Bone and Joint Health, Queen Mary University of London Faculty of Medicine and Dentistry, London, UK
Department of Emergency, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
BMJ Open. 2024 May 15;14(5):e083450. doi: 10.1136/bmjopen-2023-083450.
The objective of this study is to determine research priorities for the management of major trauma, representing the shared priorities of patients, their families, carers and healthcare professionals.
DESIGN/SETTING: An international research priority-setting partnership.
People who have experienced major trauma, their carers and relatives, and healthcare professionals involved in treating patients after major trauma. The scope included chest, abdominal and pelvic injuries as well as major bleeding, multiple injuries and those that threaten life or limb.
A multiphase priority-setting exercise was conducted in partnership with the James Lind Alliance over 24 months (November 2021-October 2023). An international survey asked respondents to submit their research uncertainties which were then combined into several indicative questions. The existing evidence was searched to ensure that the questions had not already been sufficiently answered. A second international survey asked respondents to prioritise the research questions. A final shortlist of 19 questions was taken to a stakeholder workshop, where consensus was reached on the top 10 priorities.
A total of 1572 uncertainties, submitted by 417 respondents (including 132 patients and carers), were received during the initial survey. These were refined into 53 unique indicative questions, of which all 53 were judged to be true uncertainties after reviewing the existing evidence. 373 people (including 115 patients and carers) responded to the interim prioritisation survey and 19 questions were taken to a final consensus workshop between patients, carers and healthcare professionals. At the final workshop, a consensus was reached for the ranking of the top 10 questions.
The top 10 research priorities for major trauma include patient-centred questions regarding pain relief and prehospital management, multidisciplinary working, novel technologies, rehabilitation and holistic support. These shared priorities will now be used to guide funders and teams wishing to research major trauma around the globe.
本研究旨在确定重大创伤管理的研究重点，代表患者、他们的家属、照顾者和医疗保健专业人员的共同优先事项。
设计/设置：国际研究重点设定伙伴关系。
经历过重大创伤的人、他们的照顾者和亲属以及参与治疗重大创伤后患者的医疗保健专业人员。范围包括胸部、腹部和骨盆损伤以及大出血、多发伤和威胁生命或肢体的伤。
在詹姆斯林德联盟的合作下，进行了一个多阶段的重点设定工作，历时 24 个月（2021 年 11 月至 2023 年 10 月）。一项国际调查要求受访者提交他们的研究不确定性，然后将这些不确定性合并成几个指示性问题。搜索了现有证据，以确保这些问题尚未得到充分回答。第二项国际调查要求受访者对研究问题进行优先排序。最终确定了 19 个问题的简短清单，并将其提交给利益相关者研讨会，在研讨会上达成了前 10 项重点的共识。
在最初的调查中，共收到 417 名受访者（包括 132 名患者和照顾者）提交的 1572 项不确定性。这些不确定性被细化为 53 个独特的指示性问题，在审查现有证据后，所有 53 个问题都被认为是真正的不确定性。373 人（包括 115 名患者和照顾者）对中期优先排序调查做出了回应，有 19 个问题被提交给了患者、照顾者和医疗保健专业人员之间的最终共识研讨会。在最终研讨会上，就前 10 个问题的排名达成了共识。
重大创伤的前 10 项研究重点包括以患者为中心的问题，涉及疼痛缓解和院前管理、多学科工作、新技术、康复和整体支持。这些共同的优先事项将指导全球范围内希望研究重大创伤的资助者和团队。
