title: An official multi-society statement: the role of clinical research results in the practice of critical care medicine.
abstract: BACKGROUND
  While the results of clinical research are clearly valuable in the care of critically ill patients, the limitations of such information and the role of other forms of medical knowledge for clinical decision making have not been carefully examined.
  
  
  METHODS
  The leadership of three large professional societies representing critical care practitioners convened a diverse group representing a wide variety of views regarding the role of clinical research results in clinical practice to develop a document to serve as a basis for agreement and a framework for ongoing discussion.
  
  
  RESULTS
  Consensus was reached on several issues. While the results of rigorous clinical research are important in arriving at the best course of action for an individual critically ill patient, other forms of medical knowledge, including clinical experience and pathophysiologic reasoning, remain essential. No single source of knowledge is sufficient to guide clinical decisions, nor does one kind of knowledge always take precedence over others. Clinicians will find clinical research compelling for a variety of reasons that go beyond study design. While clinical practice guidelines and protocols based upon clinical research may improve care and decrease variability in practice, clinicians must be able to understand and articulate the rationale as to why a particular protocol or guideline is used or why an alternative approach is taken. Making this clinical reasoning explicit is necessary to understand practice variability.
  
  
  CONCLUSIONS
  Understanding the strengths and weaknesses of different kinds of medical knowledge for clinical decision making and factors beyond study design that make clinical research compelling to clinicians can provide a framework for understanding the role of clinical research in practice.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Tonelli
authors.forename: J Randall
authors.initials: JR
authors.lastname: Curtis
authors.forename: Kalpalatha K
authors.initials: KK
authors.lastname: Guntupalli
authors.forename: Gordon D
authors.initials: GD
authors.lastname: Rubenfeld
authors.forename: Alejandro C
authors.initials: AC
authors.lastname: Arroliga
authors.forename: Laurent
authors.initials: L
authors.lastname: Brochard
authors.forename: Ivor S
authors.initials: IS
authors.lastname: Douglas
authors.forename: David D
authors.initials: DD
authors.lastname: Gutterman
authors.forename: Jesse R
authors.initials: JR
authors.lastname: Hall
authors.forename: Brian P
authors.initials: BP
authors.lastname: Kavanagh
authors.forename: Jordi
authors.initials: J
authors.lastname: Mancebo
authors.forename: Cheryl J
authors.initials: CJ
authors.lastname: Misak
authors.forename: Steven Q
authors.initials: SQ
authors.lastname: Simpson
authors.forename: Arthur S
authors.initials: AS
authors.lastname: Slutsky
authors.forename: Anthony F
authors.initials: AF
authors.lastname: Suffredini
authors.forename: B Taylor
authors.initials: BT
authors.lastname: Thompson
authors.forename: Lorraine B
authors.initials: LB
authors.lastname: Ware
authors.forename: Arthur P
authors.initials: AP
authors.lastname: Wheeler
authors.forename: Mitchell M
authors.initials: MM
authors.lastname: Levy
mesh_terms: D035843:Biomedical Research; D002985:Clinical Protocols; D003422:Critical Care / Q000379:methods*; D003661:Decision Support Techniques; D019317:Evidence-Based Medicine; D006801:Humans; D051188:Knowledge Bases; D010818:Practice Patterns, Physicians'; D057285:Precision Medicine; D012107:Research Design