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Price A, Clarke M, Staniszewska S, Chu L, Tembo D, Kirkpatrick M, Nelken Y. Patient and Public Involvement in research: A journey to co-production. PATIENT EDUCATION AND COUNSELING 2022; 105:1041-1047. [PMID: 34334264 DOI: 10.1016/j.pec.2021.07.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/10/2021] [Accepted: 07/12/2021] [Indexed: 06/13/2023]
Abstract
The public and patients can be powerful sensors for shaping and powering healthcare research. They are joining research teams as investigators and collaborators to co-produce evidence for the practical use of interventions in clinical practice. While clinicians and researchers are encouraged by funders and policymakers to involve the public and patients as partners in research, knowledge on what involvement consists of is limited, and the continuum between consultation, collaboration and co-production are not clearly defined. In this article, we explore Patient and Public Involvement (PPI) and introduce greater involvement through research co-production. Co-production describes ways that research partnership can work through public and patient involvement and we outline the similarities of co-production to "The Commons", a strategy utilized by economists to increase effective use of resources. We share examples of how public and patient involvement have used co-production, to demonstrate financial and health benefits. We then outline practical challenges at system, social and cultural levels and consider how others have worked to resolve them.
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Affiliation(s)
- Amy Price
- AIM Lab, Stanford School of Medicine, Department of Continuing Education, University of Oxford, UK.
| | - Mike Clarke
- Northern Ireland Clinical Trials Unit, Belfast Health and Social Care Trust, Belfast, UK; Northern Ireland Methodology Hub, Centre for Public Health, Queen's University Belfast, Belfast, UK.
| | | | - Larry Chu
- Stanford Medicine X, Stanford University School of Medicine, Stanford, CA 94305, USA.
| | - Doreen Tembo
- University of Southampton, National Institute for Health Research Evaluation Trials and Studies Coordinating Centre, UK.
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Luna A, Price A, Srivastava U, Chu LF. Critical patient insights from the same-day feedback programme at Stanford Health Care. BMJ Open Qual 2020; 9:e000773. [PMID: 32816863 PMCID: PMC7430334 DOI: 10.1136/bmjoq-2019-000773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 05/29/2020] [Accepted: 06/09/2020] [Indexed: 11/28/2022] Open
Abstract
PATIENT-CENTERED ORGANISATIONS Healthcare organisations now integrate patient feedback into value-based compensation formulas. This research considered Stanford Healthcare's same-day feedback, a programme designed to evaluate the patient experience. Specifically, how did patients with cancer interviewed in the programme assess their physicians? Furthermore, how did assessments differ across emotional, physical, practical and informational needs when interviewed by volunteer patient and family partners (PAFPs) versus hospital staff? PATIENT-PHYSICIAN COMMUNICATION BARRIERS Integral to this research was Communication Accommodation Theory (CAT), which suggests individuals adjust interactions based on conversational roles, needs and understanding. Previous influential research was conducted by Frosch et al (2012) and Di Bartolo et al (2017), who revealed barriers to patient-physician communication, and Baker et al (2011) who associated CAT with these interactions. However, we still did not know if patients alter physician assessments between interviewers. VOLUNTEERS COLLECT PATIENT NEEDS This mixed methods study worked with 190 oncology unit patient interviews from 2009 to 2017. Open-ended interview responses underwent thematic analysis. When compared with hospital staff, PAFPs collected more practical and informational needs from patients. PAFPs also collected more verbose responses that resembled detailed narratives of the patients' hospital experiences. This study contributed insightful patient perspectives of physician care in a novel hospital programme.
