ICU Admission Preferences in the Hypothetical Event of Acute Critical Illness: A Survey of Very Old Norwegians and Their Next-of-Kins
Bibliographic record
Abstract
OBJECTIVES: To explore older patients' ICU admission preferences and their next-of-kins' ability to predict these preferences. DESIGN: Self-administered survey. SETTING: Three outpatient clinics, urban tertiary teaching hospital, Norway. PATIENTS: Purposive sample of outpatients 80 years old or older regarded as potential ICU candidates and their next-of-kins. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We asked about the patients' ICU admission preferences in three hypothetical scenarios of acute critical illness. Next-of-kin respondents were asked to make a proxy statement regarding the older respondents' wishes regarding ICU admission. For each treatment choice, all respondents could provide their level of confidence. Additionally, we sought to identify demographic and healthcare-related characteristics that potentially influenced ICU admission preferences and proxy accuracy. Of 202 outpatients 80 years old or older, equal proportions opted for (39%; CI, 33-45%) and against (40%; CI, 34-46%) ICU admission, and one in five (21%; CI, 17-26%) did not wish to engage decision-making. Male gender, religiosity, and prior ICU experience increased the likelihood of older respondents opting for ICU admission. Although next-of-kins' proxy statements only weakly agreed with the older respondents' true ICU admission preferences (52%; CI, 45-59%), they agreed with the next-of-kins' own ICU admission preferences (79%; CI, 73-84%) to a significantly higher degree. Decisional confidence was high for both the older and the next-of-kin respondents. CONCLUSIONS: In this purposive sample of Norwegian potential ICU candidates 80 years old or older, we found substantial variation in the ICU admission preferences of very old patients. The next-of-kins' proxy statements did not align with the ICU admission preferences of the older respondents in half of the pairs, but next-of-kins' and older respondents' confidence levels in rendering these judgments were high.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".