Dear Colleague,
My name is A/Prof Ashwin Subramaniam. I am an intensive care specialist at Dandenong Hospital, Monash Health, and I am writing on behalf of a multidisciplinary investigator group to invite you to participate in a Delphi consensus study titled “Defining Best Practice for Very Old Patients with Frailty following Unplanned Intensive Care Admission: A Delphi Consensus Study”.
Short title: “Consensus-Based Best Practice for Very Old Patients following Unplanned ICU Admission”
Lead Investigator: A/Prof Ashwin Subramaniam
Associate Investigators: Ryan Ruiyang Ling, Sumeet Rai, Rachael Lim, Velandai Srikanth, Daryl Jones, Imogen Mitchell, Melissa Bloomer, Rand Butcher, Krish Sundararajan, Thomas Rollinson, Alex Psirides, Sushma Ashwin, Justin Oakley, Michael Beil, Christian Jung, Susannah Leaver, Hans Flaatten, Kollengode Ramanathan, Manoj Saxena, Michael Bailey, and David Pilcher.
This multi-round Delphi study aims to develop expert consensus on the triage, assessment and management of very old patients (aged 80 years and older) with critical illness. The study is supported by the Australian and New Zealand Intensive Care Society Clinical Trial Group (CTG), the Australian College of Critical Care Nursing (ACCCN), and the European Society of Intensive Care Medicine (ESICM).
Patients aged 80 years and older represent the fastest-growing population admitted to intensive care units (ICUs) in Australia and New Zealand. Given the limited high-quality evidence to guide the management of very old patients admitted unexpectedly to the ICU, expert consensus provides an important means of integrating current knowledge into pragmatic, clinically relevant recommendations.
You have been identified as part of a multidisciplinary panel of experts invited to provide opinions across the continuum of care, from ICU admission decisions through to the management of ICU survivors. Each Delphi round is completed independently over a 4-6 week period. Before subsequent rounds, you will receive anonymised summaries of group responses and be asked to reconsider your views in light of these data, supporting convergence toward consensus. This Round 1 survey will take approximately 20 minutes to complete. The statements presented reflect the steering group’s intent to develop best-practice recommendations while recognising variation across healthcare systems and jurisdictions. The term “should” is used to acknowledge that local resource constraints or system-level factors may influence implementation. You will have the opportunity to comment on the feasibility and contextual limitations of each statement.
In the first round, you will be asked to provide information about your professional background and any potential conflicts of interest, as well as optional demographic details. You are also encouraged to provide anonymised feedback on the clarity and content of individual statements to inform refinement in later rounds. At the end of the survey, you will be invited to nominate colleagues from your own and other disciplines who may also be suitable to participate.
Participation is voluntary. By participating, you consent to the use of aggregated study results for publication. There is no monetary compensation; however, all participants who participate in more than 1 round will be acknowledged in the final manuscript as Delphi Panel Members.
On behalf of my co-authors, I would be extremely grateful for your participation and support.
Please click “Next” to continue.
Sincerely,
A/Prof Ashwin Subramaniam
Intensive Care Specialist
Dandenong Hospital, Monash Health