Studying outcomes of intensive care unit survivors: Measuring exposures and outcomes

Dale M. Needham, David W. Dowdy, Pedro A. Mendez-Tellez, Margaret S. Herridge, Peter J. Pronovost

Research output: Contribution to journalReview article

Abstract

Background: Measurement of long-term outcomes and the patient and intensive care unit (ICU) factors predicting them present investigators with unique challenges. There is little systematic guidance for measuring these outcomes and exposures within the ICU setting. As a result measurement methods are often variable and noncomparable across studies. Methods: We use examples from the critical care literature to describe measurement as it relates to three key elements of clinical studies: subjects, outcomes and exposures, and time. Using this framework we review the principles and challenges of measurement and make recommendations for long-term outcomes research in the field of critical care medicine. Discussion: Relevant challenges discussed include: (a) selection bias and heterogeneity of ICU research subjects, (b) appropriate selection and measurement of outcome and exposure variables, and (c) accounting for the effect of time in the exposure-outcome relationship, including measurement of baseline data and time-varying variables. Conclusions: Addressing these methodological challenges will advance research aimed at improving the long-term outcomes of ICU survivors.

Original languageEnglish (US)
Pages (from-to)1153-1160
Number of pages8
JournalIntensive Care Medicine
Volume31
Issue number9
DOIs
StatePublished - Sep 1 2005

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Keywords

  • Epidemiological methods
  • Outcome assessment (health care)
  • Process assessment (health care)
  • Prospective studies
  • Respiratory distress syndrome, adult
  • Risk factors

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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