Which clinical research questions are the most important?:Development and preliminary validation of the Australia & New Zealand Musculoskeletal (ANZMUSC) Clinical Trials Network Research Question Importance Tool (ANZMUSC-RQIT)

Background and aimsHigh quality clinical research that addresses important questions requires significant resources. In resource-constrained environments, projects will therefore need to be prioritized. The Australia and New Zealand Musculoskeletal (ANZMUSC) Clinical Trials Network aimed to develop a stakeholder-based, transparent, easily implementable tool that provides a score for the 'importance' of a research question which could be used to rank research projects in order of importance.MethodsUsing a mixed-methods, multi-stage approach that included a Delphi survey, consensus workshop, inter-rater reliability testing, validity testing and calibration using a discrete-choice methodology, the Research Question Importance Tool (ANZMUSC-RQIT) was developed. The tool incorporated broad stakeholder opinion, including consumers, at each stage and is designed for scoring by committee consensus.ResultsThe ANZMUSC-RQIT tool consists of 5 dimensions (compared to 6 dimensions for an earlier version of RQIT): (1) extent of stakeholder consensus, (2) social burden of health condition, (3) patient burden of health condition, (4) anticipated effectiveness of proposed intervention, and (5) extent to which health equity is addressed by the research. Each dimension is assessed by defining ordered levels of a relevant attribute and by assigning a score to each level. The scores for the dimensions are then summed to obtain an overall ANZMUSC-RQIT score, which represents the importance of the research question. The result is a score on an interval scale with an arbitrary unit, ranging from 0 (minimal importance) to 1000. The ANZMUSC-RQIT dimensions can be reliably ordered by committee consensus (ICC 0.73-0.93) and the overall score is positively associated with citation count (standardised regression coefficient 0.33, pConclusionWe propose that the ANZMUSC-RQIT is a useful tool for prioritising the importance of a research question

A patient and public involvement group study on the usability of the MYJOINTPAIN.ORG website

Background: There are an estimated 4.7 million with knee osteoarthritis (OA) and 2.1 million with hip osteoarthritis in the United Kingdom. Resources to manage OA within the National Health Service are limited. National Institute for Health and Care Excellence guidelines advocate education and self-management for all people with osteoarthritis. Most recently E-health programmes via the internet are being used to deliver health services and information. . Arthritis Australia &amp; Osteoarthritis Research Society International developed Myjointpain.org to support Australians in self-managing hip and/or knee joint pain. There is currently no equivalent UK e-health resource.. This study explored the attitudes, facilitators and barriers towards using e-health by people self-managing hip/knee OA in the UK. Method: A qualitative design using semi-structured telephone interviews was used. Patient and public involvement (PPI) members were recruited via Nottingham City Hospital. PPI members were included if they had Hip and/or Knee joint pain and internet access. Each PPI member was provided with an information sheet and consent form. All consenting members received a link to the Myjointpain.org website and given XX days to practice using the programme. Participants were then contacted for a telephone interview. The interviews were transcribed and a six step thematic analysis used. This included (1) Reading/re-reading of transcript, (2) Coding interesting features of data, (3) Categorising codes into potential themes/subthemes, (4) Reviewing themes, (5) Defining themes, (6) Producing final report. Themes identified were independently verified.Results:. Twelve PPI members were recruited and contributed to telephone interviews. Overall PPI members were open to using an e-health initiative to self-manage their joint pain; Facilitators that encouraged PPI members to use Myjointpain.org included:  the interactive nature of the e-health programme; the personalised action plan, and participatns’ preceived trustworthiness of the content of the website. However excess information was reported as a barrier of use, as well as finding time to use the website due to busy lifestyles. The use of email/telephone prompting was thought may help people better engage with on line self management programmes. ..Conclusion:  PPI members with hip and /or knee OA in the UK report that they are receptive and open to considering using the Myjointpain.org web based e learning self management programme. Such an approach that emphasises personalised and interactive aspects to facilitate self management helps promote engagement with self management. Prompting is helpful in maintaining engagement (e.g. via e-mail) and provision of too much information may prevent people from engaging with the programme. Myjointpain.org presents an exciting opportunity for e-health strategies for people with arthritis in the UK. <br/