( sun tzu , the art of war , c.500 bc ) the challenge of conducting high - quality clinical studies in the critically ill population is widely recognised . heterogeneity in patient populations and clinical practice , diagnostic uncertainty , concerns with consent , and the overlapping nature of the presenting illnesses are amongst the inherent difficulties . influential studies in this population therefore increasingly involve multicentre , collaborative efforts using rigorously defined inclusion criteria and outcome measures  such projects aim to obviate the aforementioned difficulties and to reduce the influence of individual intensive care units ( icus ) and case - mix variations on the findings . ultimately , the quality of the data justifies the logistical challenge involved . for this reason , the recent article from the newly - formed irish critical care trials group is a welcome announcement of a further such alliance . the data presented describe 1,029 patients admitted to icu services in a 10-week period in 2006 , covering a slight majority of all icu beds in ireland . the data include national specialist centres and university teaching hospitals , as well as regional units . the overall pattern depicts a busy service , with 78% of admissions being emergent in nature , a mean sequential organ failure assessment score of 5.4 , and 70% of patients needing mechanical ventilation . previous research in ireland  showing an icu bed occupancy rate of 97% , an unscheduled discharge rate of 23% , and frequent cancellation of elective surgery  is consistent with this pattern . the icu readmission rate of 7.5% is perhaps attributable to these service realities  as indeed may be the failure to collect data in four of the 14 units that entered the study , including 23% of relevant patients . while accepting that the missing patient data compromise the validity of the findings , the outcomes nonetheless appear compatible with international standards and indeed are broadly indicative of the success of modern intensive care medicine . the outcomes in the subgroups are more striking : over 75% of readmitted patients survived and , of the 93 patients with five or six systems failing on admission , just over one - half survived . compatibility with international outcomes is perhaps most evident from those diagnostic categories where standard , consensus definitions are established . for severe sepsis , the icu mortality of 24% compares with a reported 35% in england , wales and northern ireland for severe sepsis in the first 24 hours . for acute lung injury / acute respiratory distress syndrome , the irish mortality was 32%  and the irish critical care trials group has previously shown that this is consistent with modern international studies in the protective ventilation era . although the numbers are relatively small ( n = 289 ) , an icu mortality of 38% for renal failure compares unfavourably with the hospital mortality of 26.3% reported by hoste and colleagues using the same criteria . nonetheless , the study arguably further validates these rifle ( risk - injury - failure - loss - end stage ) descriptors as outcome predictors in acute renal dysfunction . seasonal and regional variations can not be detected as data from a short collection period are pooled together . the use of icu mortality alone as a measure of outcome is not ideal , and more meaningful outcome assessment tools including hospital mortality should be utilised in future projects ; for example , patients who were refused readmission and who might have gone on to die in hospital wards will appear as survivors in such a crude analysis . future scientific publications should also avoid the irritation of new data introduction in the discussion of the findings . the value of the present data will be more fully realised when the irish critical care trials group produces further , hypothesis - testing studies . having taken advice from the anzics critical care trials group , the irish critical care trials group set out to achieve this epidemiological study to provide baseline information for research planning . the data provide insight into disease prevalence ( for example , of acute respiratory distress syndrome ) , and enable planning for the study duration and resource allocation once power analysis has indicated the size of the study population required . the demonstration of the willingness of team members to cooperate and of the capacity of information systems to gather and collate such information is a further key to such studies and collaborations . the authors identify an urgent requirement for audit resources to maintain the ambition shown by this study . participation in the uk 's intensive care national audit and research centre would be one option , opening up the possibility of a uk / irish database . the ability demonstrated by the irish critical care trials group study to establish a research ethos that straddles the relatively contentious border linking the irish republic with the united kingdom is scientifically encouraging . icu : intensive care unit ; rifle : risk - injury - failure - loss - end stage .