Critical care research: Which outcomes matter? Results of a national survey

Mortality has traditionally served as a primary endpoint in clinical trials. However, advancements in treatments and standard care have resulted in notable reductions in mortality rates. Consequently, detecting differences in mortality between interventions has become more challenging and often requires larger sample sizes. As a result, alternative endpoints have been proposed, such as Ventilator-Free Days (VFDs), although these are characterised by inconsistent definitions. Further development of other patient-reported outcome measures (PROMs), including assessments of quality of life and survival without sequelae, is warranted, as these may be more meaningful to patients. The survey aimed to characterise how intensivists perceive and use outcome measures in critical respiratory care research.

An anonymous electronic survey was distributed through two French intensive care society websites, enabling members to share their views; no individual email invitations were sent.

A total of 267 participants completed the survey. Variability in VFDs definitions raised concerns about their use in clinical trials. Several respondents struggled to interpret recent outcomes, such as the win ratio and its effect sizes. It was ultimately agreed that additional PROMs-such as communication ability and the absence of sequelae at discharge-should be incorporated. Finally, three respondent clusters were identified, all of which recognised the importance of PROMs.

While French critical care physicians tend to have a clearer understanding of VFD's definition, various alternative outcomes were also recognised. There was a consensus among respondents on the importance of further developing PROMs in clinical research.