning-Assisted Subphenotyping for Personalized Immunotherapy in Sepsis.Journal of personalized medicine · 2026Review
- Clinical subphenotypes and molecular endotypes in sepsis: toward an integrated and dynamic framework.Annals of intensive care · 2026Review
- Large language models in emergency and critical care medicine: a comprehensive review of applications, challenges, and future directions.Burns & trauma · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
58 authors.
Elizabeth S MunroeDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
Alexandra SpicerDivision of Pulmonary and Critical Care, Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA.
Andrea Castellvi-FontDepartment of Critical Care, Hospital del Mar, and Critical Illness Research Group (GREPAC), Hospital del Mar Research Institute (IMIM), Barcelona, Spain; Division of Respirology, Department of Medicine, University Health Network, Toronto, ON, Canada; Toronto General Hospital Research Institute, Toronto, ON, Canada.
Ann ZaluckyDepartment of Critical Care Medicine, Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary and Alberta Health Services, Foothills Medical Center, Calgary, AB, Canada; Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, University of California San Francisco, San Francisco, CA, USA.
Jose DiantiDivision of Respirology, Department of Medicine, University Health Network, Toronto, ON, Canada; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
Emma Graham LinckSchool of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.
Victor TalisaCenter for Reasearch, Investigation, and Systems Modeling of Acute Illness, Department of Critical Care Medicine, University of Pittsburgh, PA, USA.
Martin UrnerToronto General Hospital Research Institute, Toronto, ON, Canada; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada; Department of Anesthesiology & Pain Medicine, University of Toronto, Toronto, ON, Canada.
Derek C AngusCenter for Reasearch, Investigation, and Systems Modeling of Acute Illness, Department of Critical Care Medicine, University of Pittsburgh, PA, USA.
Elias Baedorf-KassisDepartment of Medicine, Harvard Medical School, Boston, MA, USA.
Bryan BletteDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA.
Lieuwe D BosDepartment of Intensive Care and Laboratory of Experimental Intensive Care and Anesthesiology, Amsterdam, Netherlands.
Kevin G BuellDivision of Pulmonary and Critical Care, Department of Medicine, University of Chicago, Chicago, IL, USA.
Jonathan D CaseyDivision of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Carolyn S CalfeeDivision of Pulmonary, Critical Care, Allergy and Sleep Medicine, University of California San Francisco, San Francisco, CA, USA.
Lorenzo Del SorboDivision of Respirology, Department of Medicine, University Health Network, Toronto, ON, Canada.
Elisa EstenssoroHospital Interzonal San Martin de La Plata, Buenos Aires, Argentina.
Niall D FergusonDivision of Respirology, Department of Medicine, University Health Network, Toronto, ON, Canada; Toronto General Hospital Research Institute, Toronto, ON, Canada; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
Rachel GiblonDivision of Biostatistics, University of Toronto, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Anders GranholmDepartment of Intensive Care, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
Michael O HarhayDepartment of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Anna HeathDivision of Biostatistics, University of Toronto, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Carol HodgsonAustralian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia.
Timothy HouleDepartment of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Cong JiangFaculté of Pharmacie, Université de Montréal, Montreal, QC, Canada.
Lina KramerDepartment of Intensive Care and Laboratory of Experimental Intensive Care and Anesthesiology, Amsterdam, Netherlands.
Patrick R LawlerInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada; Division of Cardiology, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada.
Aleksandra LeligdowiczDivision of Critial Care Medicine, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Fan LiDepartment of Biostatistics, Yale School of Public Health, New Haven, CT, USA.
Kuan LiuInstitute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada.
Amelia MaigaDivision of Acute Care Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
David MasloveDepartment of Critical Care Medicine, Queen's University, Kingston, ON, Canada.
Colin McArthurDepartment of Critical Care Medicine, Te Toka Tumai Auckland City Hospital, Auckland, New Zealand.
Daniel F McAuleyWellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, Northern Ireland.
Ary Serpa NetoDepartment of Intensive Care, Austin Hospital, Melbourne, VIC, Australia; Department of Critical Care Medicine, Hospital Israelita Albert Einstein, Sao Paolo, Brazil; Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia.
Charissa OosthuysenDivision of Respirology, Department of Medicine, University Health Network, Toronto, ON, Canada.
Anders PernerDepartment of Intensive Care, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
Hallie C PrescottDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA; VA Center for Clinical Management Research, Ann Arbor, MI, USA.
Bram RochwergDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Sarina SahetyaDivision of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Mariia SamoilenkoFaculté of Pharmacie, Université de Montréal, Montreal, QC, Canada.
Mireille E SchnitzerFaculté of Pharmacie, Université de Montréal, Montreal, QC, Canada; Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montreal, QC, Canada.
Kevin P SeitzDivision of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Faraaz ShahDivision of Pulmonary, Allergy, Critical Care, and Sleep Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Manu Shankar-HariCentre for Inflammation Research, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK.
Pratik SinhaDepartment of Anesthesiology, Washington University School of Medicine in St Louis, St Louis, MO, USA.
Arthur S SlutskyInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
Edward T QianDivision of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Steve A WebbAustralian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia.
