International research priority setting exercises in stroke: A systematic review

Because you aren't trying to solve the only goal in stroke; 100% recovery. You get useless bloviating like this. Damn it all, have you never talked to survivors? No more discussion needed, just do research that solves 100% recovery for all. Fire anyone who departs from that.

International research priority setting exercises in stroke: A systematic review

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Stephanie Leitch, Monica Logan, Lucy Beishon, ...

First Published May 12, 2022 Review Article Find in PubMed 

https://doi.org/10.1177/17474930221096935

Article information

Abstract

Background:

Agreeing on priority topics for stroke research can help make best use of limited funding, people, and time. Formal priority-setting exercises collate stakeholders’ opinions to reach consensus on the most important research questions. Several stroke research priority setting exercises have been published. Exploring commonalities and differences between these exercises could bring a better understanding of priority research topics.

Aim:

We collated and compared published stroke research priority setting exercises across international healthcare systems.

Summary of review:

Multidisciplinary, electronic literature databases were searched from 2000 to 2021, using a validated search syntax. Inclusion criteria were: full article; stroke focus (any subtype); prioritization method described; and lists priorities for research. Priorities were extracted, coded, and assigned to categories using thematic analysis. The Nine Common Themes of Good Practice and the Reporting guideline for priority setting of health research checklists were used to assess methodological and reporting quality respectively. From 623 titles assessed, 14 studies were eligible for inclusion, including 2410 participants and describing 165 priorities. The majority of priority setting exercises were conducted in high-income countries (86%, n = 12 articles), published between 2011 and 2021 (64%, n = 9), and included views of healthcare professionals (57%, n = 8), and stroke survivors (50%, n = 7). Caregivers (n = 3, 21%) were under-represented. The James Lind Alliance priority setting method was most commonly used (50%, n = 7). Priorities were grouped into 10 thematic categories. Rehabilitation and follow-up was the most common priority theme (15%, n = 25 priorities), followed by psychological recovery (14%, n = 23), pathology (14%, n = 23), and caregivers and support (14%, n = 23). Priorities differed by year and case-mix (stakeholder group and demographics) of respondents. No article was judged high quality for all aspects of method or reporting. Common limitations were around inclusiveness and evaluation of the exercise.

Conclusion:

Stroke research priorities are dynamic and context-specific. However, there was a common theme of prioritizing research that considered life after stroke. Future priority settings should consider the inclusion of nonindustrialized countries and stroke survivors with a range of impairments.

Keywords

Priority setting, research methods, stroke remove, systematic review, research prioritization, methodology

Introduction

Stroke care strives to be evidence-based. