Table 3.

Clinical vignette based studies of ICU decision making.

Paper	Type of research	Study population	Aims	Outcomes	Limitations	Category
23	Vignette-based questionnaire survey to intensivists and non-intensivists	21 intensivists and 22 internists completed five vignettes	Opinions over benefit of ICU admissions of critically ill medical inpatients differed based on physician specialty, namely intensivists and internists	Physician specialty base did not affect assessments of ICU admission benefit or accuracy in outcome prediction but resulted in a statistically significant difference in level of care assignments. A significant disagreement amongst individuals in each group was found	Canadian, small sample, single centre, ?clear cut vignettes	Scenario-based study
8	Observational, simulation study of physician decisions in patients’ admissions	100 physicians given simulated patient cases	To assess decision-making in admitting patients to ITU	Low agreement in decision-making, varies greatly for bed space availability and patient choices		Scenario-based study
24	Scenario-based survey of differences between Australian CrCU doctors and New Zealand CrCU doctors	Scenario-based survey of 238 Australian/New Zealand doctors	To assess differences in admission policies	New Zealand doctors have more selective views of what constitutes an appropriate admission to intensive care. But views vary massively within each group	Australian/New Zealand no generalised applicability	Scenario-based study
19	National questionnaire survey using eight clinical vignettes involving hypothetical patients	To assess what factors influence doctors’ decisions about admission to intensive care	232 Swiss doctors specialising in intensive care	In the vignettes factors associated with admission were patients’ wishes, ‘upbeat’ personality, younger age and a greater number of beds. Correlations between decisions on admission were very weak	Swiss	Decision-making in admission, scenario-based study
25	Hypothetical case scenario-based questionnaire	To assess the importance of age as a factor in admission decisions		When age was the only difference between two patients in a hypothetical case scenario, 80.7% of respondents chose the younger patient (age 56 years) for admission and 13.2% chose the older patient (age 82 years). Following the provision of more detailed medical and social information, however, only 53.5% chose the younger patient and 41.2% chose the older patient.		Decision-making in admission, scenario-based study

CrCU: critical care unit; DNR: do not resuscitate; ITU: intensive therapy unit.