Department of Gerontology and Geriatrics, Leiden University Medical Centre, PO Box 9600, 2300 RC, Leiden, The Netherlands.
Institute for Evidence-Based Medicine for Older People (IEMO), Leiden, The Netherlands.
Eur Geriatr Med. 2021 Apr;12(2):413-422. doi: 10.1007/s41999-020-00426-8. Epub 2020 Nov 21.
Geriatric Emergency Medicine (GEM) focuses on delivering optimal care to (sub)acutely ill older people. This involves a multidisciplinary approach throughout the whole healthcare chain. However, the underpinning evidence base is weak and it is unclear which research questions have the highest priority. The aim of this study was to provide an inventory and prioritisation of research questions among GEM professionals throughout Europe.
A two-stage modified Delphi approach was used. In stage 1, an online survey was administered to various professionals working in GEM both in the Emergency Department (ED) and other healthcare settings throughout Europe to make an inventory of potential research questions. In the processing phase, research questions were screened, categorised, and validated by an expert panel. Subsequently, in stage 2, remaining research questions were ranked based on relevance using a second online survey administered to the same target population, to identify the top 10 prioritised research questions.
In response to the first survey, 145 respondents submitted 233 potential research questions. A total of 61 research questions were included in the second stage, which was completed by 176 respondents. The question with the highest priority was: Is implementation of elements of CGA (comprehensive geriatric assessment), such as screening for frailty and geriatric interventions, effective in improving outcomes for older patients in the ED?
This study presents a top 10 of high-priority research questions for a European Research Agenda for Geriatric Emergency Medicine. The list of research questions may serve as guidance for researchers, policymakers and funding bodies in prioritising future research projects.
老年急诊医学(GEM)专注于为(亚)急性疾病的老年人提供最佳护理。这需要整个医疗保健链的多学科方法。然而,其基础证据基础薄弱,不清楚哪些研究问题具有最高优先级。本研究旨在为欧洲各地的 GEM 专业人员提供一个研究问题清单和优先级排序。
采用两阶段修改后的德尔菲法。在第 1 阶段,向欧洲各地的急诊部(ED)和其他医疗保健环境中从事 GEM 工作的各种专业人员进行了在线调查,以制作潜在研究问题清单。在处理阶段,由专家小组对研究问题进行筛选、分类和验证。随后,在第 2 阶段,根据相关性使用向同一目标人群进行的第二次在线调查对剩余的研究问题进行排名,以确定前 10 个优先研究问题。
对第一项调查作出回应的有 145 名受访者,提交了 233 个潜在的研究问题。共有 61 个研究问题被纳入第二阶段,该阶段由 176 名受访者完成。优先级最高的问题是:实施 CGA(全面老年评估)的要素,如筛查虚弱和老年干预措施,是否能有效改善 ED 中老年患者的结局?
本研究提出了欧洲老年急诊医学研究议程的前 10 个高优先级研究问题。该研究问题清单可以为研究人员、政策制定者和资助机构在确定未来研究项目的优先级方面提供指导。