Doctors' perceptions of the effects of interventions tested in prospective, randomised, controlled, clinical trials: results of a survey of ICU physicians.
OBJECTIVE
To establish a list of therapeutic interventions considered by intensive care unit (ICU) physicians to have been tested by prospective, randomised, controlled clinical trials (RCTs) in critically ill patients, and to survey the perceptions of the same physicians on the therapeutic effect of these interventions as evaluated by RCT.


METHODS
Self-applied questionnaire in an International Symposium of Intensive Care and Emergency Medicine, Brussels, Belgium.


METHODS
All 3250 registrants at the symposium.


RESULTS
There were 527 questionnaires completed, and 446 were suitable for analysis. Respondents were asked to list the therapeutic interventions used in intensive care medicine which they believed have been shown by RCTs to improve survival. Using a 5-point Likert scale, respondents were then asked to rate their assessment of the effectiveness of each intervention they listed and, using a 3-point scale, to select their level of confidence in those assessments. A total of 512 interventions were identified by the respondents as having been tested by RCT. Analysing the 42 interventions quoted more than 12 times, 31 were believed by the respondents to have been shown to have a beneficial effect, and 11 to have a harmful effect. Many of the interventions noted have not in fact been subjected to RCT.


CONCLUSIONS
Many interventions that have not been tested by RCT were believed to have been tested; conversely, some interventions actually tested by RCT were not mentioned. Few interventions used in the ICU have actually been shown by RCT to have a positive effect on outcome.
Ferreira
F
F
Department of Intensive Care, Erasme University Hospital, Route de Lennik 808, 1070 Brussels, Belgium.
Vincent
J L
JL
Brun-Buisson
C
C
Sprung
C
C
Sibbald
W
W
Cook
D
D
D000328:Adult; D001291:Attitude of Health Personnel; D003422:Critical Care / Q000379:methods / Q000592:standards*; D019317:Evidence-Based Medicine / Q000592:standards*; D006801:Humans; D007362:Intensive Care Units; D008505:Medical Staff, Hospital / Q000523:psychology*; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic / Q000592:standards*; D015203:Reproducibility of Results; D012107:Research Design / Q000592:standards*; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D016896:Treatment Outcome