Scoping review of priority setting of research topics for musculoskeletal conditions

Objective Describe research methods used in priority-setting exercises for musculoskeletal conditions and synthesise the priorities identified. Design Scoping review. Setting and population Studies that elicited the research priorities of patients/consumers, clinicians, researchers, policy-makers and/or funders for any musculoskeletal condition were included. Methods and analysis We searched MEDLINE and EMBASE from inception to November 2017 and the James Lind Alliance top 10 priorities, Cochrane Priority Setting Methods Group, and Cochrane Musculoskeletal and Back Groups review priority lists. The reported methods and research topics/questions identified were extracted, and a descriptive synthesis conducted. Results Forty-nine articles fulfilled our inclusion criteria. Methodologies and stakeholders varied widely (26 included a mix of clinicians, consumers and others, 16 included only clinicians, 6 included only consumers or patients and in 1 participants were unclear). Only two (4%) reported any explicit inclusion criteria for priorities. We identified 294 broad research priorities from 37 articles and 246 specific research questions from 17 articles, although only four (24%) of the latter listed questions in an actionable format. Research priorities for osteoarthritis were identified most often (n=7), followed by rheumatoid arthritis (n=4), osteoporosis (n=4) and back pain (n=4). Nearly half of both broad and specific research priorities were focused on treatment interventions (n=116 and 111, respectively), while few were economic (n=8, 2.7% broad and n=1, 0.4% specific), implementation (n=6, 2% broad and n=4, 1.6% specific) or health services and systems research (n=15, 5.1% broad and n=9, 3.7% specific) priorities. Conclusions While many research priority-setting studies in the musculoskeletal field have been performed, methodological limitations and lack of actionable research questions limit their usefulness. Future studies should ensure they conform to good priority-setting practice to ensure that the generated priorities are of maximum value. PROSPERO registration number CRD42017059250

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 aims High 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. Methods Using 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. Results The 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, p<0.001) and journal impact factor group (OR 6.78, 95% CI 3.17 to 14.50 for 3rd tertile compared to 1st tertile of ANZMUSC-RQIT scores) for 200 published musculoskeletal clinical trials. Conclusion We propose that the ANZMUSC-RQIT is a useful tool for prioritising the importance of a research question.William J. Taylor, Robin Willink, Denise A. O, Connor, Vinay Patel, Allison Bourne, Ian A. Harris, Samuel L. Whittle, Bethan Richards, Ornella Clavisi, Sally Green, Rana S. Hinman, Chris G. Maher, Ainslie Cahill, Annie McPherson, Charlotte Hewson, Suzie E. May, Bruce Walker, Philip C. Robinson, Davina Ghersi, Jane Fitzpatrick, Tania Winzenberg, Kieran Fallon, Paul Glasziou, Laurent Billot, Rachelle Buchbinde

Engaging Consumers with Musculoskeletal Conditions in Health Research: A User-entred Perspective

Consumers are frequently involved in different kinds of health research, such as clinical trials, focus groups, and surveys. As pointed out by different studies, recruiting and involving consumers to participate in academic research can be challenging. While different research and guidelines are provided to instruct researchers to recruit participants ethically, they seldom consider the needs and expectations of consumers. In this research, we interviewed 23 consumers with musculoskeletal conditions in Australia, to understand their needs and motivations for participating in research from a user-centred perspective. Based on these data, we systematically summarise consumers' feedback into four main themes: (1) Research as Learning Opportunity; (2) The Important Role of Communities and Health Professionals; (3) Research Transparency and Updates; and (4) Special Needs for People with MSK Conditions. As a result, a few recommendations are proposed and researchers should further consider these when designing consumer-based studies. Ultimately, with a better understanding of consumers, we hope that our research can enhance consumer engagement and improve their participation in health research

The use of web-based technologies in health research participation: Qualitative study of consumer and researcher experiences

Background: Health consumers are often targeted for their involvement in health research including randomized controlled trials, focus groups, interviews, and surveys. However, as reported by many studies, recruitment and engagement of consumers in academic research remains challenging. In addition, there is scarce literature describing what consumers look for and want to achieve by participating in research. Objective: Understanding and responding to the needs of consumers is crucial to the success of health research projects. In this study, we aim to understand consumers’ needs and investigate the opportunities for addressing these needs with Web-based technologies, particularly in the use of Web-based research registers and social networking sites (SNSs). Methods: We undertook a qualitative approach, interviewing both consumer and medical researchers in this study. With the help from an Australian-based organization supporting people with musculoskeletal conditions, we successfully interviewed 23 consumers and 10 researchers. All interviews were transcribed and analyzed with thematic analysis methodology. Data collection was stopped after the data themes reached saturation. Results: We found that consumers perceive research as a learning opportunity and, therefore, expect high research transparency and regular updates. They also consider the sources of the information about research projects, the trust between consumers and researchers, and the mobility of consumers before participating in any research. Researchers need to be aware of such needs when designing a campaign for recruitment for their studies. On the other hand, researchers have attempted to establish a rapport with consumer participants, design research for consumers’ needs, and use technologies to reach out to consumers. A systematic approach to integrating a variety of technologies is needed. Conclusions: On the basis of the feedback from both consumers and researchers, we propose 3 future directions to use Web-based technologies for addressing consumers’ needs and engaging with consumers in health research: (1) researchers can make use of consumer registers and Web-based research portals, (2) SNSs and new media should be frequently used as an aid, and (3) new technologies should be adopted to remotely collect data and reduce administrative work for obtaining consumers’ consent

Social-cognitive and perceived environment influences associated with physical activity in older Australians

Background, Regular physical activity in older adults can facilitate healthy aging, improve functional capacity, and prevent disease. However, factors associated with physical inactivity in older populations are poorly understood. This study attempts to identify social-cognitive and perceived environmental influences associated with physical activity participation in older populations. Methods. In a randomly selected sample of 449 Australian adults age 60 and older, we assessed self-reported physical activity and a range of social-cognitive and perceived environmental factors. Respondents were classified as sufficiently active and inactive based on energy expenditure estimates (kcal/week) derived from self-reported physical activity. Two logistic regression models, with and without self-efficacy included, were conducted to identify modifiable independent predictors of physical activity. Results. Significantly more males than females were physically active. Physical activity participation was related to age with a greater proportion of those age 65-69 being active than those age 60-64 or 70 or older. High self-efficacy, regular participation of friends and family, finding footpaths safe for walking, and access to local facilities were significantly associated with being active. Conclusion. Identifying predictors of physical activity in older populations, particularly social support, facility access, and neighbourhood safety, can inform the development of policy and intervention strategies to promote the health of older people. (C) 2000 American Health Foundation and Academic Press

Early development of the Australia & New Zealand Musculoskeletal (ANZMUSC) Clinical Trials Network

The Australia and New Zealand Musculoskeletal (ANZMUSC) Clinical Trials Network was formed to build capacity and infrastructure for high quality musculoskeletal clinical trials in our region. The purpose of this paper is to describe the steps taken in its formation to help others interested in establishing similar networks. In particular we describe the steps taken to form the collaboration and our progress in achieving our vision and mission. Our aim is to focus on trials of highest importance and quality to provide definitive answers to the most pressing questions in our field. This article is protected by copyright. All rights reserved.Rachelle Buchbinder, Allison Bourne, Jane Latimer, Ian Harris, Samuel L. Whittle, Bethan Richards on behalf of the ANZMUSC Clinical Trial Networ