{"id":"https://openalex.org/W7224134108","doi":"https://doi.org/10.3389/fmed.2026.1922086","title":"Development of an HFACS-based risk assessment indicator system for unplanned endotracheal extubation in adult ICU patients: a Delphi and AHP study","display_name":"Development of an HFACS-based risk assessment indicator system for unplanned endotracheal extubation in adult ICU patients: a Delphi and AHP study","publication_year":2026,"publication_date":"2026-10-28","ids":{"openalex":"https://openalex.org/W7224134108","doi":"https://doi.org/10.3389/fmed.2026.1922086"},"language":"en","primary_location":{"id":"doi:10.3389/fmed.2026.1922086","doi":"https://doi.org/10.3389/fmed.2026.1922086","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fmed.2026.1922086","pdf_url":"https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2026.1922086/pdf","source":{"id":"https://openalex.org/S2597052008","display_name":"Frontiers in Medicine","issn_l":"2296-858X","issn":["2296-858X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","norway-1","poland-70","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Medicine","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2026.1922086/pdf","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5123122385","display_name":"\u738b\u7fe0\u96ea","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210087691","display_name":"Beijing Tian Tan Hospital","ror":"https://ror.org/003regz62","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210087691"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Cuixue Wang","raw_affiliation_strings":["Department of Critical Care Medicine, Beijing Tiantan Hospital of Capital Medical University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Critical Care Medicine, Beijing Tiantan Hospital of Capital Medical University","institution_ids":["https://openalex.org/I4210087691"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5079069357","display_name":"Wei Cao","orcid":"https://orcid.org/0000-0003-1481-6310","observed_orcids":["https://orcid.org/0000-0003-1481-6310"]},"institutions":[{"id":"https://openalex.org/I4210087691","display_name":"Beijing Tian Tan Hospital","ror":"https://ror.org/003regz62","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210087691"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Wei Cao","raw_affiliation_strings":["Department of Critical Care Medicine, Beijing Tiantan Hospital of Capital Medical University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Critical Care Medicine, Beijing Tiantan Hospital of Capital Medical University","institution_ids":["https://openalex.org/I4210087691"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5160005772","display_name":"Yuan Yuan","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210087691","display_name":"Beijing Tian Tan Hospital","ror":"https://ror.org/003regz62","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210087691"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Yuan Yuan","raw_affiliation_strings":["Department of Critical Care Medicine, Beijing Tiantan Hospital of Capital Medical University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Critical Care Medicine, Beijing Tiantan Hospital of Capital Medical University","institution_ids":["https://openalex.org/I4210087691"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5160034403","display_name":"Jing Li","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210087691","display_name":"Beijing Tian Tan Hospital","ror":"https://ror.org/003regz62","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210087691"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Jing Li","raw_affiliation_strings":["Nursing Department, Beijing Tiantan Hospital of Capital Medical University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Nursing Department, Beijing Tiantan Hospital of Capital Medical University","institution_ids":["https://openalex.org/I4210087691"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5102211790","display_name":"Yana Xing","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210087691","display_name":"Beijing Tian Tan Hospital","ror":"https://ror.org/003regz62","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210087691"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Yana Xing","raw_affiliation_strings":["Department of Critical Care Medicine, Beijing Tiantan Hospital of Capital Medical University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Critical Care Medicine, Beijing Tiantan Hospital of Capital Medical University","institution_ids":["https://openalex.org/I4210087691"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5160006819","display_name":"Xiaozhe Hu","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210087691","display_name":"Beijing Tian Tan