Decision making in the democracy-based medicine era: The consensus conference process

A large number of randomized controlled trials on critically ill patients has been published in the last years, yielding often opposite or inconclusive findings. To be continuously updated is thus becoming a hard task for physicians, who have to rely on experts’ guidelines to guide their practice. Democracy based medicine is a recently developed method which overcomes the limits of experts’ guidelines. This chapter summarize the consensus process, based on a systematic review, on a formal meeting to discuss and analyze the available evidence and where the consensus statements are produced, and on a dedicated web interface which allows to share intermediate findings gather consensus from colleagues worldwide. This Consensus Conference identified 7 interventions increasing survival and 8 interventions increasing mortality in the critically ill patients. Given the increasing complexity and width of medical literature, the Consensus process is a simple solution to reach a worldwide consensus among pairs on the best published evidence.