Priority Setting

Finding the Top 10 Research Uncertainties

 

This project aimed to further refine the BSSH James Lind Alliance Priority Setting Partnership Top 10 Research Uncertainties into answerable research questions.

The output of this project could better target/focus limited resources for future research, and help try to ensure we answer questions that the wider clinical community want answered.

The project involved a survey of BSSH and BAHT members as a first step. Consensus workshop run on the top research priorities that resulted from the ranking exercise, further informed by suggestions from survey participants on potential research questions.

• Determined priority topics from amongst the JLA PSP Top 10 Uncertainties, on which to focus future research efforts
• Worked towards further specifying potential research questions within the prioritised JLA PSP Top 10 Uncertainties
• Online survey run, with 124 responders (34 therapists, 90 surgeons). Quantitative analysis completed. Qualitative analysis done
• Consensus workshop run on 7^th October 2024 (11 patients/public, 8 therapists, 14 surgeons) to develop research questions for JLA PSP Uncertainty on interventions for painful joints/arthritis in the hands/wrist
• Consensus workshop run on 7^th October 2024 (11 patients/public, 8 therapists, 14 surgeons) to develop research questions for JLA PSP Uncertainty on interventions for painful joints/arthritis in the hands/wrist

BSSH Research Prioritisation Consensus

Back in October, we held our first-ever BSSH Research Prioritisation Consensus Workshop, bringing together over 40 hand surgeons, therapists, and patients to identify key research questions for 2025. Topics included arthritis of the hand and wrist (particularly the PIP joint), the effectiveness of steroid injections, and hand OA therapy regimes. The results were presented in Belfast.
Thank you to all who participated—we will be posting a full report on the BSSH website in the New Year, and we’re excited for what’s to come in the new year! Stay tuned for updates:

The 2017 James Lind Alliance Priority Setting Partnership (JLA PSP) for Common Conditions Affecting the Hand and Wrist identified several important potential research topics. Those are quite broad, and this project aims to develop more specific research questions on one of the topics voted as a key priority by hand surgeons and therapists. A nationwide survey will help us develop a longlist of potential research questions. This will inform a consensus workshop involving patients, hand surgeons and therapists.

Through group discussions and voting steps, we will co-develop the top five research questions addressing the JLA PSP Uncertainty on hand trauma.

Background

The 2017 James Lind Alliance Priority Setting Partnership (JLA PSP) for Common Conditions Affecting the Hand and Wrist aimed to identify important potential research topics and focus research funders’ interest on these areas of hand surgery research. This work involved input from key stakeholders including hand surgeons, therapists and patients, and lead to a list of Top 10 Uncertainties across the breadth of hand surgery. This has been important in the subsequent development of research studies that have secured National Institute for Health and Care Research (NIHR) funding.

The scope of the JLA PSP was purposely broad, to maximise the impact while trying to be as time- and cost-efficient as possible. The broad nature of the Top 10 Uncertainties has advantages, but is also open to interpretation by NIHR who then use them to formulate commissioned calls, or by research teams who develop studies for researcher-led calls, that can result in controversial or less impactful research which may not necessarily help to inform clinical practice. In addition, the various studies on JLA PSP Top 10 Uncertainties that have already been commissioned should logically mean that the focus of future hand surgery research should be rebalanced in some way to address some of the other Top 10 Uncertainties.

 

In an attempt to address the issues above, this project’s goal is to further refining the BSSH JLA PSP Top 10 Uncertainties into fundable research questions that could be put forward to funders.

Work has been completed on the top-ranked JLA PSP Uncertainty prioritised by BSSH and BAHT members and this application is for funding to continue the process with the next highest ranked JLA PSP.

Research question

What are the priority research questions to focus on within the JLA PSP Uncertainty of ‘Which hand/finger/thumb injuries would benefit from surgical intervention over hand therapy or no formal treatment, considering both functional outcome and societal cost?’

Experimental plan

We will conduct a survey of BSSH and BAHT members to help inform a subsequent consensus meeting. Through this we will co-develop the Top 5 research questions on the specified priority JLA PSP Uncertainty, in as inclusive, equitable and transparent a manner as possible.

Survey

We will conduct a national survey inviting input from all BSSH and BAHT members regarding their ideas of potential research questions addressing the hand trauma JLA PSP Uncertainty.

Consensus meeting

Responses from the survey will be analysed and converted into a longlist of potential research questions. At a face-to-face consensus workshop, this longlist will serve as the starting point for consideration by patients, hand surgeons and hand therapists. The aim of the workshop is to reach agreement on a final set of five research questions focused on the prioritised Top 10 Uncertainty.

The workshop will be based on the principle of a modified nominal group technique, through facilitated discussion and iterative scoring/ranking of the longlist of research questions We will also develop a ‘glossary of terms’ to address hand anatomy as well as tackle potential jargon in the research questions