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Mistry A, Leslie A, Ojha S, Sharkey D. Identifying neonatal transport research priorities: a modified Delphi consensus. Arch Dis Child Fetal Neonatal Ed 2024:fetalneonatal-2024-327213. [PMID: 38857987 DOI: 10.1136/archdischild-2024-327213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 05/15/2024] [Indexed: 06/12/2024]
Abstract
OBJECTIVES With increasing advances in neonatal transport, a focused research strategy is required to increase the evidence base towards providing optimal care. We aimed to identify the most important neonatal transport research questions as prioritised by parents and healthcare professionals (HCPs). DESIGN Key stakeholders participated in a modified three-stage Delphi consensus process. Research questions were identified and submitted through two survey stages before the final priority setting workshop. PARTICIPANTS Parents of babies who received neonatal care, neonatal HCPs and stakeholders. OUTCOME Identify the top 10 research priorities for neonatal transport. RESULTS Overall, 269 survey responses from HCPs/stakeholders (n=161) and parents (n=108) were analysed from two survey rounds. Consensus was reached on 22 of 43 research priorities for the final priority setting workshop. The agreed top research priorities covered the domains of: (1) Pain assessment and management, (2) Long-term neurological outcomes, (3) Impact of transfer on birth-related brain injury, (4) Investigating risk of transport, (5) Safety restraints for infants, (6) Optimal temperature management, (7) Respiratory management and outcomes, (8) Benchmarking of important of transport measures, (9) Understanding transport environmental exposures, (10) Mental health and burden of transfer on families. CONCLUSION We have identified the top research questions for neonatal transport through an extensive process actively engaging parents, HCPs and key stakeholders. Targeted funding and research resources, directed towards addressing these prioritised research areas, will inform evidence-based practices and international frameworks specific to neonatal transport, helping minimise research waste and ultimately improve outcomes for these high-risk infants and their families.
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Affiliation(s)
- Aarti Mistry
- Centre for Perinatal Research (CePR), School of Medicine, University of Nottingham, Nottingham, UK
| | - Andrew Leslie
- Centre for Perinatal Research (CePR), School of Medicine, University of Nottingham, Nottingham, UK
- UK-Neonatal Transport Research Collaborative (UK-NTRC), UK-Neonatal Transport Group, Nottingham, UK
| | - Shalini Ojha
- Centre for Perinatal Research (CePR), School of Medicine, University of Nottingham, Nottingham, UK
| | - Don Sharkey
- Centre for Perinatal Research (CePR), School of Medicine, University of Nottingham, Nottingham, UK
- UK-Neonatal Transport Research Collaborative (UK-NTRC), UK-Neonatal Transport Group, Nottingham, UK
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Ross L, Finlayson M, Amato MP, Cohen JA, Hellwig K, Tintore M, Vukusic S, Salter A, Marrie RA. Priority setting: women's health topics in multiple sclerosis. Front Neurol 2024; 15:1355817. [PMID: 38440114 PMCID: PMC10910071 DOI: 10.3389/fneur.2024.1355817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/06/2024] [Indexed: 03/06/2024] Open
Abstract
Background A scoping review found that most studies on women's health in multiple sclerosis (MS) focused on pregnancy, fetal/neonatal outcomes and sexual dysfunction. Few studies addressed menopause, contraception, gynecologic cancers/cancer screening. However, the perceived relative importance of these knowledge gaps to people living with MS and other partners is unknown. We engaged a range of partners, including people living with MS, health care providers, researchers, and patient advocacy groups, to set priorities for future research in women's health in MS. Methods We employed a three-step global engagement process. First, we identified which broad research topics relevant to women's health in MS were of highest priority using two surveys. Second, we developed specific research questions within these topics using focus groups. Finally, we prioritized the research questions with a third survey. Results Overall, 5,266 individuals responded to the initial surveys [n = 1,430 global survey, mean (SD) age 50.0 (12.6), all continents; n = 3,836 North American Research Committee on Multiple Sclerosis survey, mean (SD) age 64.8 (9.6), United States]. Menopause, sexual dysfunction, pregnancy, gynecologic cancer/cancer screening, hormones and parenthood were identified as the most important topics. Focus groups generated 80 potential research questions related to these topics. In the final survey 712 individuals prioritized these questions. The highest priority questions in each research topic were: (i) How do perimenopause and menopause affect disease activity, course, response to disease-modifying treatment and quality of life in MS; (ii) What are the most effective strategies for managing issues around sexual intimacy, including related to low sexual desire, changes in physical function, and MS symptoms; (iii) Are there long-term effects of disease-modifying therapies on the children of persons with MS; (iv) What are the short and long-term effects of disease-modifying drugs on gynecologic cancer risk, particularly for high efficacy disease-modifying drugs and hematopoietic stem cell transplantation; (v) Are there hormone related treatments that can stabilize fluctuations in MS symptoms; and (vi) How does MS fatigue impact parenting strategies. Conclusion Priorities for research relating to women's health issues for persons with MS have been delineated using a collaborative process with key partners. Alignment of future research with these priorities should be monitored.
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Affiliation(s)
- Lindsay Ross
- Department of Neurology, Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Marcia Finlayson
- School of Rehabilitation Therapy, Queen’s University, Kingston, ON, Canada
| | - Maria Pia Amato
- Department of NEUROFARBA, Section of Neurosciences, University of Florence, Florence, Italy
- IRCCS Fondazione Don Carol Gnocchi, Florence, Italy
| | - Jeffrey Alan Cohen
- Department of Neurology, Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Kerstin Hellwig
- Department of Neurology, Katholische Klinikum, Ruhr University, Bochum, Germany
| | - Mar Tintore
- Multiple Sclerosis Centre of Catalonia, Department of Neurology, Hospital Universitari Vall d’Hebron, Universitat Autonoma de Barcelona, Universitat de Vic-Universitat Central de Catalunya, Barcelona, Spain
| | - Sandra Vukusic
- Service de Neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation-et Fondation Eugène Devic EDMUS pour la Sclérose en Plaques, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France
- Centre des Neurosciences de Lyon, INSERM 1028 et CNRS UMR5292, Observatoire Français de la Sclérose en Plaque, Lyon, France
- Université Claude Bernard Lyon 1, Lyon, France
| | - Amber Salter
- Department of Neurology, Section on Statistical Planning and Analysis, UT Southwestern Medical Center, Dallas, TX, United States
| | - Ruth Ann Marrie
- Department of Neurology, Section on Statistical Planning and Analysis, UT Southwestern Medical Center, Dallas, TX, United States
- Department of Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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Tang KWK, Millar BC, Moore JE. Improving health literacy of antibiotic use in people with cystic fibrosis (CF)-comparison of the readability of patient information leaflets (PILs) from the EU, USA and UK of 23 CF-related antibiotics used in the treatment of CF respiratory infections. JAC Antimicrob Resist 2023; 5:dlad129. [PMID: 38046567 PMCID: PMC10691746 DOI: 10.1093/jacamr/dlad129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 11/20/2023] [Indexed: 12/05/2023] Open
Abstract
Background Antibiotic adherence is poor amongst people with cystic fibrosis (CF). Low-quality patient information leaflets (PILs), which accompany prescription antibiotics, with poor readability may contribute to poor antibiotic adherence, with the potential for antimicrobial resistance (AMR) development. The aim of this study was to examine the readability of antibiotic PILs used to treat CF lung infections. Methods CF-related antibiotics (n = 23; seven classes: aminoglycosides, β-lactams, fluoroquinolones, macrolides/lincosamides, oxazolidinones, tetracyclines, trimethoprim/sulfamethoxazole) were investigated. Readability of PILs (n = 141; 23 antibiotics) from the EU (n = 40), USA (n = 42) and UK (n = 59) was calculated. Results Mean [± standard error of mean (SEM)] values for the Flesch Reading Ease (FRE) for EU, USA and UK were 50.0 ± 1.1, 56.2 ± 1.3 and 51.7 ± 1.1, respectively (FRE target ≥60). Mean (± SEM) values for the Flesch Kinkaid Grade Level (FKGL) for the EU, USA and UK were 9.0 ± 0.2, 7.5 ± 0.2 and 9.6 ± 0.2, respectively (FKGL target ≤8). US PILs were significantly shorter (P < 0.0001) in words (mean ± SEM = 1365 ± 52), than either UK or EU PILs, with fewer sentences (P < 0.0001), fewer words per sentence (P < 0.0001) and fewer syllables per word. The mean ( ± SEM) reading time of UK PILs (n = 59) was 12.7 ± 0.55 mins . Conclusions Readability of antibiotic PILs is poor. Improving PIL readability may lead to improved health literacy, which may translate to increased antibiotic adherence and AMR avoidance. Authors preparing written materials for the lay/patient CF community are encouraged to employ readability calculators, so that final materials are within recommended readability reference parameters, to support the health (antibiotic) literacy of their readers.