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Affiliation(s)
- Alessandro Luna
- MD Program, Columbia University College of Physicians and Surgeons, New York, New York, USA
- Alumnus, Department of Human Biology, Stanford University, Stanford, California, USA
| | - Amy Price
- Senior Research Scientist, Stanford Anesthesia Informatics and Media Lab, Stanford University School of Medicine, Stanford, California, USA
| | - Ujwal Srivastava
- Undergraduate Student, Stanford University, Stanford, California, USA
- Research Assistant, Stanford Medicine X Program, Stanford University School of Medicine, Stanford, California, USA
| | - Larry F Chu
- Professor, Department of Anesthesiology, Perioperative and Pain Medicine; Executive Director, Stanford Medicine X Program; Director, Stanford Anesthesia Informatics and Media Lab, Stanford University School of Medicine, Stanford, California, USA
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Borda A, Gray K, Fu Y. Research data management in health and biomedical citizen science: practices and prospects. JAMIA Open 2020; 3:113-125. [PMID: 32607493 PMCID: PMC7309241 DOI: 10.1093/jamiaopen/ooz052] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 07/09/2019] [Accepted: 09/30/2019] [Indexed: 12/25/2022] Open
Abstract
Background Public engagement in health and biomedical research is being influenced by the paradigm of citizen science. However, conventional health and biomedical research relies on sophisticated research data management tools and methods. Considering these, what contribution can citizen science make in this field of research? How can it follow research protocols and produce reliable results? Objective The aim of this article is to analyze research data management practices in existing biomedical citizen science studies, so as to provide insights for members of the public and of the research community considering this approach to research. Methods A scoping review was conducted on this topic to determine data management characteristics of health and bio medical citizen science research. From this review and related web searching, we chose five online platforms and a specific research project associated with each, to understand their research data management approaches and enablers. Results Health and biomedical citizen science platforms and projects are diverse in terms of types of work with data and data management activities that in themselves may have scientific merit. However, consistent approaches in the use of research data management models or practices seem lacking, or at least are not prevalent in the review. Conclusions There is potential for important data collection and analysis activities to be opaque or irreproducible in health and biomedical citizen science initiatives without the implementation of a research data management model that is transparent and accessible to team members and to external audiences. This situation might be improved with participatory development of standards that can be applied to diverse projects and platforms, across the research data life cycle.
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Affiliation(s)
- Ann Borda
- Health and Biomedical Informatics Centre, Melbourne Medical School, The University of Melbourne, Melbourne, Australia
| | - Kathleen Gray
- Health and Biomedical Informatics Centre, Melbourne Medical School, The University of Melbourne, Melbourne, Australia
| | - Yuqing Fu
- Health and Biomedical Informatics Centre, Melbourne Medical School, The University of Melbourne, Melbourne, Australia
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Dawson S, Ruddock A, Parmar V, Morris R, Cheraghi-Sohi S, Giles S, Campbell S. Patient and public involvement in doctoral research: reflections and experiences of the PPI contributors and researcher. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:23. [PMID: 32426162 PMCID: PMC7216324 DOI: 10.1186/s40900-020-00201-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 04/23/2020] [Indexed: 05/26/2023]
Abstract
PLAIN ENGLISH SUMMARY There is evidence in the literature showing that involving patients and the public in health research can have a positive influence on quality, relevance and impact of research. However, patients and the public are not always involved in all stages of the research. There is often no explanation as to why they were only involved in some stages of the research and not others. Additionally, there is often no description of researchers' or PPI contributor's experiences of involvement. This also raises another issue which is a lack of recording of impact such involvement can have on the research process and the people involved in the research. In this paper, we present what PPI in a doctoral research should look like by providing a detailed description of how involvement occurred from pre-funding to dissemination stages of the research process. We provide some practical examples of how this was done and how involving patients made a difference to the research project. Finally, we present reflections from the patient and public contributors and the researcher on involvement in this project along with some recommendations for future doctoral and postdoctoral researchers considering involving public/patient contributors in their research. ABSTRACT Background Patient