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Highly Accessed Editorial

Critical care resource allocation: trying to PREEDICCT outcomes without a crystal ball

Michael D Christian1*, Robert Fowler2, Matthew P Muller3, Charles Gomersall4, Charles L Sprung5, Nathaniel Hupert6, David Fisman7, Andrew Tillyard8, David Zygun9, John C Marshal10 and PREEDICCT Study Group

Author Affiliations

1 Department of Critical Care, Mount Sinai Hospital Toronto, 600 University Avenue, Room 18-232-1, Toronto, Ontario, Canada, M5G 1X5

2 Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Room D4 78, Toronto, Ontario, Canada, M4N 3M5

3 Infection Prevention and Control, St Michael's Hospital, 30 Bond Street, Toronto, Ontario, Canada, M5B 1W8

4 Department of Anaesthesia and Intensive Care, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, NT Hong Kong SAR

5 General Intensive Care Unit, Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, PO Box 12000, Jerusalem, Israel 91120

6 Weill Cornell Medical College, 1300 York Avenue, New York, NY 10065, USA

7 Hospital for Sick Children Research Institute, 123 Edward St, Room 428, Toronto, Ontario, Canada, M5G 1E6

8 Peninsula Medical School, Consultant Critical Care Medicine, Royal Cornwall Hospital, Treliske, Truro, Cornwall, TR1 3LJ, UK

9 Critical Care Medicine, 3C1.12 Walter Mackenzie Centre, 8440 - 112 Street, Edmonton, Alberta, Canada T6G 2B7

10 St Michael's Hospital, 30 Bond Street , Bond 4-014, Toronto , Ontario, Canada, M5B 1W8

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Critical Care 2013, 17:107  doi:10.1186/cc11842

Published: 23 January 2013

First paragraph (this article has no abstract)

Despite pandemic influenza's long reign atop the list of potential medical catastrophes, the first protocol designed to support critical care triage in a pandemic was published only in 2006 [1]. Additional protocols followed, in attempts to address the goal of developing standardized, transparent and equitable tools for allocating critical care resources to those patients most likely to benefit [2-7]. Most of these protocols used the Sequential Organ Failure Assessment score as the quantitative underpinning for triage decision-making due to its ease of use. These protocols have been shown to generally direct resources to those most likely to benefit [8], in addition to making resources available for surge patients [9]. However, the Sequential Organ Failure Assessment score does not always differentiate well between survivors and nonsurvivors of critical illness for some patient populations [10,11].