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Affiliation(s)
- Ka Wah Kelly Tang
- School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine BT52 1SA Northern Ireland, UK
| | - Beverley C Millar
- School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine BT52 1SA Northern Ireland, UK
- Laboratory for Disinfection and Pathogen Elimination Studies, Northern Ireland Public Health Laboratory, Belfast City Hospital, Lisburn Road, Belfast BT9 7AD Northern Ireland, UK
- Northern Ireland Regional Adult Cystic Fibrosis Centre, Level 8, Belfast City Hospital, Lisburn Road, Belfast BT9 7AB, Northern Ireland, UK
| | - John E Moore
- School of Biomedical Sciences, Ulster University, Cromore Road, Coleraine BT52 1SA Northern Ireland, UK
- Laboratory for Disinfection and Pathogen Elimination Studies, Northern Ireland Public Health Laboratory, Belfast City Hospital, Lisburn Road, Belfast BT9 7AD Northern Ireland, UK
- Northern Ireland Regional Adult Cystic Fibrosis Centre, Level 8, Belfast City Hospital, Lisburn Road, Belfast BT9 7AB, Northern Ireland, UK
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Nyman F. Health care of the disadvantaged: chronic obstructive pulmonary disease in later life. Front Public Health 2023; 11:1304494. [PMID: 38026408 PMCID: PMC10666629 DOI: 10.3389/fpubh.2023.1304494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Chronic diseases have emerged as the foremost causes of death and disability worldwide. This article employs an ethnographic approach to conduct a gerontological investigation of chronic obstructive pulmonary disease (COPD), the third leading cause of global mortality, trailing only cardiovascular diseases and cancers. Methods This study is rooted in an extensive amalgamation of biomedical literature and official epidemiological data. Additionally, it offers enriched insights through an extensive ethnographic research methodology, encompassing ethnographic fieldwork, participant observation, interviews, and focus groups. Results The findings expound that individuals grappling with chronic obstructive pulmonary disease often undergo intricate cognitive and emotional experiences, necessitating holistic solutions that consider psychological processes, contextual factors, and subjective age. These challenges extend beyond the purview of a purely medical perspective. Conclusion This article concludes that the lens of gerontology is invaluable in comprehending chronic obstructive pulmonary disease, particularly due to its association with old age and increased longevity. Among older individuals, diagnosing the condition presents a formidable challenge. Breathlessness, a cardinal symptom, often overlaps with normal age-related declines in pulmonary function, rendering COPD's insidious onset misconstrued as a consequence of aging-related changes.
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Affiliation(s)
- Fredrik Nyman
- Department of Psychology and Social Work, Mid Sweden University, Östersund, Sweden
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5
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Jones M, Moffatt F, Harvey A, Ryan JM. Interventions for improving adherence to airway clearance treatment and exercise in people with cystic fibrosis. Cochrane Database Syst Rev 2023; 7:CD013610. [PMID: 37462324 PMCID: PMC10353490 DOI: 10.1002/14651858.cd013610.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
BACKGROUND Cystic fibrosis (CF) is a life-limiting genetic disorder predominantly affecting the lungs and pancreas. Airway clearance techniques (ACTs) and exercise therapy are key components of physiotherapy, which is considered integral in managing CF; however, low adherence is well-documented. Poor physiotherapy adherence may lead to repeated respiratory infections, reduced exercise tolerance, breathlessness, reduced quality of life, malaise and reduced life expectancy, as well as increased use of pharmacology, healthcare access and hospital admission. Therefore, evidence-based strategies to inform clinical practice and improve adherence to physiotherapy may improve quality of life and reduce treatment burden. OBJECTIVES To assess the effects of interventions to enhance adherence to airway clearance treatment and exercise therapy in people with CF and their effects on health outcomes, such as pulmonary exacerbations, exercise capacity and health-related quality of life. SEARCH METHODS We searched the Cochrane Cystic Fibrosis Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books. Date of last search: 1 March 2023. We also searched online trials registries and the reference lists of relevant articles and reviews. Date of last search: 28 March 2023. SELECTION CRITERIA We included randomised controlled trials (RCTs) and quasi-RCTs of parallel design assessing any intervention aimed at enhancing adherence to physiotherapy in people with CF versus no intervention, another intervention or usual care. DATA COLLECTION AND ANALYSIS Two review authors independently checked search results for eligible studies and independently extracted data. We used standard procedures recommended by Cochrane and assessed the certainty of evidence using the GRADE system. MAIN RESULTS Two RCTs (77 participants with CF; age range 2 to 20 years; 44 (57%) males) met the inclusion criteria of this review. One study employed an intervention to improve adherence to exercise and the second an intervention to improve adherence to ACT. Both studies measured outcomes at baseline and at three months, but neither study formally assessed our primary outcome of adherence in terms of our planned outcome measures, and results were dependent on self-reported data. Adherence to ACTs One RCT (43 participants) assessed using specifically-composed music alongside ACTs compared to self-selected or no music (usual care). The ACT process consisted of nebuliser inhalation treatment, ACTs and relaxation or antibiotic nebuliser treatment. We graded all evidence as very low certainty. This study reported adherence to ACTs using the Morisky-Green questionnaire and also participants' perception of treatment time and enjoyment, which may influence adherence (outcome not reported specifically in this review). We are uncertain whether participants who received specifically-composed music may be more likely to adhere at six and 12 weeks compared to those who received usual care, risk ratio (RR) 1.75 (95% confidence interval (CI) 1.07 to 2.86) and RR 1.56 (95% CI 1.01 to 2.40) respectively. There may not be any difference in adherence when comparing specifically-composed music to self-selected music at six weeks, RR 1.21 (95% CI 0.87 to 1.68) or 12 weeks, RR 1.52 (95% CI 0.97 to 2.38); or self-selected music to usual care at six weeks, RR 1.44 (95% CI 0.82 to 2.52) or 12 weeks, RR 1.03 (95% CI 0.57 to 1.86). The music study also reported the number of respiratory infections requiring hospitalisation at 12 weeks, with no difference seen in the risk of hospitalisation between all groups. Adherence to exercise One RCT (24 participants) compared the provision of a manual of aerobic exercises, recommended exercise prescription plus two-weekly follow-up phone calls to reinforce exercise practice over a period of three months to verbal instructions for aerobic exercise according to the CF centre's protocol. We graded all evidence as very low certainty. We are uncertain whether an educational intervention leads to more participants in the intervention group undertaking increased regular physical activity at three months (self-report), RR 3.67 (95% CI 1.24 to 10.85), and there was no reported difference between groups in the number undertaking physical activity three times per week or undertaking at least 40 minutes of physical activity. No effect was seen on secondary outcome measures of spirometry, exercise capacity or any CF quality of life domains. This study did not report on the frequency of respiratory infections (hospitalised or not) or adverse events. AUTHORS' CONCLUSIONS We are uncertain whether a music-based motivational intervention may increase adherence to ACTs or affect the risk of hospitalisation for a respiratory infection. We are also uncertain whether an educational intervention increases adherence to exercise or reduces the frequency of respiratory infection-related hospital admission. However, these results are largely based on self-reported data and the impact of strategies to improve adherence to ACT and exercise in children and adolescents with stable CF remains inconclusive. Given that adherence to ACT and exercise therapy are fundamental to the clinical management of people with CF, there is an urgent need for well-designed, large-scale clinical trials in this area, which should conform to the CONSORT statement for standards of reporting and use appropriate, validated outcome measures. Studies should also ensure full disclosure of data for all important clinical outcomes.