and Public Involvement (PPI) has received considerable attention in the last two decades and working in partnership and co-design have now become a prerequisite in health services research in the UK. However, there is a lack of evidence and consistency in recording PPI and related activities. Researchers and PPI contributors are encouraged to record and reflect on the impact of PPI on research. There is significant variation in the way PPI contributors are involved, and it is often limited to some stages of the research cycle than others, without any reflections on the decision-making process for such involvement or any transferable learning. This has resulted in failure to provide a narrative of the research journey including researchers' and PPI contributors' personal reflections of involvement. Therefore, this paper provides an exemplar of what PPI in a doctoral research context should look like by providing a detailed account of how PPI was embedded in a doctoral research project, the PPI contributors and researcher's reflections and key recommendations for involving people specifically in doctoral research.Methods A reflective approach was taken using data from PPI contributor and researcher notes, e-mail correspondence, meeting notes. Data is presented narratively to reflect on the experiences of involvement throughout the research cycle.Results Undertaking PPI enhanced the quality and relevance of the doctoral research, contributed to the recruitment of study participants, data analysis and dissemination. Building trust and relationships with PPI contributors was key to continued involvement throughout the life of the project and beyond. There is a need to adopt flexible approaches rather than a one-size-fits-all model when working with PPI contributors. Reflections by PPI contributors and the researcher emphasises that involvement was a rewarding experience.Conclusions This paper contributes to the wider literature by providing an exemplar of how PPI can be embedded in doctoral research and demonstrates the value of PPI to the research process and the individuals involved. We also present recommendations on how PPI can be incorporated by doctoral and postdoctoral researchers when planning PPI in their research project.
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Affiliation(s)
- Shoba Dawson
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Angela Ruddock
- NIHR Greater Manchester Patient Safety Translational Research Centre, Centre for Primary Care, Division of Population Health, HSR & Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Veena Parmar
- NIHR Greater Manchester Patient Safety Translational Research Centre, Centre for Primary Care, Division of Population Health, HSR & Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Rebecca Morris
- NIHR Greater Manchester Patient Safety Translational Research Centre, Centre for Primary Care, Division of Population Health, HSR & Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Sudeh Cheraghi-Sohi
- NIHR Greater Manchester Patient Safety Translational Research Centre, Centre for Primary Care, Division of Population Health, HSR & Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Sally Giles
- NIHR Greater Manchester Patient Safety Translational Research Centre, Centre for Primary Care, Division of Population Health, HSR & Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Stephen Campbell
- NIHR Greater Manchester Patient Safety Translational Research Centre, Centre for Primary Care, Division of Population Health, HSR & Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
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Fiske A, Prainsack B, Buyx A. Meeting the needs of underserved populations: setting the agenda for more inclusive citizen science of medicine. JOURNAL OF MEDICAL ETHICS 2019; 45:617-622. [PMID: 31300487 PMCID: PMC6817991 DOI: 10.1136/medethics-2018-105253] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 04/05/2019] [Accepted: 05/27/2019] [Indexed: 05/02/2023]
Abstract
In its expansion to genomic, epidemiological and biomedical research, citizen science has been promoted as contributing to the democratisation of medical research and healthcare. At the same time, it has been criticised for reinforcing patterns of exclusion in health and biomedicine, and sometimes even creating new ones. Although citizen science has the potential to make biomedical research more inclusive, the benefits of current citizen science initiatives are not equally accessible for all people-in particular those who are resource-poor, located outside of traditional networks of healthcare services, or members of minorities and marginalised groups. In view of growing public investments in participatory research endeavours, we argue that it should be considered more explicitly if, and how, citizen science could help make research more inclusive, contribute to the public good, and possibly even lead to better and more equitable healthcare. Reflecting on emerging ethical concerns for scientific conduct and best medical practice, we propose a set of relevant considerations for researchers, practitioners, bioethicists, funders and participants who seek to advance ethical practices of citizen-led health initiatives, and address profound differences in position, privilege and power in research.
