A group of critical care doctors from several countries has called for a broader definition of critical care after the COVID-19 pandemic, which affected nearly all hospitals around the world. According to "Hospital News," physicians are looking for a definition that goes beyond syndromes and the consequences of disease, addressing the biological makeup that determines how a person responds to illness and treatment methods.
Dr. John Marshall, a critical care surgeon at St. Michael's Hospital in Toronto and a member of the Keenan Biomedical Sciences Center, stated, "Acute life-threatening illness is just the beginning of a process. Many things can alter its course. What we see is not merely a result of the initial disease but rather the outcome of its treatment and the individual's response to it. All of this becomes part of a process that can be modified."
Dr. Marshall, along with a team of critical care experts, co-authored an article outlining this call. The team includes Dr. David Maslow from Queen's University in Canada, Dr. Benjamin Tang from the University of Sydney in Australia, Dr. Mano Shankar Hary from the University of Edinburgh in the UK, and Dr. Patrick Lawlor, a cardiologist and researcher at the University Health Network in Canada.
Marshall remarked, "What we propose is to take a step back and ask: how can we find common biological traits across multiple physiological processes and diseases, thus targeting the biological process." He added, "We have conducted over 100 clinical trials examining treatments targeting biological processes known to be involved in severe diseases, none of which have resulted in effective treatments. Our viewpoint is that the inherent biological heterogeneity of these patients is the reason—specifically, we are not targeting the right patient with the right drug. Our goal is to change that."
The call also referenced what happened in the 1940s in cancer treatment: "Oncologists recognized that ovarian cancer behaves differently from skin cancer. They proposed categorizing cancers based on cell type and progression, thereby paving the way for chemotherapy and ultimately effective immunotherapy."