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Affiliation(s)
- Mandy Jones
- c/o Cochrane Cystic Fibrosis, University of Nottingham, Nottingham, UK
| | - Fiona Moffatt
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Alex Harvey
- School of Health Sciences and Social Care, Brunel University London, Uxbridge, UK
| | - Jennifer M Ryan
- Institute of Environment, Health and Societies, Brunel University London, Uxbridge, UK
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Majellano EC, Bell RL, Flynn AW, Mckenzie A, Sivamalai S, Goldman M, Vaughan L, Gibson PG. Identifying the asthma research priorities of people with asthma, their carers and other stakeholders. Respirology 2023; 28:636-648. [PMID: 36921924 DOI: 10.1111/resp.14492] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 03/01/2023] [Indexed: 03/17/2023]
Abstract
BACKGROUND AND OBJECTIVE People living with asthma, their carers, clinicians and policymakers are the end-users of research and need research that address their individual healthcare needs. We aimed to understand the research priorities of end-users of asthma research. METHODS A national cross-sectional mixed-methods study was conducted. The study included an online survey that engaged patients, carers, healthcare professionals and policymakers to provide statements to free-text questions about what they would like to see answered by research to improve living with asthma on a day-to-day basis. Responses where thematically analysed followed by three online priority setting consensus workshops. RESULTS There were 593 respondents who provided 1446 text comments. Participants prioritized 10 asthma research themes which were: (1) asthma in children, (2) COVID 19 and asthma, (3) asthma care and self-management, (4) diagnosis and medication, (5) managing asthma attacks, (6) causes, prevention and features of asthma, (7) mental health, (8) asthma and ageing, (9) severe asthma, (10) asthma and other health conditions. Each theme comprises specific research questions. CONCLUSION This project successfully established 10 priority research themes for asthma, reflecting the collective voice of the end-users of this research. These novel data can be used to address the documented mismatch in research prioritization between the research community and the end-users of research.
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Affiliation(s)
- Eleanor C Majellano
- National Health and Medical Research Council Centre for Research Excellence in Severe Asthma and Centre for Research Excellence in Treatable Traits, The University of Newcastle, Newcastle, New South Wales, Australia
- School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute Asthma and Breathing Research Program, Newcastle, New South Wales, Australia
| | - Rose L Bell
- Research, Information and Evaluation, Asthma Australia, Melbourne, Victoria, Australia
| | - Anthony W Flynn
- Research, Information and Evaluation, Asthma Australia, Melbourne, Victoria, Australia
| | - Anne Mckenzie
- Telethon Kids Institute, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Sundram Sivamalai
- Ethnic Communities' Council of Victoria, Ballarat, Victoria, Australia
| | | | - Lauren Vaughan
- Australia Marketing and Communication, Asthma Australia, Fortitude Valley, Queensland, Australia
| | - Peter G Gibson
- National Health and Medical Research Council Centre for Research Excellence in Severe Asthma and Centre for Research Excellence in Treatable Traits, The University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute Asthma and Breathing Research Program, Newcastle, New South Wales, Australia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, New South Wales, Australia
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia
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Deering K, Brimblecombe N, Matonhodze JC, Nolan F, Collins DA, Renwick L. Methodological procedures for priority setting mental health research: a systematic review summarising the methods, designs and frameworks involved with priority setting. Health Res Policy Syst 2023; 21:64. [PMID: 37365647 DOI: 10.1186/s12961-023-01003-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 05/18/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Research priority setting aims to identify research gaps within particular health fields. Given the global burden of mental illness and underfunding of mental health research compared to other health topics, knowledge of methodological procedures may raise the quality of priority setting to identify research with value and impact. However, to date there has been no comprehensive review on the approaches adopted with priority setting projects that identify mental health research, despite viewed as essential knowledge to address research gaps. Hence, the paper presents a summary of the methods, designs, and existing frameworks that can be adopted for prioritising mental health research to inform future prioritising projects. METHOD A systematic review of electronic databases located prioritisation literature, while a critical interpretive synthesis was adopted whereby the appraisal of methodological procedures was integrated into the synthesis of the findings. The synthesis was shaped using the good practice checklist for priority setting by Viergever and colleagues drawing on their following categories to identify and appraise methodological procedures: (1) Comprehensive Approach-frameworks/designs guiding the entire priority setting; (2) Inclusiveness -participation methods to aid the equal contribution of stakeholders; (3) Information Gathering-data collecting methods to identify research gaps, and (4) Deciding Priorities-methods to finalise priorities. RESULTS In total 903 papers were located with 889 papers removed as either duplicates or not meeting the inclusion and exclusion criteria. 14 papers were identified, describing 13 separate priority setting projects. Participatory approaches were the dominant method adopted but existing prioritisation frameworks were modified with little explanation regarding the rationale, processes for adaptation and theoretical foundation. Processes were predominately researcher led, although with some patient involvement. Surveys and consensus building methods gathered information while ranking systems and thematic analysis tend to generate finalised priorities. However, limited evidence found about transforming priorities into actual research projects and few described plans for implementation to promote translation into user-informed research. CONCLUSION Prioritisation projects may benefit from justifying the methodological approaches taken to identify mental health research, stating reasons for adapting frameworks alongside reasons for adopting particular methods, while finalised priorities should be worded in such a way as to facilitate their easy translation into research projects.
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Affiliation(s)
- Kris Deering
- University of Exeter Medical School, St Luke's Campus, 79 Heavitree Rd, Exeter, EX1 2LT, United Kingdom.
