Seppelt ranges over a year of fraudulent behaviour, reviews, and news in intensive care.

1. “Less is More”
Advances in Intensive Care in
2012
Dr Ian Seppelt
Dept of Intensive Care Medicine, Nepean
Hospital,
and George Institute for Global Health,

2. A personal view of 2012
1. New intensive care literature and
publications
2. New approaches to research
methodology
3. New advances in (lack of) research
ethics

3. A personal view of 2012
1. New intensive care literature and
publications
2. New approaches to research
methodology
3. New advances in (lack of) research
ethics
Less is more –
Don’t just do something, stand there!

4. A personal view of 2012
1. New intensive care literature and
publications
2. New approaches to research
methodology
3. New advances in (lack of) research
ethics
Less is more –
Don’t just do something, stand there!
Law 13: The delivery of good medical care is to do as much Nothing
as possible
– The Fat Man

5. Perner: New Engl J Med 2012

6. Perner: New Engl J Med 2012

7. Perner: New Engl J Med 2012

8. Perner: New Engl J Med 2012

11. Updated systematic review: mortality
Gattas: Under review

12. Updated systematic review: RRT
Gattas: Under review

19. `

20. `

21. Research Fraud - Joachim Boldt
German Medical Board Issues Sweeping Findings in
Boldt Case
Ninety studies implicated in probe, might require
retraction
by Adam Marcus
Unglaublich is the German word for unbelievable, and
it's an apt description for the latest development in the
case of Joachim Boldt, MD, PhD. Dr. Boldt, a
prominent German anesthesiologist, has been at the
center of a research and publishing scandal since last
October, when the journal Anesthesia & Analgesia
retracted a 2009 article of his over concerns of data
manipulation.

22. 2012 – A new record

23. 2012 – A new record

24. 2012 – A new record

25. 2012 – A new record
The top 4 clinical
research frauds are all
anaesthetists, intensivists
or perioperative
physicians

26. 2012 – A new record
The top 4 clinical
research frauds are all
anaesthetists, intensivists
or perioperative
physicians

27. 2012 – A new record
The top 4 clinical
research frauds are all
anaesthetists, intensivists
or perioperative
physicians
1. YoshitakaFuji

28. Research Integrity

29. Research Integrity

30. Research Integrity
1. CHEST
– Prespecified and
published protocol and
statistical analysis plan
– Should now be
standard

31. Research Integrity
1. CHEST
– Prespecified and
published protocol and
statistical analysis plan
– Should now be
standard
2. 6S
– Writing committee
blinded until after
results section and

32. Research Integrity
1. CHEST
– Prespecified and
published protocol and
statistical analysis plan
– Should now be
standard
2. 6S
– Writing committee
blinded until after
results section and

33. Research Integrity
1. CHEST
– Prespecified and
published protocol and
statistical analysis plan
– Should now be
standard
2. 6S
– Writing committee
blinded until after
results section and

34. Where next? Choice of fluid?

35. Where next? Choice of fluid?

36. NHMRC funding announced Oct 18th, 2012 $2,384,173.35
Where next? Fluid restriction?

38. ARDS

39. ARDS

41. Results

42. Results

45. Nutrition in ICU

46. Nutrition in ICU
1.Core business of critical medicine

47. Nutrition in ICU
1.Core business of critical medicine
2.We consistently deliver 2/3 of (prescribed)
target nutrition in first few days, up to
80-90% by a week
– Are we just no good at it?
– Or does it matter?

48. Nutrition in ICU
1.Core business of critical medicine
2.We consistently deliver 2/3 of (prescribed)
target nutrition in first few days, up to
80-90% by a week
– Are we just no good at it?
– Or does it matter?
3.Targets of nutrition have never been
validated in the critically ill
– Anorexia and catabolism is a normal adaptive
stress response
– Schofield and Harris-Benedict purely empirical
guesswork
– Even calorimetry gives an energy consumption

49. Nutrition in ICU

50. Nutrition in ICU

51. Nutrition in ICU

52. Nutrition in ICU

53. Nutrition – are the endpoints all
wrong?

54. Nutrition – are the endpoints all
wrong?

55. Nutrition – are the endpoints all
wrong?

56. Nutrition – are the endpoints all
wrong?

57. Traumatic Brain Injury

58. Imaging and
clinical
examination

59. Emerging infectious diseases

60. Emerging infectious diseases

61. Emerging infectious diseases

62. Novel research responses

63. Novel research responses

64. Novel research responses

65. seppelt@med.usyd.edu.au
Questions
?