Gurusamy Kurinchi S, Walmsley Martine, Davidson Brian R, Frier Claire, Fuller Barry, Madden Angela, Masson Steven, Morley Richard, Safarik Ivana, Tsochatzis Emmanuel A, Ahmed Irfan, Cowlin Maxine, Dillon John F, Ellicott Graham, Elsharkawy Ahmed M, Farrington Liz, Glachan Anthony, Kumar Nagappan, Milne E J, Rushbrook Simon M, Smith Amanda, Stafford Lizzie, Yeoman Andrew
Division of Surgery and Interventional Science, University College London, London, UK.
PSC Support, Oxfordshire, UK.
BMJ Open. 2019 Mar 7;9(3):e025045. doi: 10.1136/bmjopen-2018-025045.
There is a mismatch between research questions considered important by patients, carers and healthcare professionals and the research performed in many fields of medicine. The non-alcohol-related liver and gallbladder disorders priority setting partnership was established to identify the top research priorities in the prevention, diagnostic and treatment of gallbladder disorders and liver disorders not covered by the James-Lind Alliance (JLA) alcohol-related liver disease priority setting partnership.
The methods broadly followed the principles of the JLA guidebook. The one major deviation from the JLA methodology was the final step of identifying priorities: instead of prioritisation by group discussions at a consensus workshop involving stakeholders, the prioritisation was achieved by a modified Delphi consensus process.
A total of 428 unique valid diagnostic or treatment research questions were identified. A literature review established that none of these questions were considered 'answered' that is, high-quality systematic reviews suggest that further research is not required on the topic. The Delphi panel achieved consensus (at least 80% Delphi panel members agreed) that a research question was a top research priority for six questions. Four additional research questions with highest proportion of Delphi panel members ranking the question as highly important were added to constitute the top 10 research priorities.
A priority setting process involving patients, carers and healthcare professionals has been used to identify the top 10priority areas for research related to liver and gallbladder disorders. Basic, translational, clinical and public health research are required to address these uncertainties.
患者、护理人员和医疗保健专业人员认为重要的研究问题与许多医学领域所开展的研究之间存在不匹配。非酒精性肝胆疾病优先事项确定合作项目旨在确定在预防、诊断和治疗胆囊疾病及未被詹姆斯 - 林德联盟(JLA)酒精性肝病优先事项确定合作项目涵盖的肝脏疾病方面的首要研究优先事项。
方法大致遵循JLA指南手册的原则。与JLA方法的一个主要偏差在于确定优先事项的最后一步:不是通过在涉及利益相关者的共识研讨会上进行小组讨论来确定优先顺序,而是通过改进的德尔菲共识过程来实现优先排序。
共确定了428个独特有效的诊断或治疗研究问题。文献综述表明,这些问题中没有一个被认为是“已解答的”,即高质量的系统评价表明该主题无需进一步研究。德尔菲小组达成共识(至少80%的德尔菲小组成员同意),六个研究问题为首要研究优先事项。另外增加了四个德尔菲小组成员将其列为高度重要的比例最高的研究问题,以构成前10项研究优先事项。
一个涉及患者、护理人员和医疗保健专业人员的优先事项确定过程已被用于确定与肝胆疾病相关的前10项优先研究领域。需要基础、转化、临床和公共卫生研究来解决这些不确定性问题。