| | - Neil Brimblecombe
- London South Bank University, 103 Borough Road, London, SE1 0AA, United Kingdom
| | - Jane C Matonhodze
- University of Greenwich, Avery Hill Campus, Southwood Site, Avery Hill Road, London, SE9 2UG, United Kingdom
| | - Fiona Nolan
- Anglia Ruskin University, Chelmsford Campus Bishop Hall Lane, Chelmsford, CM1 1SQ, United Kingdom
| | - Daniela A Collins
- London South Bank University, 103 Borough Road, London, SE1 0AA, United Kingdom
| | - Laoise Renwick
- The University of Manchester, Oxford Rd, Manchester, M13 9PL, United Kingdom
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Mowforth OD, Burn L, Khan DZ, Yang X, Stacpoole SRL, Gronlund T, Tetreault L, Kalsi-Ryan S, Starkey ML, Sadler I, Sarewitz E, Houlton D, Carter J, Howard P, Rahimi-Movaghar V, Guest JD, Aarabi B, Kwon BK, Kurpad SN, Harrop J, Wilson JR, Grossman R, Smith EK, McNair A, Fehlings MG, Kotter MRN, Davies BM. Lived experience-centred word clouds may improve research uncertainty gathering in priority setting partnerships. BMC Med Res Methodol 2023; 23:100. [PMID: 37087419 PMCID: PMC10122197 DOI: 10.1186/s12874-023-01897-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 03/20/2023] [Indexed: 04/24/2023] Open
Abstract
INTRODUCTION AO Spine RECODE-DCM was a multi-stakeholder priority setting partnership (PSP) to define the top ten research priorities for degenerative cervical myelopathy (DCM). Priorities were generated and iteratively refined using a series of surveys administered to surgeons, other healthcare professionals (oHCP) and people with DCM (PwDCM). The aim of this work was to utilise word clouds to enable the perspectives of people with the condition to be heard earlier in the PSP process than is traditionally the case. The objective was to evaluate the added value of word clouds in the process of defining research uncertainties in National Institute for Health Research (NIHR) James Lind Alliance (JLA) Priority Setting Partnerships. METHODS Patient-generated word clouds were created for the four survey subsections of the AO Spine RECODE-DCM PSP: diagnosis, treatment, long-term management and other issues. These were then evaluated as a nested methodological study. Word-clouds were created and iteratively refined by an online support group of people with DCM, before being curated by the RECODE-DCM management committee and expert healthcare professional representatives. The final word clouds were embedded within the surveys administered at random to 50% of participants. DCM research uncertainties suggested by participants were compared pre- and post-word cloud presentation. RESULTS A total of 215 (50.9%) participants were randomised to the word cloud stream, including 118 (55%) spinal surgeons, 52 (24%) PwDCM and 45 (21%) oHCP. Participants submitted 434 additional uncertainties after word cloud review: word count was lower and more uniform across each survey subsections compared to pre-word cloud uncertainties. Twenty-three (32%) of the final 74 PSP summary questions did not have a post-word cloud contribution and no summary question was formed exclusively on post-word cloud uncertainties. There were differences in mapping of pre- and post-word cloud uncertainties to summary questions, with greater mapping of post-word cloud uncertainties to the number 1 research question priority: raising awareness. Five of the final summary questions were more likely to map to the research uncertainties suggested by participants after having reviewed the word clouds. CONCLUSIONS Word clouds may increase the perspective of underrepresented stakeholders in the research question gathering stage of priority setting partnerships. This may help steer the process towards research questions that are of highest priority for people with the condition.
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Affiliation(s)
- Oliver D Mowforth
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Lance Burn
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Danyal Z Khan
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Xiaoyu Yang
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Sybil R L Stacpoole
- Department of Clinical Neurosciences, North West Anglia NHS Foundation Trust and Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Toto Gronlund
- James Lind Alliance, National Institute for Health Research, Southampton, UK
| | - Lindsay Tetreault
- Division of Neurosurgery, University of Toronto, Toronto, ON, Canada
| | | | - Michelle L Starkey
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Iwan Sadler
- Myelopathy.Org, (Registered Charity England and Wales, No 1178673), Cambridge, UK
| | - Ellen Sarewitz
- The Goffin Consultancy, Goffin Consultancy Ltd, Riding House, Stelling Minnis, Bossingham Road, Canterbury, CT4 6AZ, UK
| | - Delphine Houlton
- Myelopathy.Org, (Registered Charity England and Wales, No 1178673), Cambridge, UK
| | - Julia Carter
- Myelopathy.Org, (Registered Charity England and Wales, No 1178673), Cambridge, UK
| | - Paige Howard
- US Person with DCM Representative - CSU, Bakersfield, CA, USA
| | - Vafa Rahimi-Movaghar
- Academic Department of Neurological Surgery, Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - James D Guest
- Department of Neurological Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Bizhan Aarabi
- Division of Neurosurgery, Shock Trauma, University of Maryland, Baltimore, MD, USA
| | - Brian K Kwon
- Division of Spine Surgery, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Shekar N Kurpad
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - James Harrop
- Division of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | | | - Robert Grossman
- Division of Neurosurgery, Houston Methodist Hospital, Houston, TX, USA
| | - Emma K Smith
- School of General Practice, NHS Health Education East of England, London, UK
| | - Angus McNair
- Center for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
| | | | - Mark R N Kotter
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- Wellcome Trust & MRC Cambridge Stem Cell Institute, Cambridge, UK
| | - Benjamin M Davies
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
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Morton RL, Tuffaha H, Blaya-Novakova V, Spencer J, Hawley CM, Peyton P, Higgins A, Marsh J, Taylor WJ, Huckson S, Sillett A, Schneemann K, Balagurunanthan A, Cumpston M, Scuffham PA, Glasziou P, Simes RJ. Approaches to prioritising research for clinical trial networks: a scoping review. Trials 2022; 23:1000. [PMID: 36510214 PMCID: PMC9743749 DOI: 10.1186/s13063-022-06928-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/15/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Prioritisation of clinical trials ensures that the research conducted meets the needs of stakeholders, makes the best use of resources and avoids duplication. The aim of this review was to identify and critically appraise approaches to research prioritisation applicable to clinical trials, to inform best practice guidelines for clinical trial networks and funders. METHODS A scoping review of English-language published literature and research organisation websites (January 2000 to January 2020) was undertaken to identify primary studies, approaches and criteria for research prioritisation. Data were extracted and tabulated, and a narrative synthesis was employed. RESULTS Seventy-eight primary studies and 18 websites were included. The majority of research prioritisation occurred in oncology and neurology disciplines. The main reasons for prioritisation were to address a knowledge gap (51 of 78 studies [65%]) and to define patient-important topics (28 studies, [35%]). In addition, research organisations prioritised in order to support their institution's mission, invest strategically, and identify best return on investment. Fifty-seven of 78 (73%) studies used interpretative prioritisation approaches (including Delphi surveys, James Lind Alliance and consensus workshops); six studies used quantitative approaches (8%) such as prospective payback or value of information (VOI) analyses; and 14 studies used blended approaches (18%) such as nominal group technique and Child Health Nutritional Research Initiative. Main criteria for prioritisation included relevance, appropriateness, significance, feasibility and cost-effectiveness. CONCLUSION Current research prioritisation approaches for groups conducting and funding clinical trials are largely interpretative. There is an opportunity to improve the transparency of prioritisation through the inclusion of quantitative approaches.
