Difficulties in knowing which critical care trial data warrant change in practice

2019 ◽  
Vol 211 (7) ◽  
pp. 306
Author(s):  
Benjamin Reddi ◽  
Mark Finnis ◽  
Sandra Peake
Keyword(s):  
Critical Care ◽  
Trial Data ◽  
Change In Practice ◽  
Critical Care Trial

Physicians declining patient enrollment in a critical care trial: a case study in thromboprophylaxis

2013 ◽  
Vol 39 (12) ◽  
pp. 2115-2125 ◽  
Author(s):  
D. Cook ◽  
◽  
Y. Arabi ◽  
N. D. Ferguson ◽  
D. Heels-Ansdell ◽  
...  
Keyword(s):  
Critical Care ◽  
Patient Enrollment ◽  
Critical Care Trial

scholarly journals Co-enrolment to UK Critical Care Studies – A 2019 update

2020 ◽  
pp. 175114372097154
Author(s):  
Timothy Felton ◽  
Natalie Pattison ◽  
Simon Fletcher ◽  
Simon Finney ◽  
Tim Walsh ◽  
...  
Keyword(s):  
Critical Care ◽  
Health Research ◽  
Time Frame ◽  
High Quality Research ◽  
Deferred Consent ◽  
Ventilation Weaning ◽  
Trial Outcomes ◽  
Mechanical Ventilation Weaning ◽  
Short Time ◽  
Critical Care Trial

In 2013, a group of clinicians on behalf of the National Institute for Health Research, collaborated with ICU Steps to produce guidance about people being enrolled in more than one critical care trial. This is referred to as “co-enrolment” and can be where a person takes part in one study at the same time as another study (or one after the other in a short time-frame). For instance, being part of a study looking at sepsis drugs and a mechanical ventilation weaning study. The drivers for developing this guidance were a lack of any existing guidance, nationally and internationally, at that time, and a desire to ensure high quality research is conducted. The emphasis was on making trials as safe as possible for patients and ensuring robust trial outcomes. Critical care was seen to lead in this, with our exemplar guidance used across all health research. We wish to revisit this guidance now that there is more experience of coenrolment in critical care trials. There is also more awareness of different consent models, such as deferred consent (taking consent when a person is awake and able to give consent) and consultee consent (asking families or independent professionals to consent). Consenting to coenrolment is an important ethical consideration for the revision of this guidance.

793: A Qualitative Analysis of Factors Influencing Critical Care Trial Enrollment Among Surrogates

2020 ◽  
Vol 49 (1) ◽  
pp. 393-393
Author(s):  
Dustin Krutsinger ◽  
Breanna Hetland ◽  
Kelly Oleary ◽  
Katherine Courtright
Keyword(s):  
Critical Care ◽  
Qualitative Analysis ◽  
Factors Influencing ◽  
Critical Care Trial

scholarly journals Critical care trial design and interpretation: A primer

2010 ◽  
Vol 38 (9) ◽  
pp. 1882-1889 ◽  
Author(s):  
Jonathan E. Sevransky ◽  
William Checkley ◽  
Greg S. Martin
Keyword(s):  
Critical Care ◽  
Trial Design ◽  
Critical Care Trial

Aligning Interests in Critical Care Trial Design*

2018 ◽  
Vol 19 (2) ◽  
pp. 176-177
Author(s):  
Ryan P. Barbaro ◽  
Michael Gaies
Keyword(s):  
Critical Care ◽  
Trial Design ◽  
Critical Care Trial

THE EFFECT OF A NEW POLICY FOR INWARD TRANSFER OF PATIENTS DIAGNOSED WITH CEREBRAL VENOUS THROMBOSIS (CVT) ACROSS GREATER MANCHESTER TO THE TERTIARY NEUROSCIENCES CENTRE

2015 ◽  
Vol 86 (11) ◽  
pp. e4.102-e4
Author(s):  
Timothy Lavin ◽  
Jason McMinn ◽  
Martin Punter ◽  
Mark Kellett
Keyword(s):  
Critical Care ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Waiting Times ◽  
Large Change ◽  
Number Of Patients ◽  
Change In Practice ◽  
Bed Days ◽  
The Impact

BackgroundFrom June 2014, Greater Manchester, Lancashire and Cumbria neurology network implemented regional guidelines on management of CVT. Central to this was an agreement to transfer where appropriate all radiologically confirmed CVT to the regional neurosciences unit within 24 hr. Given this change in practice we assessed the impact on our service in Greater Manchester Neurosciences Centre.ResultsBetween June 2014 and November 2014, 14 patients were admitted; compared to 6 in 2012 and 6 in 2013.The wait for urgent beds did not vary compared to equivalent period in 2012 and 2013; median wait 1d. The wait for non-urgent beds increased slightly between 2013 and 2014 from 15.9d to 16.7d. Both were worse compared to 2012 (9.8d), likely reflecting overall pressure on acute services.There was no increase in the average LOS for the acute neurology wards. Average LOS was 15.3d between June and Nov 2014 compared to 22.3d in the equivalent period in 2013.ConclusionDespite a large change in practice for management of CVT there was a small increase in number of patients and no significant effect on admission waiting times, average LOS or critical care bed days was noted.

scholarly journals TP10.1.9End Colostomy Formation: Change in Practice during the Covid-19 Pandemic

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
E Z Farrow ◽  
T A Cook
Keyword(s):  
Critical Care ◽  
Recovery Period ◽  
Surgical Practice ◽  
Stoma Formation ◽  
Change In Practice ◽  
End Colostomy ◽  
The Impact ◽  
Early Phases

Abstract Aim Intercollegiate guidance favoured the increased stoma formation during the early phases of the Covid-19 pandemic due to uncertainty around the availability of critical care beds and peri-operative impact of SARS-CoV-2. This study assessed the impact the Covid-19 pandemic and changing guidance had on end colostomy formation. Methods Data were reviewed from a prospectively collected database on the number of end colostomies formed over a 10-month period from 1st March to 31st December 2020. Comparison was made with the same period in 2019. Details were confirmed using clinical letters. Results There was an overall 11.5% increase in the number of end colostomies formed in the in the same 10-month period in 2020 compared with 2019 (87 vs 78). The increase in end colostomy formation was most marked in the 3-month period of March to May, with 36.8% more end colostomies formed in 2020 than in 2019 (26 vs 19). The number of end colostomies formed in the remaining 7-month period of June to December was similar in the two years (61 vs 59). Conclusions There was a change in surgical practice in favour of stoma formation, which peaked in the period of March to May 2020. This coincided with a time of maximum uncertainty surrounding the Covid-19 pandemic and changing intercollegiate guidance. The change in practice has implications for patients longer term and may impact on the service in the post-Covid recovery period with patients requesting reversal procedures.

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