A Consensus Building Exercise to Determine Research Priorities for Silver Trauma

For which topic were research priorities identified?

silver trauma

In which location was the research priority setting conducted?

Europe - United Kingdom

Why was it conducted at all?

‘Silver Trauma’ is major trauma consequent upon relatively minor injury mechanisms, commonly seen in older people. As the population of older adults is increasing worldwide, so will rates of silver trauma. Emergency and prehospital care represent central parts of a trauma patients’ care journey, and play major roles in determining their outcomes. The growth of the silver trauma population has resulted in increased demand to provide the optimal level of emergency care which, in turn, requires more evidence-based practice for the treatment and management of this population. However, research into silver trauma is not extensive and many research questions remain unanswered. Furthermore, it is unclear which outcomes might be valued most by older people with silver trauma – whose priorities might well be different to working age population (the main beneficiaries of trauma research to date). An effective way to determine research priorities in healthcare is to build consensus amongst clinicians.

What was the objective?

to build a consensus among clinicians to determine research priorities for silver trauma (major trauma consequent upon relatively minor injury mechanisms)

What was the outcome?

a ranking list of 5 research questions

How long did the research prioritization take?

No information provided.

Which methods were used to identify research priorities?


How were the priorities for research identified exactly?

Step 1: Delphi round 1: participants were asked to compose up to three research questions they considered important to address in future research, participants were asked to formulate questions in PICO format, 248 issues were submitted. Step 2: data processing: similar ideas were grouped together, out of scope ideas were removed, resulting in 74 PICO questions. Step 3: Delphi round 2a: silver trauma panel evaluated questions, panelists voted on questions, only questions that were clinically significant to improve the outcomes and needed to be addressed in future research remained, resulting in shortlist of 20 priorities. Step 4: Delphi round 2b: participants were asked to rate each research question. Step 5: Delphi round 3: meeting: participants discussed results of round 2, participants were then asked to rank the top three research questions that they thought were most important

Which stakeholders took part?

Clinicians. Panel: 6 doctors (geriatricians and emergency physicians), Delphi round 1: 94 participants (55% doctors, 42% paramedics), Delphi round 2: 87 participants (95% doctors), Delphi round 3: 8 participants (4 doctors, 3 advanced clinical practitioners, 1 nurse)

How were stakeholders recruited?

The online questionnaires in round I and second step of round II of this study were sent through email to all members of the following networks and groups: (1) Trauma Audit and Research Network (TARN) - Older People’s group, UK, (2) The Royal College of Emergency Medicine (RCEM) - Clinical Studies group, UK, (3) The National Ambulance Service Medical Directors (NASMeD), UK, (4) European Geriatric Medicine Society (EuGMS), Europe, (5) American College of Emergency Physicians (ACEP) - Geriatric Emergency Medicine Section, United States of America (USA), (6) Society for Academic Emergency Medicine (SAEM) - Academy of Geriatric Emergency Medicine (AGEM), USA, (7) American Academy of Emergency Medicine (AAEM) - Geriatric Interest Group, USA, and (8) Australasian College for Emergency Medicine (ACEM), Australia. The ‘Silver Trauma Panel’ in the first step of round II of the study composed of geriatricians and emergency physicians from LRI hospital, NHS, UK. In the final round of this study, experts from the EMMTN – Frailty Group, UK, who have strong interest and experience in caring for silver trauma patients were invited to the consensus meeting.

Were stakeholders actively involved or did they just participate?

Stakeholders were mere participants of the research prioritization process; they were not actively involved in the process.