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Affiliation(s)
- Rachael L. Morton
- grid.1013.30000 0004 1936 834XNational Health and Medical Research Council Clinical Trials Centre (NHMRC CTC), University of Sydney, Sydney, Australia
| | - Haitham Tuffaha
- grid.1003.20000 0000 9320 7537Centre for the Business and Economics of Health, University of Queensland, Brisbane, Australia
| | - Vendula Blaya-Novakova
- grid.1013.30000 0004 1936 834XNational Health and Medical Research Council Clinical Trials Centre (NHMRC CTC), University of Sydney, Sydney, Australia
| | - Jenean Spencer
- Australian Clinical Trials Alliance (ACTA), Melbourne, Victoria Australia
| | - Carmel M. Hawley
- grid.1003.20000 0000 9320 7537Australasian Kidney Trials Network (AKTN), Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Phil Peyton
- grid.418175.e0000 0001 2225 7841Australian and New Zealand College of Anaesthetists (ANZCA), Melbourne, Australia
| | - Alisa Higgins
- grid.1002.30000 0004 1936 7857Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), Monash University, Melbourne, Victoria Australia
| | - Julie Marsh
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, West Perth, Australia
| | - William J. Taylor
- grid.29980.3a0000 0004 1936 7830University of Otago, Rehabilitation Teaching and Research Unit, Dunedin, New Zealand
| | - Sue Huckson
- grid.489411.10000 0004 5905 1670Australian and New Zealand Intensive Care Society (ANZICS), Camberwell, Victoria Australia
| | - Amy Sillett
- grid.467202.50000 0004 0445 3920AstraZeneca Australia, Macquarie Park, New South Wales Australia
| | - Kieran Schneemann
- Australian Clinical Trials Alliance (ACTA), Melbourne, Victoria Australia ,grid.467202.50000 0004 0445 3920AstraZeneca Australia, Macquarie Park, New South Wales Australia
| | | | - Miranda Cumpston
- Australian Clinical Trials Alliance (ACTA), Melbourne, Victoria Australia ,grid.266842.c0000 0000 8831 109XSchool of Medicine and Public Health, The University of Newcastle, Newcastle, Australia
| | - Paul A. Scuffham
- grid.1003.20000 0000 9320 7537Centre for the Business and Economics of Health, University of Queensland, Brisbane, Australia
| | - Paul Glasziou
- grid.1033.10000 0004 0405 3820Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Australia
| | - Robert J. Simes
- grid.1013.30000 0004 1936 834XNational Health and Medical Research Council Clinical Trials Centre (NHMRC CTC), University of Sydney, Sydney, Australia
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Katirai A, Kogetsu A, Kato K, Yamamoto B. Patient involvement in priority-setting for medical research: A mini review of initiatives in the rare disease field. Front Public Health 2022; 10:915438. [PMID: 35928485 PMCID: PMC9343727 DOI: 10.3389/fpubh.2022.915438] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/30/2022] [Indexed: 11/19/2022] Open
Abstract
Patient involvement (PI) in determining medical research priorities is an important way to ensure that limited research funds are allocated to best serve patients. As a disease area for which research funds are limited, we see a particular utility for PI in priority-setting for medical research on rare diseases. In this review, we argue that PI initiatives are an important form of evidence for policymaking. We conducted a study to identify the extent to which PI initiatives are being conducted in the rare disease field, the features of such initiatives, the trends in the priorities elicited, and the extent to which translation into policy is reported in the academic literature. Here, we report the results of this exploratory review of the English-language literature gathered through online databases and search engines, with the aim of identifying journal articles published prior to December 2020, describing PI initiatives focused on determining priorities for medical research funding in the rare disease field. We identified seven recently-published articles and found that the majority made use of structured methodologies to ensure the robustness of the evidence produced, but found little reported practical implementation or concrete plans for implementation of the results of the initiatives. We conclude that priority-setting initiatives are meaningful mechanisms for involving patients in determining research directions. However, we highlight the importance of translation into policy as a necessary next step to fully utilize the results and move beyond well-intentioned exercises. Finally, we draw attention to the benefits of involving patients throughout this process.
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Affiliation(s)
- Amelia Katirai
- Department of Kyosei Studies (Critical Studies in Coexistence, Symbiosis and Conviviality), Graduate School of Human Sciences, Osaka University, Suita, Japan
| | - Atsushi Kogetsu
- Department of Biomedical Ethics and Public Policy, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Kazuto Kato
- Department of Biomedical Ethics and Public Policy, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Beverley Yamamoto
- Department of Kyosei Studies (Critical Studies in Coexistence, Symbiosis and Conviviality), Graduate School of Human Sciences, Osaka University, Suita, Japan
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Altabee R, Carr SB, Abbott J, Cameron R, Office D, Matthews J, Simmonds N, Cosgriff R, Turner D, Whitty J. Exploring the nature of perceived treatment burden: a study to compare treatment burden measures in adults with cystic fibrosis [version 1; peer review: 2 approved]. NIHR OPEN RESEARCH 2022; 2:36. [PMID: 36855412 PMCID: PMC7614250 DOI: 10.3310/nihropenres.13260.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/14/2022] [Indexed: 11/22/2022]
Abstract
Background Despite the importance of reducing treatment burden for people with cystic fibrosis (CF), it has not been fully understood as a concept. This study aims to quantify the treatment burden perceived by CF adults and explore the association between different validated treatment burden measures. Methods This is a cross-sectional observational study of CF adults attending a single large UK adult center. Participants completed an online survey that contained three different treatment burden scales; CF Questionnaire-Revised (CFQ-R) subscale, CF Quality of Life (CFQoL) subscale, and the generic multimorbidity treatment burden questionnaire (MTBQ). Results Among 101 participants, the median reported treatment burden by the CFQ-R subscale was 55.5 (IQR 33.3 - 66.6), the CFQoL subscale was 66.6 (IQR 46.6 - 86.6), and the MTBQ reversed global score was 84.6 (IQR 73.1 - 92.3). No correlation was found between respondents' demographic or clinical variables and treatment burden measured via any of the three measures. All treatment burden measures showed correlations against each other. More treatments were associated with high treatment burden as measured by the CFQ-R, CFQoL subscales, and the MTBQ. However, longer treatment time and more complex treatment plans were correlated with high treatment burden as measured by the CFQ-R and CFQoL subscales, but not with the MTBQ. Conclusions Treatment burden is a substantial issue in CF. Currently, the only available way to evaluate it is with the CF-specific quality of life measure treatment burden subscales (CFQ-R and CFQoL); both indicated that treatment burden increases with more treatments, longer treatment time, and more complex treatments.
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Affiliation(s)
- Rana Altabee
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, UK
- College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah, 22384, Saudi Arabia
| | - Siobhan B. Carr
- Department of Paediatric Respiratory Medicine, Royal Brompton & Harefield NHS Trust, London, SW3 6NP, UK
- National Heart and Lung Institute, Imperial College London, London, SW7 2BX, UK
| | - Janice Abbott
- School of Psychology, University of Central Lancashire, Preston, PR1 2HE, UK
| | - Rory Cameron
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, UK
- National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) East of England (EoE), Cambridge, CB2 8AH, UK
| | - Daniel Office
- Adult Cystic Fibrosis Centre, Royal Brompton & Harefield NHS Trust, London, SW3 6NP, UK
| | - Jessie Matthews
- Adult Cystic Fibrosis Centre, Royal Brompton & Harefield NHS Trust, London, SW3 6NP, UK
| | - Nicholas Simmonds
- National Heart and Lung Institute, Imperial College London, London, SW7 2BX, UK
- Adult Cystic Fibrosis Centre, Royal Brompton & Harefield NHS Trust, London, SW3 6NP, UK
| | | | - David Turner
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, UK
| | - Jennifer Whitty
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, UK
- National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) East of England (EoE), Cambridge, CB2 8AH, UK
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Sivaratnam S, Hwang K, Chee-A-Tow A, Ren L, Fang G, Jibb L. Using Social Media to Engage Knowledge Users in Health Research Priority Setting: Scoping Review. J Med Internet Res 2022; 24:e29821. [PMID: 35188476 PMCID: PMC8902657 DOI: 10.2196/29821] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 11/25/2021] [Accepted: 12/23/2021] [Indexed: 12/16/2022] Open
Abstract
Background
The need to include individuals with lived experience (ie, patients, family members, caregivers, researchers, and clinicians) in health research priority setting is becoming increasingly recognized. Social media–based methods represent a means to elicit and prioritize the research interests of such individuals, but there remains sparse methodological guidance on how best to conduct these social media efforts and assess their effectiveness.
Objective
This review aims to identify social media strategies that enhance participation in priority-setting research, collate metrics assessing the effectiveness of social media campaigns, and summarize the benefits and limitations of social media–based research approaches, as well as recommendations for prospective campaigns.
Methods
We searched PubMed, Embase, Cochrane Library, Scopus, and Web of Science from database inception until September 2021. Two reviewers independently screened all titles and abstracts, as well as full texts for studies that implemented and evaluated social media strategies aimed at engaging knowledge users in research priority setting. We subsequently conducted a thematic analysis to aggregate study data by related codes and themes.
