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INNOVATION

Setting research priorities in emergency care

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A priority-setting partnership, involving doctors, nurses and patients, will help establish priorities for emergency medicine research

Citation: Smith J, Morley R, Odam M and O’Brien R (2016) Setting research priorities in emergency care. Nursing Times; 112: 3/4, 23.

Authors: Jason E Smith is surgeon captain, professor of emergency medicine, Derriford Hospital, Plymouth. Richard Morley is Cochrane Consumer Network coordinator and James Lind Alliance adviser. Miranda Odam is research nurse manager and Rachel O’Brien is lead research nurse, both at the emergency medicine research group of Edinburgh (EMERGE), Royal Infirmary of Edinburgh.

  • A version of this article originally appeared in the Emergency Medicine Journal (2015; 32: 11, 830)
  • Scroll down to read the article or download a print-friendly PDF here

Introduction

Emergency medicine is a broad specialty, and should focus on answering research efforts about the most pressing clinical dilemmas. Funding for research is limited, and competition for money is fierce. It is, therefore, imperative that the specialty defines the most important questions to improve the clinical care our patients receive. The people who should be involved in defining these questions must include nurses working in our emergency departments, but also patients and their carers.

Setting priorities

Over the coming months, a research priority-setting process will take place, to establish what the most important research questions are to doctors and nurses working in the specialty of emergency medicine, and also to the patients they serve. The Royal College of Emergency Medicine, in partnership with the James Lind Alliance (JLA), will be conducting a research priority-setting partnership, involving doctors, nurses, patients and carers.

A research prioritisation process is important for several reasons. Academic emergency medicine is a relatively young specialty and, as such, is at a disadvantage when compared with some of the larger and better-resourced academic powerhouses, such as the cardiology and oncology research specialties.

Bodies that award large research grants look to specialties to provide evidence of the need for research on particular topics to decide why they should fund a project.

The most powerful way to conduct a process of prioritisation involves not only those doing the research, but also clinicians in that specialty, and in particular the users of the service.  

Role of the JLA

The JLA is an organisation co-located with, and managed by, the National Institute of Health Research (NIHR) Evaluation, Trials and Studies Coordinating Centre in Southampton. It brings together clinicians, patients, and other stakeholders in partnership to set research priorities. It aims to identify unanswered questions within a specialty, and rank them in order of priority, with the final output being a “top 10” of research priorities for that given area.

The advantage of the JLA is that it provides a framework, with a reproducible process, and advisers who guide the process along the way. It is recognised as the gold standard in research prioritisation. This means that those applying for a research grant, and can map their application to one of the research priorities, which adds considerable weight to the application. While the process will be undertaken in the UK, many of the research questions generated will be generalisable across the boundaries of international emergency medicine.  

The process

The process is likely to take 18 months to two years to complete, and involves several phases. Initially, a broad invitation is distributed to contribute research questions, among members of the emergency medicine community, including patient groups and carer organisations. Several different tools, including social media, will be used to encourage involvement.

The research ideas will be scrutinised to formulate defined questions. A literature review will be undertaken to establish whether there is already an answer to a research question within the existing literature. This will be one of the most time-consuming phases of the process, but will produce a series of mini-systematic reviews. Questions that have not already been answered will go forward to a prioritisation process, initially electronically. Once there is a shortlist, a final summary meeting will be held to establish the top 10 research priorities for the specialty.

Conclusion

This initiative will embed a process for research prioritisation into the emergency medicine community, and enable us to stand toe to toe with larger and longer established academic specialties. This is an opportunity to influence the research that happens in the specialty over the next decade. We urge you all to participate.

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