ArticleJournal of intensive care2026
Development and 2025 re-evaluation of a Japanese quality indicator set for adult intensive care: a modified RAND/UCLA Delphi study.
Article in Journal of intensive care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundQuality indicators (QIs) support measurement and improvement of ICU care; however, until 2017 there was no comprehensive, evidence-based QI set tailored to frontline adult ICU practice in Japan. Because evidence and practice evolve, periodic updating is required. We developed a Japanese ICU QI set in 2017-2018 and conducted a formal re-evaluation in 2025 to confirm current validity and update the core set.
methodsWe used a modified RAND/UCLA appropriateness method. First, an initial list of candidate QIs was generated through a systematic literature review and major clinical guidelines. Next, a multidisciplinary panel of 14 Japanese experts (including intensivists, a nurse, a physiotherapist, and a clinical engineer) rated the appropriateness of these indicators using a nine-point Likert scale (Round 1). Following Round 1, a face-to-face consensus meeting was held to discuss, refine, add, or delete indicators based on scientific evidence, clinical importance, and feasibility, followed by Round 2 to finalize the 2018 consensus set. In 2025 (Round 3), the panel re-rated all indicators from the 2018 set using the same rating and classification framework and also rated newly proposed indicators reflecting contemporary practice.
resultsThe systematic review yielded 44 initial candidate QIs. After the two-round rating process and the expert panel meeting, a 2018 consensus set of 38 QIs was established (13 structure indicators, 10 process indicators, and 15 outcome indicators). In Round 3 (2025), 37 indicators remained Appropriate, whereas one indicator was reclassified as Uncertain and was not retained in the updated core set. One newly proposed indicator was rated Appropriate and added, resulting in an updated 2025 core set of 38 indicators. All selected indicators were deemed appropriate and relevant for the Japanese ICU setting by the expert panel.
conclusionsUsing a rigorous modified RAND/UCLA appropriateness method and a 2025 re-evaluation, we developed and updated a feasible, contextually adapted Japanese ICU QI set. The updated core set, with operational definitions and specified data sources, provides a foundation for national benchmarking and continuous quality improvement in Japanese ICUs. 330 words.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.