Table 2.

Challenges for the greater use of long-term and patient-centered outcomes in intensive care

Implementation challenges	Comment
Loss of follow-up	Long follow-up periods may result in large losses to follow-up (due to death or sequela).
Selection bias	More severe patients may become inaccessible over time due to death or severe sequelae, resulting in a population different from that representative of the post-ICU reality.
Memory bias	Long-term follow-up may favor the occurrence of memory bias regarding relevant outcomes, especially if the interval between follow-ups is long.
Confusion bias	Long-term outcomes can be determined by events subsequent to those studied.
Patient-centered outcomes
The limited inclusion of patients and relatives in the determination of relevant outcomes	There is a gap in the importance of outcomes between patients (and their families) and researchers/health professionals.
Lack of consensus on the health domains evaluated	The lack of consensus among researchers regarding a minimum set of health domains evaluated contributes to the lack of uniformity of publications and a delay in the evolution of knowledge on the subject
High heterogeneity of assessment instruments	The lack of uniformity of measurement instruments can make it difficult to summarize the evidence in meta-analyses, for example