Table 4.

Survey or interview based studies of ICU decision making.

Paper	Type of research	Study population	Aims	Outcomes	Limitations	Category
26	Combined observation and interviews with critical care physicians	30 Critical care doctors managing 71 referrals and conducted 10 interviews with senior decision-makers in a UK hospital	Explore the themes in accepting intensivists’ decision-making	Patient, physician and contextual factors strongly shaped the decision to transfer the patient to critical care. There were no absolute patient indications or contraindications for transfer to critical care. Instead, sets of relative indications and contraindications for admission were ‘summed’, with the overall balance swaying the eventual outcome	Qualitative research	Accepting admission decision-making
27	Survey-based study of ITU doctors in 20 ITUs in Milan	225 Doctors from 20 ITUs in Milan responded to the survey	To assess physicians’ perceptions and attitudes regarding inappropriate admissions and resource allocation in the intensive care setting	Inappropriate admissions were acknowledged by 86% of respondents. The reasons given were clinical doubt (33%); limited decision time (32%); assessment error (25%); pressure from superiors (13%), referring clinician (11%) or family (5%); threat of legal action (5%) and an economically advantageous ‘Diagnosis Related Group’ (1%)	Italian	Decision-making admission
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	Most rated as important or very important the prognosis of the underlying disease and of the acute illness and the patients’ wishes. Few considered important the socioeconomic circumstances of the patients’ religious beliefs and emotional state		Admission criteria objective and subjective
25	Hypothetical case scenario-based questionnaire	To assess the importance of age as a factor in admission decisions		In a ranking of several admission factors, age was found to be of less importance than severity of presenting illness, previous medical history and DNR status but of more importance than patient motivation, ability to contribute to society, family support and ability to pay for care		Age questionnaire

DNR: do not resuscitate; ITU: intensive therapy unit.