Pollock Alex, Campbell Pauline, Baer Gillian, Choo Pei Ling, Morris Jacqui, Forster Anne
Nursing, Midwifery and Allied Health Professions Research Unit (NMAHP RU), Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, UK.
Department of Physiotherapy, Queen Margaret University, Queen Margaret Drive, Edinburgh, EH21 6UU, UK.
Syst Rev. 2015 Apr 20;4:55. doi: 10.1186/s13643-015-0023-5.
This paper describes the structured methods used to involve patients, carers and health professionals in an update of a Cochrane systematic review relating to physiotherapy after stroke and explores the perceived impact of involvement.
We sought funding and ethical approval for our user involvement. We recruited a stakeholder group comprising stroke survivors, carers, physiotherapists and educators and held three pre-planned meetings during the course of updating a Cochrane systematic review. Within these meetings, we used formal group consensus methods, based on nominal group techniques, to reach consensus decisions on key issues relating to the structure and methods of the review.
The stakeholder group comprised 13 people, including stroke survivors, carers and physiotherapists with a range of different experience, and either 12 or 13 participated in each meeting. At meeting 1, there was consensus that methods of categorising interventions that were used in the original Cochrane review were no longer appropriate or clinically relevant (11/13 participants disagreed or strongly disagreed with previous categories) and that international trials (which had not fitted into the original method of categorisation) ought to be included within the review (12/12 participants agreed or strongly agreed these should be included). At meeting 2, the group members reached consensus over 27 clearly defined treatment components, which were to be used to categorise interventions within the review (12/12 agreed or strongly agreed), and at meeting 3, they agreed on the key messages emerging from the completed review. All participants strongly agreed that the views of the group impacted on the review update, that the review benefited from the involvement of the stakeholder group, and that they believed other Cochrane reviews would benefit from the involvement of similar stakeholder groups.
We involved a stakeholder group in the update of a Cochrane systematic review, using clearly described structured methods to reach consensus decisions. The involvement of stakeholders impacted substantially on the review, with the inclusion of international studies, and changes to classification of treatments, comparisons and subgroup comparisons explored within the meta-analysis. We argue that the structured approach which we adopted has implications for other systematic reviews.
本文描述了在更新一项关于中风后物理治疗的Cochrane系统评价时，用于让患者、护理人员和卫生专业人员参与其中的结构化方法，并探讨了参与的感知影响。
我们为用户参与寻求资金和伦理批准。我们招募了一个由中风幸存者、护理人员、物理治疗师和教育工作者组成的利益相关者小组，并在更新Cochrane系统评价的过程中举行了三次预先计划好的会议。在这些会议中，我们使用基于名义小组技术的正式小组共识方法，就与评价的结构和方法相关的关键问题达成共识决定。
利益相关者小组由13人组成，包括具有不同经验的中风幸存者、护理人员和物理治疗师，每次会议有12或13人参加。在第一次会议上，达成的共识是，Cochrane原始评价中使用的干预措施分类方法不再合适或与临床无关（11/13的参与者不同意或强烈不同意先前的分类），并且评价应纳入国际试验（这些试验不符合原始分类方法）（12/12的参与者同意或强烈同意应将其纳入）。在第二次会议上，小组成员就27个明确界定的治疗组成部分达成了共识，这些组成部分将用于在评价中对干预措施进行分类（12/12同意或强烈同意），在第三次会议上，他们就完成的评价中出现的关键信息达成了一致。所有参与者都强烈同意，小组的意见对评价更新产生了影响，评价受益于利益相关者小组的参与，并且他们认为其他Cochrane评价将受益于类似利益相关者小组的参与。
我们让一个利益相关者小组参与了Cochrane系统评价的更新，使用明确描述的结构化方法达成共识决定。利益相关者的参与对评价产生了重大影响，纳入了国际研究，并在荟萃分析中探讨了治疗、对照和亚组对照分类的变化。我们认为我们采用的结构化方法对其他系统评价具有启示意义。