Results
A total of 23 papers reporting on 22 unique studies were included. These studies used Facebook, Twitter, Reddit, websites, video-calling platforms, emails, blogs, e-newsletters, and web-based forums to engage with health research stakeholders. Priority-setting engagement strategies included paid platform–based advertisements, email-embedded survey links, and question-and-answer forums. Dissemination techniques for priority-setting surveys included snowball sampling and the circulation of participation opportunities via internal members’ and external organizations’ social media platforms. Social media campaign effectiveness was directly assessed as number of clicks and impressions on posts, frequency of viewed posts, volume of comments and replies, number of times individuals searched for a campaign page, and number of times a hashtag was used. Campaign effectiveness was indirectly assessed as numbers of priority-setting survey responses and visits to external survey administration sites. Recommendations to enhance engagement included the use of social media group moderators, opportunities for peer-to-peer interaction, and the establishment of a consistent tone and brand.
Conclusions
Social media may increase the speed and reach of priority-setting participation opportunities leading to the development of research agendas informed by patients, family caregivers, clinicians, and researchers. Perceived limitations of the approach include underrepresentation of certain demographic groups and addressing such limitations will enhance the inclusion of diverse research priority opinions in future research agendas.
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Affiliation(s)
- Surabhi Sivaratnam
- Michael G Degroote School of Medicine, McMaster University, Hamilton, ON, Canada
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON, Canada
| | - Kyobin Hwang
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON, Canada
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | | | - Lily Ren
- Lane Medical Library, Stanford University, Stanford, CA, United States
| | - Geoffrey Fang
- Faculty of Applied Science and Engineering, University of Toronto, Toronto, ON, Canada
| | - Lindsay Jibb
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON, Canada
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
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13
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Nowakowski A“XCH, Balasa G“E, Figueira MF, LaRosa F“TJ, Lawlor JMJ. Coming Full Circle: Reflections and Inspirations from a Cystic Fibrosis Patient Scientist Panel. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580221086921. [PMID: 35420504 PMCID: PMC9016558 DOI: 10.1177/00469580221086921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Care for many progressive chronic diseases continues to improve, allowing
patients to survive and thrive for longer periods of time1. People
living with such conditions may now find themselves able to achieve long-term
goals in education and career development2. Many people now occupy
the dual roles of scientist and patient3. This commentary article
synthesizes experiences of scientists and advocates with the progressive genetic
disease cystic fibrosis (CF) who collaborated on a career development session
for the Cystic Fibrosis Foundation’s inaugural ResearchCon event in 2019. It
explores how such collaborations affirm and transform individual perspectives on
patient science and its importance in broader scientific research agenda
setting. We first share our own individual insights about the experience and
impact of the ResearchCon panel session before progressing to discussion and
future directions centering the shared insights from one another’s
reflections.
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Affiliation(s)
| | | | - Miriam F. Figueira
- Cystic Fibrosis Research and Treatment Center, University of North Carolina, Chapel Hill, NC, USA
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Opportunities and pitfalls of social media research in rare genetic diseases: a systematic review. Genet Med 2021; 23:2250-2259. [PMID: 34282302 DOI: 10.1038/s41436-021-01273-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/25/2021] [Accepted: 06/30/2021] [Indexed: 01/04/2023] Open
Abstract
PURPOSE Social media may be particularly valuable in research in rare genetic diseases because of the low numbers of patients and the rare disease community's robust online presence. The goal of this systematic review was to understand how social media is currently used in rare disease research and the characteristics of the participants in these studies. METHODS We conducted a systematic review of six databases to identify studies published in English between January 2004 and November 2020, of which 120 met inclusion criteria. RESULTS Most studies were observational (n = 114, 95.0%) and cross-sectional (n = 107, 89.2%), and more than half (n = 69, 57.5%) utilized only surveys. Only 101 rare diseases were included across all studies. Participant demographics, when reported, were predominantly female (70.1% ± 22.5%) and white (85.0% ± 11.0%) adult patients and caregivers. CONCLUSION Despite its potential benefits in rare disease research, the use of social media is still methodologically limited and the participants reached may not be representative of the rare disease population by gender, race, age, or rare disease type. As scholars explore using social media for rare disease research, careful attention should be paid to representativeness when studying this diverse patient community.
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Simpson PL, Guthrie J, Jones J, Butler T. Identifying research priorities to improve the health of incarcerated populations: results of citizens' juries in Australian prisons. LANCET PUBLIC HEALTH 2021; 6:e771-e779. [PMID: 34115972 DOI: 10.1016/s2468-2667(21)00050-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/25/2021] [Accepted: 03/03/2021] [Indexed: 12/12/2022]
Abstract
Health disparities in incarcerated populations should guide investment in the health care and research of these communities. Although users of health-care services are important in providing input into decisions about research, the voices of people in prison are absent regarding research into their health. In this Health Policy paper, we present priorities for research into the health of people in prison according to people in prison themselves. By use of a deliberative research approach, citizens' juries were conducted in six prisons (three men's and three women's prisons) in Australia. Participants were selected following submissions of expression of interest forms that were distributed within the prisons. Prerecorded information by experts in the health of incarcerated people was shown to participants. Participants deliberated for up to 4 h before agreeing on five research priorities. All citizens' juries endorsed mental health as a number one research priority. Prison health-care services, alcohol and other drug use, education, and infectious diseases were identified as research priorities by most citizens' juries. Focal points within priorities included serious mental illness; grief and trauma; medication management; health-care service access, quality, and resources; drug withdrawal and peer support; prison-based needle and syringe programmes; and health and life skills education. If endeavours in research priority setting are to consider health equity goals, the views of our most health affected citizens need to be included.
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Affiliation(s)
- Paul L Simpson
- School of Population Health, University of New South Wales (UNSW Sydney), Sydney, NSW, Australia.
| | - Jill Guthrie
- Research School of Population Health, The Australian National University, Canberra, ACT, Australia
| | - Jocelyn Jones
- National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - Tony Butler
- School of Population Health, University of New South Wales (UNSW Sydney), Sydney, NSW, Australia
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Coucke R, Chansard A, Bontemps V, Grenet D, Hubert D, Martin C, Lammertyn E, Bardin E, Bulteel V, Chedevergne F, Bourgeois ML, Burgel PR, Honore I, de Keyser H, Kirszenbaum M, de Carli P, Sermet-Gaudelus I, Hayes K. "Il faut continuer à poser des questions" patient reported outcome measures in cystic fibrosis: An anthropological perspective. J Cyst Fibros 2021; 20:e108-e113. [PMID: 33648900 DOI: 10.1016/j.jcf.2021.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 01/11/2021] [Accepted: 02/17/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND People with cystic fibrosis (pwCF) are central in the development of patient-led assessment tools. Qualitative analysis of a frequently used CF-specific patient-reported outcome measure (PROM) sought patient recommendations for development of a new quality of life (QoL) tool. METHODS We performed an inventory of PROMs, symptom-report and QoL tools used in clinical trials within the European Cystic Fibrosis Society Clinical Trial Network (ECFS-CTN) and in routine clinical practice among Cystic Fibrosis Europe and ECFS members. A qualitative study using cognitive interviews with pwCF and their caregivers reviewed the Cystic Fibrosis Questionnaire (CFQ), the French initial form of the Cystic Fibrosis Questionnaire-Revised (CFQ-R). RESULTS Survey results from 33 countries revealed over 70 tools used in routine clinical practice, utilized by clinical specialists (n=124), pwCF/parents/carers (n=49) and other allied health professionals (n=60). The CFQ-R was the main PROM used in clinical trials. The qualitative study enrolled 99 pwCF, 6 to 11 years (n=31); 12 to 18 years (n=38); >18 years (n=30) and 26 parents. Inductive thematic analysis based on the CFQ, revealed 19 key themes. Themes common across all cohorts included burden of treatment, impact of disease on day-to-day life, relationships/family, stress/mood, and nutrition. Themes unique to individual groups included, treatment when not symptomatic for the paediatric group; education/studies and planning for the future for adolescents, impact of anxiety and depression on day-to-day life for adults, and for parents, questions addressing anxiety and their role as carers. CONCLUSIONS Patient-centeredness is paramount in development of an up-to-date PROM in the era of novel therapies.
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Affiliation(s)
- Rosa Coucke
- Service de Pneumologie et Allergologie Pédiatriques, Centre de Ressourcés et de Compétence de la Mucoviscidose, Hôpital Necker Enfants Malades 149 rue de Sévres, INSERM U1151, Institut Necker Enfants Malades, Université Paris Sorbonne, Paris 75743, France
| | | | - Véronique Bontemps
- Institut de Recherche Interdisciplinaire sur les Enjeux Sociaux, Campus Condorcet, Bâtiment Recherche Sud, 5 cours de Humanitiés, 93322 Aubervillers cedex, France
| | | | - Dominique Hubert
- Hôpital Cochin, Assistance Publique Hôpitaux de Paris and Université de Paris, Institut Cochin, Inserm U1016, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - Clémence Martin
- Hôpital Cochin, Assistance Publique Hôpitaux de Paris and Université de Paris, Institut Cochin, Inserm U1016, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France
| | | | | | | | - Frédérique Chedevergne
- Service de Pneumologie et Allergologie Pédiatriques, Centre de Ressourcés et de Compétence de la Mucoviscidose, Hôpital Necker Enfants Malades 149 rue de Sévres, INSERM U1151, Institut Necker Enfants Malades, Université Paris Sorbonne, Paris 75743, France
| | - Muriel Le Bourgeois
- Service de Pneumologie et Allergologie Pédiatriques, Centre de Ressourcés et de Compétence de la Mucoviscidose, Hôpital Necker Enfants Malades 149 rue de Sévres, INSERM U1151, Institut Necker Enfants Malades, Université Paris Sorbonne, Paris 75743, France
| | - Pierre-Régis Burgel
- Hôpital Cochin, Assistance Publique Hôpitaux de Paris and Université de Paris, Institut Cochin, Inserm U1016, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - Isabelle Honore
- Hôpital Cochin, Assistance Publique Hôpitaux de Paris and Université de Paris, Institut Cochin, Inserm U1016, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France
| | | | - Maya Kirszenbaum
- Service de Pneumologie et Allergologie Pédiatriques, Centre de Ressourcés et de Compétence de la Mucoviscidose, Hôpital Necker Enfants Malades 149 rue de Sévres, INSERM U1151, Institut Necker Enfants Malades, Université Paris Sorbonne, Paris 75743, France
| | - Paola de Carli
- Association Vaincre la Mucoviscidose, 181 rue de Tolbiac, 75013 Paris, France
| | - Isabelle Sermet-Gaudelus
- Service de Pneumologie et Allergologie Pédiatriques, Centre de Ressourcés et de Compétence de la Mucoviscidose, Hôpital Necker Enfants Malades 149 rue de Sévres, INSERM U1151, Institut Necker Enfants Malades, Université Paris Sorbonne, Paris 75743, France
| | - Kate Hayes
- European Cystic Fibrosis Society, Karup, Denmark; Northern Ireland Clinical Research Facility, The Wellcome-Wolfson Centre for Experimental Medicine, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7BL, Ireland.
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Tikellis G, Tong A, Lee JYT, Corte TJ, Hey-Cunningham AJ, Bartlett M, Crawford T, Glaspole I, Price J, Maloney J, Holland AE. Top 10 research priorities for people living with pulmonary fibrosis, their caregivers, healthcare professionals and researchers. Thorax 2020; 76:575-581. [PMID: 33277429 DOI: 10.1136/thoraxjnl-2020-215731] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 09/18/2020] [Accepted: 10/24/2020] [Indexed: 01/30/2023]
Abstract
INTRODUCTION People with pulmonary fibrosis (PF) experience a high symptom burden, reduced quality of life and a shortened lifespan. Treatment options are limited and little is known about what patients, caregivers and healthcare professionals (HCPs)/researchers consider as the most important research priorities. This study aimed to identify the top 10 research priorities for PF across all stakeholders. METHODS Participants included people with PF, caregivers and HCPs/researchers involved with PF. The research priority setting exercise involved three stages: (1) identifying priorities using an open-ended questionnaire and thematic analysis, (2) development of specific research questions at a face-to-face workshop, and (3) online ranking of research questions to identify the top 10 research priorities using nominal group ranking method. RESULTS 196 participants completed stage 1 generating 560 questions and 14 research themes were identified. Stage 2 involved 32 participants and generated 53 indicative questions from which 39 were used for the final ranking. Stage 3 was completed by 270 participants. The top ranked priorities focussed on medications to reverse scarring in the lungs (ranked 1st), improving lung function (ranked 2nd, 6th and 8th), interventions aimed at alleviating symptoms (ranked 5th and 7th), prevention of PF (ranked 3rd and 4th) and the best exercise programme for PF (ranked 10th). There was good consensus among patients/carers and HCPs/researchers on the top 10 priorities, however, causes of acute exacerbations and early diagnosis for improving survival, was ranked higher by HCPs/researchers. CONCLUSION Interventions for preserving lung health and alleviation of symptom burden were top research priorities for PF stakeholders.
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Affiliation(s)
- Gabriella Tikellis
- Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Physiotherapy, La Trobe University, Melbourne, Victoria, Australia
- National Health and Medical Research Council Centre of Research Excellence in Pulmonary Fibrosis, The University of Sydney, Sydney, New South Wales, Australia
| | - Allison Tong
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Joanna Y T Lee
- Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne, Victoria, Australia
| | - Tamera J Corte
- National Health and Medical Research Council Centre of Research Excellence in Pulmonary Fibrosis, The University of Sydney, Sydney, New South Wales, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Department of Respiratory Medicine, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- School of Medicine (Central Clinical School), The University of Sydney, Sydney, New South Wales, Australia
| | - Alison J Hey-Cunningham
- National Health and Medical Research Council Centre of Research Excellence in Pulmonary Fibrosis, The University of Sydney, Sydney, New South Wales, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Tonia Crawford
- Lung Foundation Australia, Milton, Queensland, Australia
| | - Ian Glaspole
- Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne, Victoria, Australia
- National Health and Medical Research Council Centre of Research Excellence in Pulmonary Fibrosis, The University of Sydney, Sydney, New South Wales, Australia
- Department of Respiratory and Sleep Medicine, Alfred Health, Melbourne, Victoria, Australia
| | - John Price
- Institute of Respiratory Health, Perth, Western Australia, Australia
| | - Jamie Maloney
- Lung Foundation Australia, Milton, Queensland, Australia
| | - Anne E Holland
- Department of Allergy, Immunology and Respiratory Medicine, Monash University, Melbourne, Victoria, Australia
- National Health and Medical Research Council Centre of Research Excellence in Pulmonary Fibrosis, The University of Sydney, Sydney, New South Wales, Australia
- Department of Physiotherapy, Alfred Health, Melbourne, Victoria, Australia
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Jongsma K, van Seventer J, Verwoerd A, van Rensen A. Recommendations from a James Lind Alliance priority setting partnership - a qualitative interview study. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:68. [PMID: 33292829 PMCID: PMC7678261 DOI: 10.1186/s40900-020-00240-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 10/07/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND The James Lind Alliance (JLA) offers a method for research priority setting with patients, clinicians and carers. The method is increasingly used but publications primarily discuss the outcome of such projects, rather than reflecting on the JLA method itself. Scrutiny of the method is crucial in order to understand and correctly interpret its outcomes. METHODS We conducted a qualitative interview study with people involved in a JLA project into Juvenile Idiopathic Arthritis (JIA) (n = 30) to better understand the mechanisms, procedures and decisional processes during such a project and to formulate recommendations for those who consider starting a JLA project in the future. RESULTS Four main themes were identified: 1) motivations, goals and expectations 2) inclusivity, roles and representation 3) procedures and decision-making 4) outcomes and future steps. CONCLUSION While the top 10 of 'evidence uncertainties' seems to take the centre stage in JLA projects, the ways in which these priorities are determined may be influenced by 'process uncertainties'. We have formulated ten specific recommendations for future JLA projects. Reflection on and reporting of these process uncertainties would contribute to the improvement of JLA projects and increase the validity of the outcome of such projects.
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Affiliation(s)
- Karin Jongsma
- Department of Medical Humanities, University Medical Center Utrecht, Julius Center for Health, Sciences and Primary Care, PO Box 85500, 3508 GA Utrecht, The Netherlands
| | - Juliette van Seventer
- Department of Medical Humanities, University Medical Center Utrecht, Julius Center for Health, Sciences and Primary Care, PO Box 85500, 3508 GA Utrecht, The Netherlands
| | - Anouk Verwoerd
- Department of Paediatric Rheumatology and Immunology, Wilhelmina Children’s Hospital, PO Box 85090, 3584 EA Utrecht, The Netherlands
- University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
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Short C, Saunders C, Davies J. Utility of lung clearance index in CF: What we know, what we don't know and musings on how to bridge the gap. J Cyst Fibros 2020; 19:852-855. [DOI: 10.1016/j.jcf.2020.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 10/21/2020] [Accepted: 10/22/2020] [Indexed: 11/26/2022]
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Ho A, Webster L, Bowen L, Creighton F, Findlay S, Gale C, Green M, Gronlund T, Magee LA, McManus RJ, Mistry HD, Singleton G, Thornton J, Whybrow R, Chappell L. Research priorities for pregnancy hypertension: a UK priority setting partnership with the James Lind Alliance. BMJ Open 2020; 10:e036347. [PMID: 32665388 PMCID: PMC7365422 DOI: 10.1136/bmjopen-2019-036347] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To identify research priorities for hypertensive disorders of pregnancy from individuals with lived experience and healthcare professionals. DESIGN Prospective surveys and consensus meetings using principles outlined by the James Lind Alliance. SETTING UK. METHODS A steering group was established and 'uncertainties' were gathered using an online survey and literature search. An interim online survey ranked long-listed questions and the top 10 research questions were reached by consensus at a final prioritisation workshop. PARTICIPANTS Women, partners, relatives and friends of those with lived experience of pregnancy hypertension, researchers and healthcare professionals. RESULTS The initial online survey was answered by 278 participants (180 women with lived experience, 9 partners/relatives/friends, 71 healthcare professionals and 18 researchers). Together with a literature search, this identified 764 questions which were refined into 50 summary questions. All summary questions were presented in an interim prioritisation survey that was answered by 155 participants (87 women with lived experience, 4 partners/relatives/friends, 49 healthcare professionals and 15 researchers). The top 25 highest ranked questions were considered by the final prioritisation workshop. The top 10 uncertainties were identified by consensus and ranked as follows in order of priority: long-term consequences of pregnancy hypertension (for the woman and baby), short-term complications of pregnancy hypertension (for the woman and baby), screening tests for pre-eclampsia, prevention of long-term problems (for the woman and baby), causes of pregnancy hypertension, prevention of recurrent pregnancy hypertension, educational needs of healthcare professionals, diagnosis of pre-eclampsia, management of pregnancy hypertension, provision of support for women and families. CONCLUSIONS Research priorities shared by those with lived experience of pregnancy hypertension and healthcare professionals have been identified. Researchers should use these to inform the choice of future studies in this area.
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Affiliation(s)
- Alison Ho
- Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Louise Webster
- Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Liza Bowen
- School of Population Health and Environmental Sciences, King's College London, London, UK
| | | | | | - Chris Gale
- Neonatal Medicine, School of Public Health, Imperial College London, London, UK
| | - Marcus Green
- Action on Pre-eclampsia, The Stables, Evesham, Worcestershire, UK
| | - Toto Gronlund
- James Lind Alliance, National Institute for Health Research Evaluation, Trials and Studies Coordinating Centre, Southampton, UK
| | - Laura A Magee
- Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Richard J McManus
- Dept of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Hiten D Mistry
- Division of Child Health, Obstetrics and Gynaecology, School of Medicine, University of Nottingham, Nottingham, UK
| | | | - Jim Thornton
- Division of Child Health, Obstetrics and Gynaecology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Rebecca Whybrow
- Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - Lucy Chappell
- Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
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Jones M, Moffatt F, Harvey A, Ryan JM. Interventions for improving adherence to airway clearance treatment and exercise in people with cystic fibrosis. Hippokratia 2020. [DOI: 10.1002/14651858.cd013610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Mandy Jones
- Centre for Research in Rehabilitation, School of Health Sciences and Social Care; Brunel University; Uxbridge UK
| | - Fiona Moffatt
- School of Health Sciences; University of Nottingham; Nottingham UK
| | - Alex Harvey
- School of Health Sciences and Social Care; Brunel University; Uxbridge UK
| | - Jennifer M Ryan
- Institute of Environment, Health and Societies; Brunel University London; Uxbridge UK
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Meissner P, Cottler LB, Eder M“M, Michener JL. Engagement science: The core of dissemination, implementation, and translational research science. J Clin Transl Sci 2020; 4:216-218. [PMID: 32695491 PMCID: PMC7348030 DOI: 10.1017/cts.2020.8] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 01/08/2020] [Accepted: 01/14/2020] [Indexed: 02/06/2023] Open
Abstract
Stakeholder engagement is acknowledged as central to dissemination and implementation (D&I) of research that generates and answers new clinical and health service research questions. There is both benefit and risk in conducting stakeholder engagement. Done wrong, it can damage trust and adversely impact study results, outcomes, and reputations. Done correctly with sensitivity, inclusion, and respect, it can significantly facilitate improvements in research prioritization, communication, design, recruitment strategies, and ultimately provide results useful to improve population and individual health. There is a recognized science of stakeholder engagement, but a general lack of knowledge that matches its strategies and approaches to particular populations of interest based on history and characteristics. This article reviews stakeholder engagement, provides several examples of its application across the range of translational research, and recommends that Clinical Translational Science Awards, with their unique geographical, systems, and historical characteristics, actively participate in deepening our understanding of stakeholder engagement science and methods within implementation and dissemination research. These recommendations include (a) development of an inventory of successful stakeholder engagement strategies; (b) coordination and intentionally testing a variety of stakeholder engagement strategies; (c) tool kit development; and (d) identification of fundamental motivators and logic models for stakeholder engagement to help align stakeholders and researchers.
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Affiliation(s)
- Paul Meissner
- Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Linda B. Cottler
- Clinical and Translational Science Institute, University of Florida, Gainesville, FL, USA
| | - Milton “Mickey” Eder
- Department of Family Medicine and Community Health, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, USA
| | - J. Lloyd Michener
- Clinical and Translational Science Institute, Duke University School of Medicine, Durham, NC, USA
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