Citation Information :
British Limb Reconstruction Society Research Collaborative, Graham SM. Identifying Research Priorities in Limb Reconstruction Surgery in the United Kingdom. 2024; 19 (1):1-8.
Introduction: Limb reconstruction surgery (LRS) has a wide range of clinical applications within orthopaedic and trauma surgery. We sought a consensus view from limb reconstruction healthcare practitioners across the United Kingdom to help guide research priorities within LRS. Our aim is to guide future clinical research in LRS, and assist healthcare practitioners, clinical academics, and funding bodies in identifying key research priorities to improve patient care.
Materials and methods: A modified Delphi approach was used; it involved an initial scoping survey and a 2-round Delphi process to identify the consensus research priorities in both adult and paediatric LRS. Participants were asked to rank approved submitted questions according to perceived importance on a 5-point Likert scale, where 1 represented lowest importance and 5 indicated highest importance. Mean scores were calculated to identify a consensus of the top ten research priorities for adult and paediatric LRS.
Results: One hundred and fifteen participants primarily from across the United Kingdom working in LRS contributed to the modified Delphi process. Participants ranked and then re-ranked the presented research topics in terms of perceived importance. This led to the identification of a top ten research priorities in both adult and paediatric LRS, respectively, based on the collective responses of LRS practitioners. The highest-ranked questions in both adult and paediatric practice related to how to best assess and record patient-reported outcome measures (PROMs) in LRS patients. Other priorities included the effectiveness of specialist physiotherapy, the use of patient-focused psychological support, and the use of various operative management strategies for infection and limb length discrepancies.
Conclusion: We present a consensus-driven research priority study that outlines the key research topics and themes determined by healthcare professionals within LRS in the United Kingdom.
Clinical significance: These questions will assist funding bodies in prioritising where research funding may be best utilised and help drive future improvement in patient care.
Mehta N, Graham S, Lal N, et al. Fine wire vs locking plate fixation of type C pilon fractures. Eur J Orthop Surg Traumatol 2022;32(5): 875–882. DOI: 10.1007/s00590-021-03048-3.
Hohmann E, Birkholtz F, Glatt V, et al. The ‘Road to Union’ protocol for the reconstruction of isolated complex high-energy tibial trauma. Injury 2017;48(6):1211–1216. DOI: 10.1016/j.injury.2017.03. 018.
Chalmers I, Bracken MB, Djulbegovic B, et al. How to increase value and reduce waste when research priorities are set. Lancet 2014;383(9912):156–165. DOI: 10.1016/S0140-6736(13)62229-1.
Turner S, Ollerhead E, Cook A. Identifying research priorities for public health research to address health inequalities: Use of Delphi-like survey methods. Health Res Policy Syst 2017;15(1):87. DOI: 10.1186/s12961-017-0252-2.
Tallon D, Chard J, Dieppe P. Relation between agendas of the research community and the research consumer. Lancet 2000;355(9220): 2037–2040. DOI: 10.1016/S0140-6736(00)02351-5.
Wright J, Timms A, Fugazzotto S, et al. Development of a patient-reported outcome measure in limb reconstruction: A pilot study assessing face validity. Bone Jt Open 2021;2(9):705–709. DOI: 10.1302/2633-1462.29.BJO-2021-0105.R1.
Perry D, Achten J, Knight R, et al. Immobilisation of torus fractures of the wrist in children (FORCE): A randomised controlled equivalence trial in the UK. Lancet 2022;400(10345):39–47. DOI: 10.1016/S0140-6736(22)01015-7.
Perry D, Costa M, Appelbe D, et al. Children's Radius Acute Fracture Fixation Trial (CRAFFT): A multicentre prospective randomised non-inferiority trial of surgical reduction vs non-surgical casting for displaced distal radius fractures in children. University of Oxford Study Protocol [online] V1.0 28 January 2020. Available at: https://njladmin.nihr.ac.uk/document/download/2032483. Accessed on: 24 June 2023.
Perry D, Achten J, Dutton S, et al. Surgery or Cast for injuries of the EpicoNdyle in Children's Elbows (SCIENCE): A multicentre prospective randomised superiority trial of operative fixation vs non-operative treatment for medial epicondyle fractures of the humerus. University of Oxford Study Protocol [online] V1.0 20 February 2019. Available at: https://njl-admin.nihr.ac.uk/document/download/2028846. Accessed on: 24 June 2023.
Churruca K, Pomare C, Ellis LA, et al. Patient-reported outcome measures (PROMs): A review of generic and condition-specific measures and a discussion of trends and issues. Health Expect 2021;24(4):1015–1024. DOI: 10.1111/hex.13254.
Leggett H, Scantlebury A, Sharma H, et al. Quality of life following a lower limb reconstructive procedure: A protocol for the development of a conceptual framework. BMJ Open 2020;10(12):e040378. DOI: 10.1136/bmjopen-2020-040378.
Hsu CC, Sandford BA. The Delphi technique: Making sense of consensus. Pract Assess Res Evaluation 2007;12(10):1–8. DOI: 10.7275/pdz9-th90.
Boddy K, Cowan K, Gibson A, et al. Does funded research reflect the priorities of people living with type 1 diabetes? A secondary analysis of research questions. BMJ Open 2017;7(9):e016540. DOI: 10.1136/bmjopen-2017-016540.
Crowe S, Fenton M, Hall M, et al. Patients’, clinicians’ and the research communities’ priorities for treatment research: There is an important mismatch. Res Involv Engagem 2015;14(1):1. DOI: 10.1186/s40900-015-0014-7.