LAUSR

Introduction Critical care has evolved tremendously over the last halfcentury and made it possible for thousands of critically ill patients to survive and recover from life-threatening, complex medical and surgical diseases. Despite this success, most interventions delivered to critically ill patients and most technologies used in critical care have been implemented without proper validation. While this development and implementation strategy may not differ from other areas of medicine or society as whole, its consequences appear clearly in the critical care setting. In critical care, interventions and technologies implemented without proper validation have harmed many patients and resulted in an enormous waste of resources. We know this because research programs led by academic networks with limited or no industry involvement have shown neutral or even harmful effects of standard care monitoring or interventions [1, 2]. The risk of us harming our patients is not trivial. In a systematic review of interventions that was shown to affect mortality in critical care trials [2], half of the interventions increased mortality and several of these interventions were in use in clinical practice at the time of testing.