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Affiliation(s)
- Amelia Fiske
- Institute for History and Ethics in Medicine, Technical University of Munich, Munich, Germany
- Anthropology Department, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Barbara Prainsack
- Department of Political Science, University of Vienna, Vienna, Austria
- Department of Global Health & Social Medicine, King’s College London, London, UK
| | - Alena Buyx
- Institute for History and Ethics in Medicine, Technical University of Munich, Munich, Germany
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Nguyen VT, Benchoufi M, Young B, Ghosn L, Ravaud P, Boutron I. A scoping review provided a framework for new ways of doing research through mobilizing collective intelligence. J Clin Epidemiol 2019; 110:1-11. [PMID: 30772456 DOI: 10.1016/j.jclinepi.2019.02.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 01/14/2019] [Accepted: 02/04/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVES New forms of research involving collective intelligence (CI) of diverse individuals mobilized through crowdsourcing is successfully emerging in various fields. This scoping review aimed to describe these methods across different fields and propose a framework for implementation. STUDY DESIGN AND SETTING We searched seven electronic databases for reports describing projects that had mobilized CI with crowdsourcing. We used content analysis to develop themes and categories of the methods. RESULTS We identified 145 reports. CI was mobilized to generate ideas, conduct evaluations, solve problems, and create intellectual outputs. Most projects (n = 110, 76%) were open to the public without restrictions on participants' expertise. Participants contributed to projects by independent contribution (i.e., no interaction with other participants) (n = 50, 34%), collaboration (n = 41, 28%), competitions (n = 33, 23%), and playing games (n = 16, 11%). In total, 61% of articles (n = 89) reported methods to evaluate participants' contribution and decision-making process: 43% used an independent panel of experts and 18% involved end users. We identified challenges in implementation and sustainability of CI and proposed solutions. CONCLUSION New research methods based on CI through crowdsourcing could transform clinical research. This framework facilitates the implementation of these methods.
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Affiliation(s)
- Van Thu Nguyen
- INSERM, U1153 Epidemiology and Biostatistics Sorbonne Paris Cité Research Center (CRESS), Methods of Therapeutic Evaluation of Chronic Diseases Team (METHODS), Paris, F-75014 France; Paris Descartes University, Sorbonne Paris Cité, France; Department of Health Services Research, Institute of Population Health Sciences, University of Liverpool, Liverpool L69 3GB, UK.
| | - Mehdi Benchoufi
- INSERM, U1153 Epidemiology and Biostatistics Sorbonne Paris Cité Research Center (CRESS), Methods of Therapeutic Evaluation of Chronic Diseases Team (METHODS), Paris, F-75014 France; Paris Descartes University, Sorbonne Paris Cité, France; Centre d'Epidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Bridget Young
- Department of Health Services Research, Institute of Population Health Sciences, University of Liverpool, Liverpool L69 3GB, UK
| | - Lina Ghosn
- INSERM, U1153 Epidemiology and Biostatistics Sorbonne Paris Cité Research Center (CRESS), Methods of Therapeutic Evaluation of Chronic Diseases Team (METHODS), Paris, F-75014 France; Paris Descartes University, Sorbonne Paris Cité, France; Centre d'Epidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Philippe Ravaud
- INSERM, U1153 Epidemiology and Biostatistics Sorbonne Paris Cité Research Center (CRESS), Methods of Therapeutic Evaluation of Chronic Diseases Team (METHODS), Paris, F-75014 France; Paris Descartes University, Sorbonne Paris Cité, France; Centre d'Epidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Isabelle Boutron
- INSERM, U1153 Epidemiology and Biostatistics Sorbonne Paris Cité Research Center (CRESS), Methods of Therapeutic Evaluation of Chronic Diseases Team (METHODS), Paris, F-75014 France; Paris Descartes University, Sorbonne Paris Cité, France; Centre d'Epidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, Paris, France
