Algorithms that Might Replace Clinical Intuition in Critical Care

Among senior critical care physicians, a reliance on autonomy and clinical intuition has long been the norm. While this approach allows for adaptability in managing complex and unpredictable situations, it also leads to unwarranted variations in care delivery and to potential harm. Despite resistance from some physicians, there is a growing trend towards the use of standardised healthcare documents, such as guidelines and algorithms, stored and displayed digitally. Transitioning towards a formalised approach to creating these documents would necessitate that expert physicians define and discuss preferred practices in a manner akin to computer programming. This would reduce irrationality and contradiction, while enabling assessment of computability and logic faults. Adding techniques to capture the intuition of the experts holds promise, particularly in complex or evidence-limited scenarios. Looking ahead, the integration of sophisticated algorithms into critical care may redefine the role of computers, positioning them not merely as tools but as valued members of the clinical team.