title: Variability of preference toward mechanical ventilator settings: a model-based behavioral analysis.
abstract: OBJECTIVE
  The purpose of this study was to evaluate Danish clinicians' opinions toward ventilator settings using standardized model-simulated patients. The models ensured that all clinicians received identical presentations of data and anticipated responses to changes in patient state, enabling opinions on the same patient cases to be obtained from different clinicians.
  
  
  METHODS
  Ten Danish intensive care clinicians' and a computerized decision support system each provided suggestions for respiratory frequency (f), tidal volume (Vt) and insoired oxygen fraction (FiO2) in the same 10 model-simulated patient cases. The 110 suggestions were then evaluated by the 10 clinicians in a ranking and classification procedure.
  
  
  RESULTS
  Clinicians' preferences toward ventilator settings (Fio(2), Vt, and f) and the resulting simulated values of arterial oxygen saturation, peak inspiratory pressure, and pH were significantly different (P < .005). The results of the classification showed that clinicians generally had poor opinion of the advice provided by other clinicians and the decision support system, considering this advice to be unacceptable in 33% of cases and good only in 21%. The ranking procedure also showed that clinicians did not agree on the best and worst advice.
  
  
  CONCLUSIONS
  The present study shows significant difference in opinion on appropriate settings of f, Vt, and Fio(2) in the same computerized decision support system model-simulated patient cases.
authors: Department of Anaesthesia, Aalborg Hospital, Aarhus University, DK-9000 Aalborg, Denmark. c.allerod@post.tele.dk
authors: Charlotte
authors: C
authors: Allerød
authors: Dan S
authors: DS
authors: Karbing
authors: Per
authors: P
authors: Thorgaard
authors: Steen
authors: S
authors: Andreassen
authors: Søren
authors: S
authors: Kjærgaard
authors: Stephen E
authors: SE
authors: Rees
mesh_terms: D003198:Computer Simulation; D003422:Critical Care; D003661:Decision Support Techniques; D003718:Denmark; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011659:Pulmonary Gas Exchange; D012121:Respiration, Artificial