Jeremy Groves, ICS Council Member, took the opportunity to attend the Society’s Foundation Board and Research Committee meetings in January and looks at the Society’s contribution and commitment to UK Critical Care Research.
I’ve always been a believer in evidence based medicine. However, in day to day practice one hears lots of opinion about best practice but, as fallible humans, much of what we believe is not born out by the facts.
I may be wrong but as a rule intensivists like shiny, complex machines. Our speciality after all emerged from improvements in ventilator technology. This desire for the esoteric can compete with our rational thinking about what works, and what doesn’t. I recall during the H1N1 influenza outbreak hearing a call for increased access to oscillatory ventilation. The mode, the proponents enthused, dramatically improved outcome. I was uncomfortable with this as the OSCAR trial (of machines, not of Pistorius) was still in progress. When OSCAR, and the parallel OSCILLATE trials reported in 2013, OSCAR showed no difference in mortality at one month and OSCILLATE an increased mortality in ARDS patients. It reinforced my bias for evidence over opinion. A triumph for research.
OSCAR showed no difference in mortality at one month and OSCILLATE an increased mortality in ARDS patients. It reinforced my bias for evidence over opinion
We’re in a similar position with the REST trial at the moment. Does extracorporeal carbon dioxide removal result in a reduction in mortality? Like OSCAR it involves a fancy piece of kit. We as clinicians love that, and so do the relatives according to Richard Innes, whose unit in Musgrove Park Hospital in Taunton is participating in the trial. However, just because it’s a fancy ‘scientific machine’ doesn’t necessarily mean it does any good. There are important questions to be answered.
Getting trials such as OSCAR and REST off the ground require ideas, enthusiasm and money. Our members are central to all these components.. The Society has played, and continues to play, a major role in forwarding the UK Critical Care research agenda. Indeed, if you look at the articles of association, research is one of the Intensive Care Society’s raison d’être. Many members support this aspect of the Society’s functions through generous donations to the Intensive Care Foundation, the Society’s research branch.
Many members support this aspect (research) of the Society’s functions through generous donations to the Intensive Care Foundation
I took the opportunity in January to sit in on the Society’s Research Committee and Foundation Board meetings. I was enthused and heartened by who was there and what I heard. First and foremost I couldn’t believe the number of studies we’re supporting (some listed below), particularly at an early stage. It does this through its Directors of Research, by giving them the time to develop and move ideas through the system, such as ADAPT-Sepsis, being run by Paul Dark, looking at guiding the duration of antibiotic therapy in sepsis using common biomarkers. Then there are the new investigator awards to encourage the new generation of researchers.
Funding major studies requires bucket loads of cash, as an example the REST trial is costing £2,113,673.00, and the Society’s Foundation doesn’t have this sort of money. Other funding bodies do. The money that bodies such as the National Institute for Health Research and the Welcome Foundation possess is spent very carefully and the support of the profession, which is demonstrated by the Society supporting the researchers, plays a major role in influencing their decision making processes. Its something we need to continue to do, and ideally expand.
To this end the Society is looking to improve it’s communication about it’s role in UK critical care research. The Society’s Foundation and research committees will be looking to produce a more regular update on their activities. There is also a desire to raise more money for research both from industry and the public. To achieve this, in addition to fund raising initiatives such as ‘Air for Sale’, we are looking to put information about the Society’s Foundation, and how to donate money to it, into relatives areas in our critical care units. We hope you will feel able to support these initiatives.
More information about the Society’s Foundation and it’s research activities can be found on our website at http://www.ics.ac.uk/ICS/The_Foundation/ICS/research.aspx.