What is new? Methods for the identification of research priorities through consensus of patients and clinicians working together are being developed. However, whether they have any effect upon research activity is unclear. The James Lind Alliance Priority Setting Partnership on Urinary Incontinence successfully developed and employed a methodology for identification and prioritization of research needs by patient-clinician consensus. It would appear from this assessment of its impact that
In brief, the process involved five phases. In the first phase, 30 UK clinician and patient organizations whose area of interest included UI were identified through web searches and peer consultation and invited to participate. Eight patient and 13 clinician groups participated, including both large organizations, such as royal colleges and national patient charities, and small organizations with specific clinical interests.
In the second phase, participating organizations asked their members to
For each of the prioritized questions in turn, information is presented about research that is known be in development or for which funding applications have been made.
The breadth of UI as a clinical area was reflected in the wide range of evidence needs included in the final list. Each prioritized question related to uncertainties about treatment and management strategies that have profound effects on quality of life and rehabilitation of those affected by UI, and yet little evidence exists to guide practice.
To identify new research activity in the wake of the JLA PSP on UI, this report has relied on searching of research databases and consultation with
Thanks are due to the patients and clinicians who submitted uncertainties, all the participating organizations and their representatives, Mark Fenton of DUETs, Sally Crowe of Crowe Associates, Patricia Atkinson of James Lind Alliance, Ron Marsh, the Cochrane Incontinence Review Group, Jude Frankau and Alexandra Greene, and Katherine Cowan.
Fig. 1 shows the study flow diagram which summarizes the selection process. Of the 28, 322 citations identified, we included 31 articles reporting on 29 studies (one article reported on three studies [18], whereas four other studies were reported in two articles each [19–26]). We excluded 1, 025 articles at the full-text screening phase (see Supplementary File 4 for reasons for exclusion).
A mix of primary and secondary research was most frequently used to determine research prioritization, namely, priority setting (e.g., JLA PSP methods). These methods involve the participation of patients, caregivers, and health and social care professionals in identifying research questions, then prioritizing them by using a combination of primary and secondary research [1,17,18,42–44,46,47,49,50,54,57–65]. The main method for determining research prioritization with primary research was the Delphi survey, which is a practical and productive approach to obtaining opinions from a wide number of relevant experts for identifying potential priority topic areas for research [51,54–56].
Currently, despite a substantial volume of research on health care in the field of bipolar disorder, there is still a gap between research outcomes and clinical practice. In everyday clinical practice, questions commonly arise that research-based evidence cannot answer (Buckley et al., 2013), e.g. which type of treatment to offer to different subpopulations or which medication will be effective for an individual patient. This may result in treatment choices that are not evidence based.
However, in some instances, it is necessary to support decisions to accept or reject proposals or commissions for Cochrane reviews. Many CRGs have therefore undertaken prioritization exercises, using a variety of methods [1], including online surveys; Delphi panels; workshops; evidence mapping; stakeholder partnerships; consultations with partner organizations, experts, and other stakeholders; scoping exercises; searches of trial registries; horizon scanning; interviews with policy- and decision-makers; and combinations of these [2–10]. We report here the results of Cochrane ARIs group's prioritization project, which consisted of two phases.
Sources of funding and support: The costs of the James Lind Alliance (JLA) Priority Setting Partnership on urinary incontinence were supported in part by a grant from the Cochrane Collaboration’s Prioritization Fund and by the JLA, whose core funding is provided by the Medical Research Council and the Department of Health. The consultation processes were supported by the partner organizations. The authors have been supported by their respective academic institutions.
Disclaimer: The views contained in the article are those of the authors and are necessarily shared by the funders or the participating organizations.
Conflicts of interest: B.S.B. is an editor and author with the Cochrane Incontinence Group and a grant holder on studies funded by the Health Research Board of Ireland and by the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) program. He is a voluntary member of the Board of Trustees of the Bladder & Bowel Foundation. A.M.G. was Coordinating editor of the Cochrane Incontinence Group until December 2007 and holds NIHR grants evaluating treatments of urinary incontinence. He is the Director of the NIHR Program Grants for Applied Research Program. C.M.A.G. is a Joint Coordinating Editor of the Cochrane Incontinence Review Group and an Investigator on studies funded by the NIHR HTA program and well being of women.
