Table 5.

Studies investigating decision making by referring non intensivists.

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	Referring and accepting
5	Prospective, observational cohort study of lung cancer inpatients with organ failure	140 Lung cancer patients with organ failure	To investigate factors associated with ITU admission in this population	Factors independently associated with ICU referral were performance status, nonprogressive malignancy and no explicit refusal of ICU admission by the patient and/or family. Factors independently associated with ICU admission were the initial ward being other than the lung cancer unit and an available medical ICU bed		Referral and admission criteria objective
28	Prospective, observational cohort study of patients aged ≥80 years who were triaged in the emergency room, with at least one independent criteria suggesting ITU admission could be useful	Decisions for ITU admission for a total of 2646 Patients aged ≥80 years with at least one criterion in French hospitals	To describe ICU referral decisions by emergency room physicians in patients aged ≥80 years	Factors associated independently with no ICU referral were age, active cancer, unknown hospitalization status, unknown living arrangements, regular psychotropic medications, low severity, low activity in daily living score, emergency and ICU physicians were extremely reluctant to consider ICU admission of patients aged >80 years, despite the presence of criteria indicating that ICU admission was certainly appropriate.	French	Referral admission criteria objective, age

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