Hospital","ror":"https://ror.org/003regz62","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210087691"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Xiaozhe Hu","raw_affiliation_strings":["Department of Critical Care Medicine, Beijing Tiantan Hospital of Capital Medical University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Critical Care Medicine, Beijing Tiantan Hospital of Capital Medical University","institution_ids":["https://openalex.org/I4210087691"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5136803414","display_name":"Ran Zhang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210087691","display_name":"Beijing Tian Tan Hospital","ror":"https://ror.org/003regz62","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210087691"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Ran Zhang","raw_affiliation_strings":["Nursing Department, Beijing Tiantan Hospital of Capital Medical University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Nursing Department, Beijing Tiantan Hospital of Capital Medical University","institution_ids":["https://openalex.org/I4210087691"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5079069357"],"corresponding_institution_ids":["https://openalex.org/I4210087691"],"apc_list":{"value":3150,"currency":"CHF","value_usd":3801},"apc_paid":{"value":3150,"currency":"CHF","value_usd":3801},"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.86193368,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"13","issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10508","display_name":"Patient Safety and Medication Errors","score":0.9911999702453613,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10508","display_name":"Patient Safety and Medication Errors","score":0.9911999702453613,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12871","display_name":"Healthcare Quality and Management","score":0.0013000000035390258,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12443","display_name":"Delphi Technique in Research","score":0.000699999975040555,"subfield":{"id":"https://openalex.org/subfields/3312","display_name":"Sociology and Political Science"},"field":{"id":"https://openalex.org/fields/33","display_name":"Social Sciences"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/hfacs","display_name":"HFACS","score":0.7960000038146973},{"id":"https://openalex.org/keywords/risk-assessment-indicators","display_name":"risk assessment indicators","score":0.9139999747276306},{"id":"https://openalex.org/keywords/patient-safety","display_name":"patient safety","score":0.5210000276565552},{"id":"https://openalex.org/keywords/root-cause-analysis","display_name":"root cause analysis","score":0.7409999966621399},{"id":"https://openalex.org/keywords/safety-audits","display_name":"safety audits","score":0.8489999771118164},{"id":"https://openalex.org/keywords/unsafe-acts","display_name":"unsafe acts","score":0.46700000762939453},{"id":"https://openalex.org/keywords/inadequate-supervision","display_name":"inadequate supervision","score":0.9079999923706055},{"id":"https://openalex.org/keywords/organizational-impact","display_name":"organizational impact","score":0.9599999785423279},{"id":"https://openalex.org/keywords/indicator-weighting","display_name":"indicator weighting","score":0.49900001287460327},{"id":"https://openalex.org/keywords/delphi-consensus","display_name":"Delphi consensus","score":0.5899999737739563},{"id":"https://openalex.org/keywords/analytic-hierarchy-process","display_name":"analytic hierarchy process","score":0.8100000023841858}],"concepts":[{"id":"https://openalex.org/C60641444","wikidata":"https://www.wikidata.org/wiki/Q841602","display_name":"Delphi method","level":2,"score":0.7731000185012817},{"id":"https://openalex.org/C87345402","wikidata":"https://www.wikidata.org/wiki/Q485202","display_name":"Analytic hierarchy process","level":2,"score":0.6263999938964844},{"id":"https://openalex.org/C2779495148","wikidata":"https://www.wikidata.org/wiki/Q487378","display_name":"Delphi","level":2,"score":0.6136999726295471},{"id":"https://openalex.org/C58916136","wikidata":"https://www.wikidata.org/wiki/Q1663508","display_name":"Content validity","level":3,"score":0.6015999913215637},{"id":"https://openalex.org/C12174686","wikidata":"https://www.wikidata.org/wiki/Q1058438","display_name":"Risk assessment","level":2,"score":0.5591999888420105},{"id":"https://openalex.org/C160798450","wikidata":"https://www.wikidata.org/wiki/Q4230870","display_name":"Concordance","level":2,"score":0.53329998254776},{"id":"https://openalex.org/C199521495","wikidata":"https://www.wikidata.org/wiki/Q181487","display_name":"Audit","level":2,"score":0.499099999666214},{"id":"https://openalex.org/C2779328685","wikidata":"https://www.wikidata.org/wiki/Q1475557","display_name":"Patient