To the Editor The CHECKLIST-ICU investigators assessed the effect of a quality improvement intervention on the mortality of adults who were critically ill using a cluster randomized trial.1 The results were not significant. However, we believe that the results should be interpreted with caution because cluster randomized trials can be susceptible to a range of methodological problems.
Ramiro Manzano Nunez, Herney Andrés García Perdomo, Isabel Cristina Muñoz Chavez. Quality Improvement Intervention and Mortality of Critically Ill Patients. JAMA. 2016;316(8):879. doi:10.1001/jama.2016.9269