Patient- and public-driven health research: a model of co-leadership and partnership in research priority setting using a modified James Lind Alliance approach

OBJECTIVES

To describe the Strategy for Patient-Oriented Research Evidence Alliance's methodological approach to systematically identify 23 high priority health research topics (three in 2021 and 20 in 2023) from patient partners (including caregivers) and members of the public across Canada and beyond.

STUDY DESIGN AND SETTING

In 2021 and 2023, we collaborated with patient and public partners to co-design and co-conduct two priority setting initiatives. These initiatives involved a diverse group of patients, the public, clinicians, researchers, and health system decision-makers to systematically and collectively prioritize research topics based on their perceived importance and anticipated impact. We used a modified James Lind Alliance approach, where all participants were engaged as equal partners. The prioritization process consisted of the following steps: 1) identification and collection of research priorities from patients and the public; 2) summarizing the research priorities gathered; 3) conducting semistructured interviews (1-on-1 or focus groups depending on the number of submissions for each unique topic), conducting literature searches on each topic to identify relevant knowledge synthesis and appraising the quality of relevant evidence using the AMSTAR 2 (A MeaSurement Tool to Assess systematic Reviews) checklist, and preparing lay summaries (1-2 pages) for each unique topic using a predefined template cocreated with patient partners; 4) conducting a priority setting exercise with a multidisciplinary panel consisting of an interim priority setting rating questionnaire to score each topic based on nine questions, followed by a virtual workshop to reach consensus on the final rating and ranking of topics; and 5) facilitating research by funding selected topics and providing capacity-building support to research teams. We conducted a formal process evaluation of engagement, transparency, information management, and considerations of values and context in 2023.

RESULTS

A total of 98 topics were received across two research priority setting initiatives. Approximately, half the submissions were made by individuals who identified as patients (2021: 45% [n = 5] and 2023: 52% [n = 45]), whereas the rest identified as caregivers or members of the public. Topics were spread across 26 health themes, with arthritis and osteoporosis (27% [n = 3]) being the most common theme in 2021 and quality of care (26% [n = 23]) in 2023. Twenty-three priorities from 98 topics submitted by patients and public were selected. A formal process evaluation in 2023 revealed 85% of the respondents who participated in the priority setting panel "strongly agreed" that their experience was valuable and they would participate again in a future initiative. The 23 prioritized projects are currently being co-led with the patient and public partner topic submitters and nominated research teams.

CONCLUSION

Priority setting exercises successfully engaged a diverse group of interested parties, resulting in the identification of relevant and impactful research topics. The positive feedback from participants suggests that these exercises were well-received and that similar methodologies should be applied and refined in future efforts.

PLAIN LANGUAGE SUMMARY

The Strategy for Patient-Oriented Research Evidence Alliance used a patient- and public-driven approach to set research priorities across different topics. They conducted two priority setting initiatives in 2021 and 2023, involving patients, the public, researchers, clinicians, and health system managers. This approach aimed to prioritize research topics based on their perceived importance and anticipated impact. A total of 98 topics were received across two research priority setting initiatives, with nearly half the submissions from patients and the other half from caregivers or members of the public. The topics covered 26 health themes, with arthritis and osteoporosis (2021) and quality of care (2023) being the most common themes. From these topics, the 23 highest priority topics were selected by a multidisciplinary priority setting panel. A formal process evaluation in 2023 revealed that 85% of the respondents who participated in the priority setting panel "strongly agreed" that their experience was valuable, and they would participate again in a future initiative. In conclusion, the priority setting exercises successfully engaged a diverse group of individuals and identified important research topics. The positive feedback suggests that this approach was well received and should be applied in future efforts.

Cobuilding patient and public capacity in knowledge synthesis: designed and delivered by patient and public partners for patient and public partners

OBJECTIVES

To describe the Strategy for Patient-Oriented Research Evidence Alliance's cocreation and evaluation of two capacity building courses on knowledge synthesis for patient and public partners.

STUDY DESIGN AND SETTING

Two 3-week courses were collaboratively designed by, with, and for patient and public partners on engagement in knowledge synthesis. The first course, offered virtually in 2021, focused on patient and public engagement in systematic reviews and rapid reviews. The second course was offered virtually in 2022 with an expanded scope covering the most common type of knowledge synthesis (eg, systematic reviews with or without meta-analysis, scoping reviews, overview of reviews) under systematic, rapid, and living review contexts.

RESULTS

A total of 46 patient and public learners were trained across the two courses. Learners represented 11 provinces and territories in Canada, with two-third of learners residing in Ontario across both years (2021: 39%; 2022: 35%). Weekly formative evaluations and a summative evaluation were conducted for both courses. The evaluations revealed that the majority of respondents agreed (2021: 91%; 2022: 88%) that they achieved their learning goals and that their overall learning experience was valuable (2021: 95%; 2022: 89%).

CONCLUSION

The capacity-building courses in 2021 and 2022 successfully engaged 46 patient and public partners across Canada. As a result, these partners are now well-prepared to participate in knowledge synthesis activities. The positive experiences from respondents indicated successful and satisfactory experiences and that similar capacity building opportunities should be offered to continue to address research capacity gaps.

