A multicenter prospective observational study conducted in 2004/2005 revealed that specific pain scores were used in 28% of patients. Looking at our results of patient survey data, the use of pain scores drops to 43%. It is noteworthy that 70% of the ICUs did not use any assessment tool, specifically developed for assessing pain in sedated patients. Hence, sedated patients are at higher risk of suffering from insufficient analgesia. This survey contributes to our knowledge about the management of analgesia, sedation and delirium in Ginsenoside-F4 clinical practice. Until now, there are only two studies that have been conducted on an Gomisin-D international level. Furthermore, this study is the first to report about delirium, sedation and analgesia in a general ICU population, taking into account differences between perceived and actual practice. Nevertheless, limitations are inherent to surveys. We would expect a responder bias regarding the participants of this study. It is more likely that colleagues who are interested in delirium, sedation and analgesia participated in the survey. Taking this into account, it seems interesting that we found notable discrepancies between guideline recommendations and current practice. Considering the above mentioned responder bias, this observed gap may be even larger in reality. Further studies are necessary to evaluate this realtionship. Despite an extensive preparation, a sixth of all webpage visitors completed the questionnaire. Regional differences regarding the management of analgesia, delirium and sedation were not assessed. The results of our survey indicate that awareness concerning a systematic management of delirium, sedation and analgesia and patient outcome is increasing. However, our data also show that the implementation of these measures in daily routine lacks behind. In our opinion, intelligent and sustainable implementation strategies are of key importance in order to transfer guideline recommendations to practise. Further studies will be necessary to assess and evaluate implementation strategies and improve clinical practice. Technical support was given by email and a telephone hotline on the day of study. Participants could access and complete the online questionnaires within one week. In addition to the online survey, participants were given the possibility to download a printable version of the survey and submit it by fax. Data from the printed and online questionnaires were merged in a database and exported to a worksheet for further statistical analysis. Numerous epidemiological studies have shown that the incidence of cardiovascular and cerebrovascular diseases is increasing. Preventive interventions should be conducted for patients with subclinical disease because reducing the exposure to risk factors has been shown to be most effective during this stage. There are few reports describing the epidemiological features of traditional risk factors in different genders and age groups as well as the relevant cutpoints for risk factors. In most studies, logistic regression analysis has been used to screen for the important risk factors after adjustment for gender and age. Gender and age are unmodifiable risk factors for cardio-cerebral vascular disease, and confounding could occur through collinearity in a logistic regression in cases in which multiple risk factors are involved. Decision tree analysis could overcome such disadvantages, screen for the most important risk factors for cardiovascular diseases in different genders and age groups and identify the cutpoints for risk factors.