Paul J YoungAustralian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia; Intensive Care Unit, Wellington Hospital, Wellington, New Zealand; Medical Research Institute of New Zealand, Wellington, New Zealand; Department of Critical Care, University of Melbourne, Melbourne, VIC, Australia.
Fernando G ZampieriDepartment of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta and Alberta Health Services, Edmonton, AB, Canada.
Ryan ZarychanskiDepartment of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada.
Eddy FanDivision of Respirology, Department of Medicine, University Health Network, Toronto, ON, Canada; Toronto General Hospital Research Institute, Toronto, ON, Canada; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
Matthew W SemlerDivision of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Matthew ChurpekDivision of Pulmonary and Critical Care, Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA; School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.
Ewan C GoligherDivision of Respirology, Department of Medicine, University Health Network, Toronto, ON, Canada; Toronto General Hospital Research Institute, Toronto, ON, Canada; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada. Electronic address: ewan.goligher@utoronto.ca.
Platform of Randomized Adaptive Clinical Trials in Critical Illness (PRACTICAL) investigators
Evidence-based Individualized Treatment Effects (EvITE) Group
Funding
Research Training for Computation and Informatics in Biology and MedicineT15LM007359 · NLM · UNIVERSITY OF WISCONSIN-MADISON · PI Mark W. Craven, Colin Noel Dewey · 2002 to 2026
$22.6MPULMONARY CELLULAR AND MOLECULAR BIOLOGY TRAININGT32HL007749 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Robert Pickett Dickson · 1993 to 2026
$19.9MRESEARCH TRAINING IN RESPIRATORY BIOLOGYT32HL007605 · NHLBI · UNIVERSITY OF CHICAGO · PI Yun Fang, Gokhan M. Mutlu · 1985 to 2026
$18.1MClinical and Translational Training Program in Pulmonary MedicineT32HL087738 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Lorraine B Ware · 2007 to 2026
$7.0MPrecision Medicine in the Acute Respiratory Distress SyndromeR35HL140026 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CALFEE, CAROLYN · 2018 to 2024
$6.8MUsing Machine Learning for Early Recognition and Personalized Treatment of Acute Kidney InjuryR01DK126933 · NIDDK · UNIVERSITY OF CHICAGO · PI CHURPEK, MATTHEW MICHAEL, KOYNER, JAY L · 2021 to 2025
$3.4MUsing causal machine learning for personalized treatment recommendations in critically ill patientsR01HL157262 · NHLBI · UNIVERSITY OF WISCONSIN-MADISON · PI Matthew Michael Churpek · 2021 to 2026
$3.1MAdvancing the design, analysis, and interpretation of acute respiratory distress syndrome trials using modern statistical toolsR01HL168202 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI Michael Oscar Harhay, Fan Li · 2023 to 2026
$2.9MPrecision Medicine Approach to Glucocortisteroids in SepsisR01GM141081 · NIGMS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI ANGUS, DEREK C, YENDE, SACHIN · 2021 to 2024
$2.6MSepsis Early Prediction and Subphenotype Illumination Study (SEPSIS)R01GM123193 · NIGMS · UNIVERSITY OF WISCONSIN-MADISON · PI CHURPEK, MATTHEW MICHAEL · 2017 to 2021
$1.9MPhenotyping ARDS, Pneumonia, and Sepsis over time to elucidate shared and distinct trajectories ofillness and recoveryU01HL168419 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI Michael Oscar Harhay, Nuala Jennings Meyer · 2023 to 2026
$1.8MImproving Prognostication for Traumatic Brain InjuryK23GM150110 · NIGMS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Amelia Maiga · 2023 to 2026
$695kNHLBI NIH HHS F32 HL172463NHLBI NIH HHS K23 HL177175NHLBI NIH HHS L30 HL170379NHLBI NIH HHS R01 HL157262NHLBI NIH HHS R01 HL168202NHLBI NIH HHS R35 HL140026NHLBI NIH HHS T32 HL007605NHLBI NIH HHS T32 HL007749NHLBI NIH HHS T32 HL087738NHLBI NIH HHS U01 HL168419NIDDK NIH HHS R01 DK126933NIGMS NIH HHS K23 GM150110NIGMS NIH HHS R01 GM123193NIGMS NIH HHS R01 GM141081NLM NIH HHS T15 LM007359Wellcome Trust
Abstract
Clinicians aim to provide treatments that will result in the best outcome for each patient. Ideally, treatment decisions are based on evidence from randomised clinical trials. Randomised trials conventionally report an aggregated difference in outcomes between patients in each group, known as an average treatment effect. However, the actual effect of treatment on outcomes (treatment response) can vary considerably between individuals, and can differ substantially from the average treatment effect. This variation in response to treatment between patients-heterogeneity of treatment effect-is particularly important in critical care because common critical care syndromes (eg, sepsis and acute respiratory distress syndrome) are clinically and biologically heterogeneous. Statistical approaches have been developed to analyse heterogeneity of treatment effect and predict individualised treatment effects for each patient. In this Review, we outline a framework for deriving and validating individualised treatment effects and identify challenges to applying individualised treatment effect estimates to inform treatment decisions in clinical care.
Indexed as
Critical CareCritical IllnessEvidence-Based MedicinePrecision MedicineHumansRandomized Controlled Trials as TopicRespiratory Distress SyndromeTreatment Outcome
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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.