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Price A, Schroter S, Snow R, Hicks M, Harmston R, Staniszewska S, Parker S, Richards T. Frequency of reporting on patient and public involvement (PPI) in research studies published in a general medical journal: a descriptive study. BMJ Open 2018; 8:e020452. [PMID: 29572398 PMCID: PMC5875637 DOI: 10.1136/bmjopen-2017-020452] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES While documented plans for patient and public involvement (PPI) in research are required in many grant applications, little is known about how frequently PPI occurs in practice. Low levels of reported PPI may mask actual activity due to limited PPI reporting requirements. This research analysed the frequency and types of reported PPI in the presence and absence of a journal requirement to include this information. DESIGN AND SETTING A before and after comparison of PPI reported in research papers published in The BMJ before and 1 year after the introduction of a journal policy requiring authors to report if and how they involved patients and the public within their papers. RESULTS Between 1 June 2013 and 31 May 2014, The BMJ published 189 research papers and 1 (0.5%) reported PPI activity. From 1 June 2015 to 31 May 2016, following the introduction of the policy, The BMJ published 152 research papers of which 16 (11%) reported PPI activity. Patients contributed to grant applications in addition to designing studies through to coauthorship and participation in study dissemination. Patient contributors were often not fully acknowledged; 6 of 17 (35%) papers acknowledged their contributions and 2 (12%) included them as coauthors. CONCLUSIONS Infrequent reporting of PPI activity does not appear to be purely due to a failure of documentation. Reporting of PPI activity increased after the introduction of The BMJ's policy, but activity both before and after was low and reporting was inconsistent in quality. Journals, funders and research institutions should collaborate to move us from the current situation where PPI is an optional extra to one where PPI is fully embedded in practice throughout the research process.
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Affiliation(s)
- Amy Price
- The BMJ, London, UK
- Department for Continuing Education, The University of Oxford, Oxford, UK
| | | | - Rosamund Snow
- Health Experiences Institute, Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, University of Oxford, Oxford, UK
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Price A, Albarqouni L, Kirkpatrick J, Clarke M, Liew SM, Roberts N, Burls A. Patient and public involvement in the design of clinical trials: An overview of systematic reviews. J Eval Clin Pract 2018; 24:240-253. [PMID: 29076631 DOI: 10.1111/jep.12805] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 07/03/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Funders encourage lay-volunteer inclusion in research. There are controversy and resistance, given concerns of role confusion, exploratory methods, and limited evidence about what value lay-volunteers bring to research. This overview explores these areas. METHODS Eleven databases were searched without date or language restrictions for systematic reviews of public and patient involvement (PPI) in clinical trials design. This systematic overview of PPI included 27 reviews from which areas of good and bad practice were identified. Strengths, weaknesses, opportunities, and threats of PPI were explored through use of meta-narrative analysis. RESULTS Inclusion criteria were met by 27 reviews ranging in quality from high (n = 7), medium (n = 14) to low (n = 6) reviews. Reviews were assessed using CERQUAL NICE, CASP for qualitative research and CASP for systematic reviews. Four reviews report risk of bias. Public involvement roles were primarily in agenda setting, steering committees, ethical review, protocol development, and piloting. Research summaries, follow-up, and dissemination contained PPI, with lesser involvement in data collection, analysis, or manuscript authoring. Trialists report difficulty in finding, retaining, and reimbursing volunteers. Respectful inclusion, role recognition, mutual flexibility, advance planning, and sound methods were reported as facilitating public involvement in research. Public involvement was reported to have increased the quantity and quality of patient relevant priorities and outcomes, enrollment, funding, design, implementation, and dissemination. Challenges identified include lack of clarity within common language, roles, and research boundaries, while logistical needs include extra time, training, and funding. Researchers report struggling to report involvement and avoid tokenism. CONCLUSIONS Involving patients and the public in clinical trials design can be beneficial but requires resources, preparation, training, flexibility, and time. Issues to address include reporting deficits for risk of bias, study quality, and conflicts of interests. We need to address these tensions and improve dissemination strategies to increase PPI and health literacy.
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Affiliation(s)
- Amy Price
- University of Oxford, UK.,Empower-2-Go, UK and USA
| | - Loai Albarqouni
- Bond University, Faculty of Health Sciences and Medicine, Gold Coast Australia, Australia
| | | | - Mike Clarke
- Northern Ireland Methodology Hub, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | | | - Nia Roberts
- Bodleian Health Care Libraries, University of Oxford, UK
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