Research Priorities in Fragility Fractures of the Lower Limb and Pelvis: A UK Priority Setting Partnership with the James Lind Alliance

For which topic were research priorities identified?

fragility fractures of the lower limb and pelvis

In which location was the research priority setting conducted?

Europe - United Kingdom

Why was it conducted at all?

Adults with fragility fractures of the lower limb or pelvis usually require treatment in hospital and often have other medical comorbidities, along with complex health and social care needs requiring intervention from a number of healthcare professionals and carers.

What was the objective?

to determine research priorities in fragility fractures of the lower limb and pelvis which represent the shared priorities of patients, their friends and families, carers and healthcare professionals and to establish the research priorities for adults with fragility fractures of the lower limb and pelvis which represent the shared interests and priorities of patients, their families and friends, carers and health care professionals

What was the outcome?

a ranking list of 10 research questions

How long did the research prioritization take?

August 2016 - January 2018

Which methods were used to identify research priorities?

JLA method

How were the priorities for research identified exactly?

Step 1: collecting research questions: survey: participants were asked to submit research uncertainties, additionally literature review, 954 questions submitted. Step 2: data processing: thematic analysis, indicative questions formulated based on themes and sub-themes, indicative questions reviewed by steering group, check against current research evidence to ensure that proposed indicative questions were true uncertainties, 76 indicative questions remained. Step 3: interim ranking: via survey, participants were asked to rate importance of each question, ranking scores calculated, results reviewed by steering group, top 25 questions taken to final prioritization workshop. Step 4: final prioritization: workshop: small group discussion to independently rank the top 25 indicative questions, small group rankings combined, further round of small group discussions and rankings, plenary session to agree on top 10

Which stakeholders took part?

Patients over 60 years of age who have experienced a fragility fracture of the lower limb or pelvis; carers involved in their care (both in and out of hospital), family and friends of patients; healthcare professionals involved in the treatment of these patients including but not limited to surgeons, anaesthetists, paramedics, nurses, general practitioners, physicians, physiotherapists and occupational therapists. Survey: 365 participants: 51% healthcare professionals and 49% non-healthcare professionals (23% family and friends, 16% patients, 10% carers). Interim ranking: 209 participants: 47%healthcare professionals and 53% non-healthcare professionals (15% family and friends, 28% patients, 10% carers).

How were stakeholders recruited?

The scoping survey was circulated via the steering group and their partner organizations as an open invitation. The second national survey was circulated as an open invitation.

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 patient representatives, healthcare professionals, and carers. The members were involved in data processing, interim ranking and the workshop.