Liossi Christina, Anderson Anna-Karenia, Howard Richard F
Department of Psychology, University of Southampton, Southampton, UK; Department of Paediatric Psychology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
The Royal Marsden Hospital, Sutton, UK; Shooting Star Chase Children's Hospice, Guildford, UK.
Br J Pain. 2017 Feb;11(1):9-15. doi: 10.1177/2049463716668906. Epub 2016 Sep 16.
Priority setting for healthcare research is as important as conducting the research itself because rigorous and systematic processes of priority setting can make an important contribution to the quality of research. This project aimed to prioritise clinical therapeutic uncertainties in paediatric pain and palliative care in order to encourage and inform the future research agenda and raise the profile of paediatric pain and palliative care in the United Kingdom. Clinical therapeutic uncertainties were identified and transformed into patient, intervention, comparison and outcome (PICO) format and prioritised using a modified Nominal Group Technique. Members of the Clinical Studies Group in Pain and Palliative Care within National Institute for Health Research (NIHR) Clinical Research Network (CRN)-Children took part in the prioritisation exercise. There were 11 clinically active professionals spanning across a wide range of paediatric disciplines and one parent representative. The top three research priorities related to establishing the safety and efficacy of (1) gabapentin in the management of chronic pain with neuropathic characteristics, (2) intravenous non-steroidal anti-inflammatory drugs in the management of post-operative pain in pre-schoolers and (3) different opioid formulations in the management of acute pain in children while at home. Questions about the long-term effect of psychological interventions in the management of chronic pain and various pharmacological interventions to improve pain and symptom management in palliative care were among the 'top 10' priorities. The results of prioritisation were included in the UK Database of Uncertainties about the Effects of Treatments (DUETS) database. Increased awareness of priorities and priority-setting processes should encourage clinicians and other stakeholders to engage in such exercises in the future.
医疗保健研究的优先级设定与开展研究本身同样重要，因为严谨且系统的优先级设定过程能对研究质量做出重要贡献。本项目旨在确定儿科疼痛与姑息治疗方面的临床治疗不确定性，以推动并为未来的研究议程提供信息，并提高英国儿科疼痛与姑息治疗的关注度。确定了临床治疗不确定性，并将其转化为患者、干预措施、对照和结局（PICO）格式，然后使用改良的名义小组技术进行优先级排序。英国国家卫生研究院（NIHR）临床研究网络（CRN）儿童疼痛与姑息治疗临床研究小组的成员参与了优先级排序活动。有11名临床活跃的专业人员，涵盖广泛的儿科领域，还有一名家长代表。排名前三的研究重点是确定（1）加巴喷丁治疗具有神经病理性特征的慢性疼痛的安全性和有效性，（2）静脉注射非甾体抗炎药治疗学龄前儿童术后疼痛的安全性和有效性，以及（3）不同阿片类药物制剂治疗儿童在家时急性疼痛的安全性和有效性。关于心理干预对慢性疼痛管理的长期影响以及各种药物干预以改善姑息治疗中疼痛和症状管理的问题也在“十大”重点之中。优先级排序的结果被纳入英国治疗效果不确定性数据库（DUETS）。提高对优先级和优先级设定过程的认识应会鼓励临床医生和其他利益相关者未来参与此类活动。