safety","level":3,"score":0.49079999327659607},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.4406000077724457},{"id":"https://openalex.org/C43214815","wikidata":"https://www.wikidata.org/wiki/Q7310987","display_name":"Reliability (semiconductor)","level":3,"score":0.43630000948905945},{"id":"https://openalex.org/C31170391","wikidata":"https://www.wikidata.org/wiki/Q188619","display_name":"Hierarchy","level":2,"score":0.42660000920295715},{"id":"https://openalex.org/C21547014","wikidata":"https://www.wikidata.org/wiki/Q1423657","display_name":"Operations management","level":1,"score":0.39329999685287476},{"id":"https://openalex.org/C112930515","wikidata":"https://www.wikidata.org/wiki/Q4389547","display_name":"Risk analysis (engineering)","level":1,"score":0.3718000054359436},{"id":"https://openalex.org/C32896092","wikidata":"https://www.wikidata.org/wiki/Q189447","display_name":"Risk management","level":2,"score":0.3637000024318695},{"id":"https://openalex.org/C49453240","wikidata":"https://www.wikidata.org/wiki/Q1592163","display_name":"Construct validity","level":3,"score":0.3626999855041504},{"id":"https://openalex.org/C3020580240","wikidata":"https://www.wikidata.org/wiki/Q663272","display_name":"Expert opinion","level":2,"score":0.3582000136375427},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.35179999470710754},{"id":"https://openalex.org/C20685875","wikidata":"https://www.wikidata.org/wiki/Q7239678","display_name":"Predictive validity","level":2,"score":0.3328999876976013},{"id":"https://openalex.org/C2780801425","wikidata":"https://www.wikidata.org/wiki/Q5164392","display_name":"Construct (python library)","level":2,"score":0.313400000333786},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.310699999332428},{"id":"https://openalex.org/C70364389","wikidata":"https://www.wikidata.org/wiki/Q18757","display_name":"Validity","level":3,"score":0.3028999865055084},{"id":"https://openalex.org/C200601418","wikidata":"https://www.wikidata.org/wiki/Q2193887","display_name":"Reliability engineering","level":1,"score":0.3009999990463257},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.29989999532699585},{"id":"https://openalex.org/C162446236","wikidata":"https://www.wikidata.org/wiki/Q653137","display_name":"Content analysis","level":2,"score":0.29089999198913574},{"id":"https://openalex.org/C135510737","wikidata":"https://www.wikidata.org/wiki/Q860554","display_name":"Performance indicator","level":2,"score":0.2833999991416931},{"id":"https://openalex.org/C150241267","wikidata":"https://www.wikidata.org/wiki/Q7336285","display_name":"Risk management tools","level":3,"score":0.27399998903274536},{"id":"https://openalex.org/C58328972","wikidata":"https://www.wikidata.org/wiki/Q184609","display_name":"Expert system","level":2,"score":0.27239999175071716},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.2694999873638153},{"id":"https://openalex.org/C2777267654","wikidata":"https://www.wikidata.org/wiki/Q3519023","display_name":"Test (biology)","level":2,"score":0.25679999589920044}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.3389/fmed.2026.1922086","doi":"https://doi.org/10.3389/fmed.2026.1922086","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fmed.2026.1922086","pdf_url":"https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2026.1922086/pdf","source":{"id":"https://openalex.org/S2597052008","display_name":"Frontiers in Medicine","issn_l":"2296-858X","issn":["2296-858X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","norway-1","poland-70","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Medicine","raw_type":"journal-article"},{"id":"pmh:oai:doaj.org/article:a235280066fe4ee19597022c31976a9a","doi":null,"is_oa":false,"landing_page_url":"https://doaj.org/article/a235280066fe4ee19597022c31976a9a","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Frontiers in Medicine, Vol 13 (2026)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.3389/fmed.2026.1922086","doi":"https://doi.org/10.3389/fmed.2026.1922086","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fmed.2026.1922086","pdf_url":"https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2026.1922086/pdf","source":{"id":"https://openalex.org/S2597052008","display_name":"Frontiers in Medicine","issn_l":"2296-858X","issn":["2296-858X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","norway-1","poland-70","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Medicine","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":0.98580002784729,"display_name":"Good health and