Institute of Life Course and Medicine Sciences, Pain Research Institute, University of Liverpool, and Walton Centre NHS Foundation Trust, Liverpool, UK.
Institute of Psychiatry, Psychology and Neuroscience, Wolfson Centre for Age Related Disease, King's College, London, UK.
Pain Med. 2022 May 30;23(6):1084-1094. doi: 10.1093/pm/pnab338.
Fibromyalgia syndrome (FMS) is the most common chronic widespread pain condition in rheumatology. Until recently, no clear pathophysiological mechanism for fibromyalgia had been established, resulting in management challenges. Recent research has indicated that serum immunoglobulin Gs (IgGs) may play a role in FMS. We undertook a research prioritisation exercise to identify the most pertinent research approaches that may lead to clinically implementable outputs.
Research priority setting was conducted in five phases: situation analysis; design; expert group consultation; interim recommendations; consultation and revision. A dialogue model was used, and an international multi-stakeholder expert group was invited. Clinical, patient, industry, funder, and scientific expertise was represented throughout. Recommendation-consensus was determined via a voluntary closed eSurvey. Reporting guideline for priority setting of health research were employed to support implementation and maximise impact.
Arising from the expert group consultation (n = 29 participants), 39 interim recommendations were defined. A response rate of 81.5% was achieved in the consensus survey. Six recommendations were identified as high priority- and 15 as medium level priority. The recommendations range from aspects of fibromyalgia features that should be considered in future autoantibody research, to specific immunological investigations, suggestions for trial design in FMS, and therapeutic interventions that should be assessed in trials.
By applying the principles of strategic priority setting we directed research towards that which is implementable, thereby expediating the benefit to the FMS patient population. These recommendations are intended for patients, international professionals and grant-giving bodies concerned with research into causes and management of patients with fibromyalgia syndrome.
纤维肌痛综合征（FMS）是风湿病学中最常见的慢性广泛性疼痛疾病。直到最近，纤维肌痛还没有明确的病理生理机制，这导致了管理上的挑战。最近的研究表明，血清免疫球蛋白 G（IgG）可能在 FMS 中起作用。我们进行了一项研究重点确定工作，以确定可能导致具有临床可操作性结果的最相关研究方法。
研究重点确定分五个阶段进行：情况分析；设计；专家组咨询；中期建议；咨询和修订。使用对话模型，并邀请了一个国际多利益相关者专家组。整个过程都代表了临床、患者、行业、资助者和科学专业知识。建议共识是通过自愿的封闭式电子调查确定的。采用卫生研究优先事项设定报告准则，以支持实施并最大限度地提高影响。
在专家组咨询（n=29 名参与者）中，提出了 39 条中期建议。共识调查的回复率为 81.5%。有 6 项建议被确定为高度优先，15 项为中等优先。这些建议的范围从未来自身抗体研究中应考虑的纤维肌痛特征方面，到具体的免疫学研究、FMS 临床试验设计建议以及应在临床试验中评估的治疗干预措施。
通过应用战略重点设定原则，我们将研究方向指向可实施的研究，从而加速 FMS 患者群体的受益。这些建议面向患者、关注纤维肌痛综合征患者病因和管理的国际专业人士和资助机构。
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