University Surgery Unit, Faculty of Medicine, University of Southampton, Southampton, UK.
Department of Paediatric Surgery and Urology, Southampton Children's Hospital, Southampton, UK.
BJS Open. 2021 Mar 5;5(2). doi: 10.1093/bjsopen/zraa062.
The evidence base underlying clinical practice in children's general surgery is poor and high-quality collaborative clinical research is required to address current treatment uncertainties. The aim of this study was, through a consensus process, to identify research priorities for clinical research in this field amongst surgeons who treat children.
Questions were invited in a scoping survey amongst general surgeons and specialist paediatric surgeons. These were refined by the study team and subsequently prioritized in a two-stage modified Delphi process.
In the scoping survey, a total of 226 questions covering a broad scope of children's elective and emergency general surgery were submitted by 76 different clinicians. These were refined to 71 research questions for prioritization. A total of 168 clinicians took part in stage one of the prioritization process, and 157 in stage two. A 'top 10' list of priority research questions was generated for both elective and emergency general surgery of childhood. These cover a range of conditions and concepts, including inguinal hernia, undescended testis, appendicitis, abdominal trauma and enhanced recovery pathways.
Through consensus amongst surgeons who treat children, 10 priority research questions for each of the elective and emergency fields have been identified. These should provide a basis for the development of high-quality multicentre research projects to address these questions, and ultimately improve outcomes for children requiring surgical care.
儿童普通外科临床实践的证据基础薄弱，需要高质量的协作临床研究来解决当前治疗中的不确定性。本研究的目的是通过共识过程，确定治疗儿童的外科医生在该领域进行临床研究的优先事项。
在普通外科医生和小儿外科专家的范围调查中邀请提出问题。这些问题由研究小组进行了精炼，并随后在两阶段的修改 Delphi 过程中进行了优先排序。
在范围调查中，共有 76 位不同的临床医生提交了涵盖广泛范围的儿童选择性和紧急普通外科的 226 个问题。这些问题被精炼为 71 个优先研究问题。共有 168 位临床医生参加了优先排序过程的第一阶段，157 位参加了第二阶段。为儿童选择性和紧急普通外科手术生成了一份“十大”优先研究问题清单。这些问题涵盖了一系列病症和概念，包括腹股沟疝、隐睾、阑尾炎、腹部创伤和加速康复途径。
通过治疗儿童的外科医生之间的共识，确定了每个选择性和紧急领域的 10 个优先研究问题。这些问题应该为解决这些问题制定高质量的多中心研究项目提供基础，并最终改善需要手术治疗的儿童的结果。