PLAIN LANGUAGE SUMMARY

In 2021 and 2022, the Strategy for Patient-Oriented Research Evidence Alliance adopted a cocreation approach to deliver two courses on patient and public engagement in knowledge synthesis for patient and public partners. These courses aimed to build confidence and provide foundational knowledge for patient and public partner engagement in knowledge synthesis. A total of 46 learners were trained across the two courses. Formal evaluations revealed that the courses were effective in meeting their learning goals. Feedback suggests a continued need and opportunity to offer similar courses designed by, with, and for patient and public partners.

From code to care: Clinician and researcher perspectives on an optimal therapeutic web portal for acute myeloid leukemia

BACKGROUND

Acute myeloid leukemia (AML), a rapidly progressing cancer of the blood and bone marrow, is the most common and fatal type of adult leukemia. Therapeutic web portals have great potential to facilitate AML research advances and improve health outcomes by increasing the availability of data, the speed and reach of new knowledge, and the communication between researchers and clinicians in the field. However, there is a need for stakeholder research regarding their optimal features, utility, and implementation.

METHODS

To better understand stakeholder perspectives regarding an ideal pan-Canadian web portal for AML research, semi-structured qualitative interviews were conducted with 17 clinicians, researchers, and clinician-researchers. Interview guides were inspired by De Laat's "fictive scripting", a method where experts are presented with scenarios about a future technology and asked questions about its implementation. Content analysis relied on an iterative process using themes extracted from both existing scientific literature and the data.

RESULTS

Participants described potential benefits of an AML therapeutic portal including facilitating data-sharing, communication, and collaboration, and enhancing clinical trial matchmaking for patients, potentially based on their specific genomic profiles. There was enthusiasm about researcher, clinician, and clinician-researcher access, but some disagreement about the nature of potential patient access to the portal. Interviewees also discussed two key elements they believed to be vital to the uptake and thus success of a therapeutic AML web portal: credibility and user friendliness. Finally, sustainability, security and privacy concerns were also documented.

CONCLUSIONS

This research adds to existing calls for digital platforms for researchers and clinicians to supplement extant modes of communication to streamline research and its dissemination, advance precision medicine, and ultimately improve patient prognosis and care. Findings are applicable to therapeutic web portals more generally, particularly in genomic and translational medicine, and will be of interest to portal end-users, developers, researchers, and policymakers.

Researcher-patient partnership generated actionable recommendations, using quantitative evaluation and deliberative dialogue, to improve meaningful engagement

OBJECTIVES

To demonstrate how the 22-item Patient Engagement in Research Scale (PEIRS-22) can be used to develop recommendations for improving the meaningfulness of patient engagement.

STUDY DESIGN AND SETTING

PEIRS-22 previously captured quantitative evaluation data from 15 patient partners in a self-study of the Strategy for Patient-Oriented Research (SPOR) Evidence Alliance. Guided by deliberative dialogue, the current study involved 3 steps: (1) In-depth analysis and interpretation of the PEIRS-22 data produced a lay evidence summary with identified areas for improvement of meaningful engagement; (2) A 3-hour virtual workshop with patient partners and researchers generated initial recommendations; and (3) In two successive post-workshop surveys, ratings by workshop invitees led to consensus on the recommendations.

RESULTS

Twenty-five participants attended the workshops and dialogued on 8 areas for improvement identified from the PEIRS-22 data. Twenty-eight unique initial recommendations led to consensus on 14 key recommendations organized across 4 categories: setting expectations for all team members, building trust and ongoing communication, providing opportunities to enhance learning and to develop skills, and acknowledging contributions of patient partners.

CONCLUSION

Using PEIRS-22 data within a deliberate dialogue elucidated 14 actionable recommendations to support ongoing improvement of patient engagement at SPOR Evidence Alliance, a pan-Canadian health research initiative.

An inclusive and diverse governance structure of the strategy for patient-oriented research (SPOR) Evidence Alliance

The Strategy for Patient Oriented Research (SPOR) Evidence Alliance is a research initiative in Canada whose mission is to promote the synthesis, dissemination, and integration of research results into health care and public health decision-making and clinical practice. The aim of this paper is to ( i) outline the governance and committee structure of the SPOR Evidence Alliance, ( ii) outline the procedures for patient and health system decision-maker engagement, and ( iii) present the capacity-building strategy for governance members. The governance structure includes the following six standing committees: the International Advisory Committee, Steering Committee, Executive Committee, Knowledge Translation Committee, Partnerships Committee, and Training and Capacity Development Committee. The guiding principles embrace inclusiveness, support, mutual respect, transparency, and co-building. There are currently 64 committee members across the six committees, 13 patient and public partners, 8 health system decision-makers, 7 research trainees, and 36 researchers. A multi-disciplinary and diverse group of people in Canada are represented from all regions and at various levels of training in knowledge generation, exchange, and translation. This collaborative model makes the SPOR Evidence Alliance strong and sustainable by leveraging the knowledge, lived experiences, expertise, skills, and networks among its 342 members and 12 principal investigators.