Randomized clinical trials (RCTs) are conducted to guide clinicians’ selection of therapies for individual patients.

Currently, RCTs in critical care often report an overall mean effect and selected individual subgroups. Yet work in other fields suggests that such reporting practices can be improved.

Specifically, this Critical Care Perspective reviews recent work on so-called “heterogeneity of treatment effect” (HTE) by baseline risk and extends that work to examine its applicability to trials of acute respiratory failure and severe sepsis.

Because patients in RCTs in critical care medicine-and patients in intensive care units-have wide variability in their risk of death, these patients will have wide variability in the absolute benefit that they can derive from a given therapy.

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