The Eldicus prospective, observational study of triage decision making in European intensive care units. Part II: intensive care benefit for the elderly.

Rationale: Life and death triage decisions are made daily by intensive care unit physicians. Admission to an intensive care unit is denied when intensive care unit resources are constrained, especially for the elderly.

Objective: To determine the effect of intensive care unit triage decisions on mortality and intensive care unit benefit, specifically for elderly patients.

The Eldicus prospective, observational study of triage decision making in European intensive care units: part I--European Intensive Care Admission Triage Scores.

Objective: Life and death triage decisions are made daily by intensive care unit physicians. Scoring systems have been developed for prognosticating intensive care unit mortality but none for intensive care unit triage. The objective of this study was to develop an intensive care unit triage decision rule based on 28-day mortality rates of admitted and refused patients.

Exclusion of older people from clinical trials: professional views from nine European countries participating in the PREDICT study.

Background: There has been concern about under-representation of older people in clinical trials. The PREDICT study reported that older people and those with co-morbidity continue to be excluded unjustifiably from clinical trials. However, there is no information about differences of opinion on these issues between EU countries.

The persistent exclusion of older patients from ongoing clinical trials regarding heart failure.

Background: Much clinical research of relevance to elderly patients examines individuals who are younger than those who have the disease in question. A good example is heart failure. Therefore, we investigated the extent of exclusion of older individuals in ongoing clinical trials regarding heart failure.

Implications of ICU triage decisions on patient mortality: a cost-effectiveness analysis.

Introduction: Intensive care is generally regarded as expensive, and as a result beds are limited. This has raised serious questions about rationing when there are insufficient beds for all those referred. However, the evidence for the cost effectiveness of intensive care is weak and the work that does exist usually assumes that those who are not admitted do not survive, which is not always the case.

The Budapest Meeting 2005 intensified networking on ethics of science: the case of reproductive cloning, germline gene therapy and human dignity.

This paper reports on the meeting of the Sounding Board of the EU Reprogenetics Project that was held in Budapest, Hungary, 6-9 November 2005. The Reprogenetics Project runs from 2004 until 2007 and has a brief to study the ethical aspects of human reproductive cloning and germline gene therapy. Discussions during The Budapest Meeting are reported in depth in this paper as well as the initiatives to involve the participating groups and others in ongoing collaborations with the goal of forming an integrated network of European resources in the fields of ethics of science.

SAPS 3--From evaluation of the patient to evaluation of the intensive care unit. Part 1: Objectives, methods and cohort description.

Objective: Risk adjustment systems now in use were developed more than a decade ago and lack prognostic performance. Objective of the SAPS 3 study was to collect data about risk factors and outcomes in a heterogeneous cohort of intensive care unit (ICU) patients, in order to develop a new, improved model for risk adjustment.

Design: Prospective multicentre, multinational cohort study.

SAPS 3--From evaluation of the patient to evaluation of the intensive care unit. Part 2: Development of a prognostic model for hospital mortality at ICU admission.

Objective: To develop a model to assess severity of illness and predict vital status at hospital discharge based on ICU admission data.

Design: Prospective multicentre, multinational cohort study.

Patients And Setting: A total of 16,784 patients consecutively admitted to 303 intensive care units from 14 October to 15 December 2002.

Comparative costing analysis of intensive care services between Hungary and United Kingdom.

Objective: The study presents the findings of the first National Intensive Care Cost Block Analysis in Hungary.

Methods: There were 13 Intensive Care Units (ICUs) involved in this study: 5 University Hospitals, 6 District County Hospitals and 2 City Hospitals. The annual costs of ICUs were measured by "top-down" approach based on Cost Block Method.

Economies of scale in British intensive care units and combined intensive care/high dependency units.

Objective: To estimate the relationship between size of intensive care unit and combined intensive care/high dependency units and average costs per patient day.

Design: Retrospective data analysis. Multiple regression of average costs on critical care unit size, controlling for teaching status, type of unit, occupancy rate and average length of stay.

Nondrug costs of therapy in acute care--are they important?

Drug acquisition costs are only a proportion of the total costs associated with drug therapy. The relevance of these costs are often not appreciated. However, they impact on the Intensive Care Unit via resources and quality of care.