well-being"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7224134108.pdf","grobid_xml":"https://content.openalex.org/works/W7224134108.grobid-xml"},"referenced_works_count":38,"referenced_works":["https://openalex.org/W1480935765","https://openalex.org/W1768073071","https://openalex.org/W1980123919","https://openalex.org/W2021745111","https://openalex.org/W2024581654","https://openalex.org/W2056239965","https://openalex.org/W2073575422","https://openalex.org/W2107508861","https://openalex.org/W2144049007","https://openalex.org/W2189958402","https://openalex.org/W2197568292","https://openalex.org/W2329583823","https://openalex.org/W2539880441","https://openalex.org/W2724418875","https://openalex.org/W2745086080","https://openalex.org/W2778326186","https://openalex.org/W2797437823","https://openalex.org/W2885896746","https://openalex.org/W2902848870","https://openalex.org/W2918369002","https://openalex.org/W2921631183","https://openalex.org/W2951847552","https://openalex.org/W2954982714","https://openalex.org/W3006405313","https://openalex.org/W3016169868","https://openalex.org/W3093450586","https://openalex.org/W3168012077","https://openalex.org/W4214854985","https://openalex.org/W4281652138","https://openalex.org/W4293281170","https://openalex.org/W4399805488","https://openalex.org/W4399974306","https://openalex.org/W4400663895","https://openalex.org/W4408787149","https://openalex.org/W4409225886","https://openalex.org/W4412071956","https://openalex.org/W4414552795","https://openalex.org/W7203536052"],"related_works":["https://openalex.org/W3130719244","https://openalex.org/W7124408379","https://openalex.org/W4389732463","https://openalex.org/W2390871567","https://openalex.org/W7135025355","https://openalex.org/W7140387578","https://openalex.org/W4225275130","https://openalex.org/W7223158778","https://openalex.org/W4402695084","https://openalex.org/W7160362136"],"abstract_inverted_index":{"Objective":[0],"To":[1],"construct":[2],"a":[3,28,208],"risk-assessment":[4,180],"indicator":[5,80,181,211],"system":[6,182,212],"for":[7,32,101,158,164,168,170,175,213,225],"unplanned":[8],"endotracheal":[9],"extubation":[10],"(UEE)":[11],"among":[12],"adult":[13,219],"ICU":[14],"patients":[15],"based":[16],"on":[17],"the":[18,91,102,149,153],"Human":[19],"Factors":[20],"Analysis":[21],"and":[22,26,36,51,68,109,120,135,173,188,203,232,253],"Classification":[23],"System":[24],"(HFACS),":[25],"provide":[27],"structured":[29],"multi-level":[30],"framework":[31,222],"unit-level":[33],"safety":[34,216,227],"auditing":[35],"root-cause":[37,233],"analysis":[38,53,234],"of":[39,54,128,161],"UEE":[40,56,214],"events.":[41],"Methods":[42],"Initial":[43],"indicators":[44,191],"were":[45,106,118,133,156],"generated":[46],"via":[47],"systematic":[48],"literature":[49],"review":[50],"retrospective":[52],"local":[55],"adverse-event":[57],"cases.":[58],"A":[59],"two-round":[60,200],"Delphi":[61,104,201],"expert":[62,114,124,146],"consultation":[63],"was":[64,76,88],"performed":[65],"to":[66,78,247],"screen":[67],"revise":[69],"indicators.":[70],"The":[71,97,113,178],"Analytic":[72],"Hierarchy":[73],"Process":[74],"(AHP)":[75],"adopted":[77],"calculate":[79],"weights":[81,155],"at":[82],"each":[83],"hierarchical":[84],"level.":[85],"Content":[86],"validity":[87,93],"evaluated":[89],"using":[90],"content":[92,195],"index":[94],"(CVI).":[95],"Results":[96],"valid":[98],"response":[99],"rates":[100],"two":[103],"rounds":[105],"100.0%":[107],"(20/20)":[108],"95.0%":[110],"(19/20),":[111],"respectively.":[112],"authority":[115],"coefficients":[116,127],"(Cr)":[117],"0.893":[119],"0.915,":[121],"indicating":[122],"high":[123],"authority.":[125],"Kendall's":[126],"concordance":[129],"(":[130,137],"W":[131],")":[132],"0.242":[134],"0.254":[136],"P":[138],"<":[139],"0.001),":[140],"showing":[141],"statistically":[142],"significant":[143],"yet":[144],"low":[145],"agreement.":[147],"Among":[148],"four":[150],"primary":[151],"dimensions,":[152],"combined":[154],"0.448":[157],"unsafe":[159,171],"behavior":[160],"clinicians,":[162],"0.257":[163],"inadequate":[165],"supervision,":[166],"0.151":[167],"preconditions":[169],"acts,":[172],"0.144":[174],"organizational":[176],"influence.":[177],"final":[179],"comprised":[183],"4":[184],"primary,":[185],"13":[186],"secondary,":[187],"63":[189],"tertiary":[190],"with":[192],"acceptable":[193],"overall":[194],"validity.":[196],"Conclusion":[197],"Using":[198],"HFACS,":[199],"consultation,":[202],"AHP,":[204],"this":[205],"study":[206],"developed":[207],"consensus-driven":[209],"preliminary":[210],"risk-related":[215],"management":[217],"in":[218],"ICUs.":[220],"This":[221],"is":[223,245],"intended":[224],"system-oriented":[226],"audits,":[228],"training":[229],"priority":[230],"setting,":[231],"rather":[235],"than":[236],"bedside":[237],"individual-patient":[238],"risk":[239],"prediction.":[240],"Further":[241],"prospective":[242],"clinical":[243,258],"validation":[244],"required":[246],"verify":[248],"its":[249],"predictive":[250],"validity,":[251],"reliability":[252],"practical":[254],"feasibility":[255],"before":[256],"widespread":[257],"implementation.":[259]},"counts_by_year":[],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2026-10-29T00:00:00"}