NCT07013175: WICH-ICU

Wise Choices in the Intensive Care Unit

Recruiting now NA Last updated 2 December 2025

What this trial tests

NA trial testing Choosing wisely protocol in Critical Illness in 10,000 participants. Currently enrolling.

Timeline

3 November 2025

Primary endpoint
31 December 2026

31 December 2027

Quick facts

Lead sponsor	Karolinska Institutet
Phase	NA
Status	Recruiting now
Study type	INTERVENTIONAL
Allocation	randomized
Design	sequential
Masking	none
Primary purpose	treatment
Enrollment	10,000
Start date	3 November 2025
Primary completion	31 December 2026
Estimated completion	31 December 2027
Sites	2 locations across Sweden

Drugs / interventions tested

• Choosing wisely protocol

Conditions studied

• Critical Illness — all drugs for Critical Illness →
• Ventilation — all drugs for Ventilation →
• Outcome — all drugs for Outcome →
• Dialysis — all drugs for Dialysis →

Sponsor

Karolinska Institutet

Who can join

18 and older, any sex, with Critical Illness or Ventilation. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

Aim: to evaluate if the Choosing Wisely campaign can be introduced without harming critically ill patients.

Background: Each year, around 45,000 patients are admitted to Sweden's 81 ICUs (intensive care units), costing 6-7 billion SEK (6% of total healthcare expenditure). The high costs of health care are partly attributable to overuse of diagnostic tests. Up to 30% of these tests lead to treatments that provide no benefit for patients, some of them may even be harmful(1-3). To improve quality of care while combating this problem of cost, the American Board of Internal Medicine Foundation developed the Choosing Wisely Campaign, tasking professional societies to develop lists of top five medical services patients and physicians should question. Patients in the ICU, can especially benefit from this paradigm shift. They are subjected to multiple testing on a daily - sometimes hourly - basis, therefore this field of medicine responded to the campaign quickly. Two sets of top-five-lists of tests and interventions that can be questioned have been published(4 5).

In multiple countries, including Sweden, the Choosing Wisely campaign is gathering traction among critical care physicians and is on the verge of being introduced. It is both common-sensical and will save money, so health care leaders are positive. However, the investigators have an opportunity, and a duty, to assess the evidence; can the Choosing Wisely campaign be introduced without harming ICU patients?

The present study thus aims to evaluate the introduction of the Choosing Wisely campaign in the context of the ICU. Is this change of care strategy associated with changes in 30-day-mortality? Secondary outcomes include ICU length of stay, use of non-invasive- or invasive mechanical ventilation and continuous renal replacement therapy. This is a registry-based cluster randomized controlled study (R-RCT), targeting Swedish ICU's across multiple regions. Primary and secondary outcomes will be retrieved from the Swedish Intensive care Register (SIR), making ICU participation easier and less costly.

Publications & conference data

No peer-reviewed publications indexed yet for this trial.