Identifying Research Priorities in Anaesthesia and Perioperative Care: Final Report of the Joint National Institute of Academic Anaesthesia/James Lind Alliance Research Priority Setting Partnership

Boney et al. (2015) full text summary PDF

For which topic were research priorities identified?

anesthesia and perioperative care

In which location was the research priority setting conducted?

Europe - United Kingdom

Why was it conducted at all?

Medical research aims to investigate questions that remain as yet unanswered. Much attention has focused in recent decades on refining research methodology, because flawed research may yield erroneous conclusions or ‘wrong' answers. However, less consideration has been given to deciding what questions are most worth researching. The process of selecting questions for research funding or deciding research priorities is an area of increasing interest. Research funding bodies seeking the maximum benefit and impact from their investment in research are becoming increasingly aware of the need to concentrate funding on questions of real relevance and importance to both service users and healthcare professionals.

What was the objective?

to bring together patients, carers and clinicians to identify and prioritize unanswered questions for research in anaesthesia and perioperative care, and to agree, by consensus, the ‘top ten' most important unanswered questions from those identified

What was the outcome?

a list of 10 research questions

How long did the research prioritization take?

Setting up PSP: October 2013. Survey: June 2014 - July 2014. Refining longlist into shortlist: December 2014. Interim ranking: February 2015 - April 2015. Workshop: May 2015.

Which methods were used to identify research priorities?

JLA method

How were the priorities for research identified exactly?

Step 1: setting up PSP: inviting partner organizations and establishing steering group, engaging stakeholders via awareness meeting, defining scope of PSP. Step 2: collecting research questions: survey: participants were asked patients, carers and clinicians to submit up to three ideas for research, 1476 research questions submitted. Step 3: data processing: classifying suggestions into themes, out-of-scope questions removed, 1325 responses remained on shortlist, then refining suggestions: between 4 and 15 summary questions drafted for each theme identified, followed by literature review to ascertain whether any of the summary questions had already been answered, 92 summary questions remained in shortlist. Step 4: interim ranking: via survey, participants were asked to select the 10 most important research questions from the shortlist of 92 summary questions, ‘lay' votes for each question were doubled to achieve a more even representation of clinician and lay, the most popular 25 questions were identified (all nominated by both clinicians and lay participants). Step 9: final prioritization: workshop: small group discussions, small group rankings, consensus rankings

Which stakeholders took part?

45 stakeholder organizations (25 professionals, 20 patients/carers). Survey: 388 (63%) healthcare professionals, 304 (49%) patients with experience of surgery or anaesthesia, 299 (48%) carers or friends of patients who had undergone surgery or anaesthesia. Interim ranking: 1718 participants: 628 participants (37%) patients, carers or friends/relatives of someone who had undergone surgery or anaesthesia, 1393 participants (81%) healthcare professionals. Workshop: 23 partner organization representatives (13 clinicians, 10 patient and carer representatives).

How were stakeholders recruited?

Stakeholders were defined as ‘any person or organization with an interest in anaesthesia and perioperative care'. In practice, this encompassed healthcare professionals (clinicians such as anaesthetists, surgeons, theatre staff, operating department practitioners, surgical ward and ITU nurses, general practitioners (GPs), community nurses, etc) and service users of anaesthesia, surgery and perioperative care (patients who have had, or may in the future have, surgery and their carers and relatives). The PSP approached all subspecialist UK anaesthetic societies affiliated to the NIAA along with other organizations representing specific healthcare professional groups, plus a range of patient organizations. The survey was advertised and publicised through various routes using the Steering Group's collective expertise and resources; additionally it was advertised on the NIAA website. All partner organizations promoted the survey to their members via newsletters, emails, social media and advertising on their websites. All anaesthetists on the Royal College of Anaesthetists membership database were emailed at least once regarding the survey. Two professionally-designed posters advertising the survey were commissioned for display in outpatient clinics and GP practices. Steering Group members were encouraged to disseminate the survey to friends, families and colleagues (the traditional ‘word of mouth' approach). The anaesthetic trainee-led research and audit groups, and the NIAA Health Service Research Centre's ‘QuARC' (Quality, Audit and Research Coordinator) network, were contacted to promote and disseminate the survey within their own hospitals. Interim ranking survey was advertised through similar channels.

Were stakeholders actively involved or did they just participate?

Stakeholders not only participated but were also actively involved in the research prioritization process: They were part of a steering group. The steering group consisted of representatives of the funding partner organizations, patients, carers and the JLA. The members piloted survey, advertised survey, and were involved in data processing.