Wise Choices in the Intensive Care Unit: A Cluster Randomized Registry-Based Clinical Trial to Assess Diagnostic Test Reduction in ICU Care

What this Trial Is About

Researchers are evaluating the introduction of the Choosing Wisely campaign in intensive care units (ICUs) to determine if it can be used without harming critically ill patients. This campaign aims to reduce unnecessary diagnostic testing, which is common in ICUs and contributes to high healthcare costs. The study focuses on adult patients treated in Swedish ICUs and assesses whether this new care strategy affects 30-day mortality and other important clinical outcomes. The study compares two groups: one following the Choosing Wisely protocol, which minimizes the number of arterial blood gases, venous tests, and chest x-rays, and the other receiving regular ICU care without this protocol. It is a registry-based cluster randomized controlled trial involving multiple Swedish ICUs. The study phases include a control period and an intervention period, with monitoring of diagnostic test use during both phases. Participants' outcomes will be tracked using the Swedish Intensive Care Register, focusing on 30-day mortality as the primary outcome. Secondary outcomes include ICU length of stay, time on invasive and non-invasive mechanical ventilation, time on continuous renal replacement therapy, and unplanned ICU readmissions within 72 hours. Data collection for outcomes may extend up to one year after ICU admission, allowing comprehensive monitoring of patient safety and resource use.

Wise Choices in the Intensive Care Unit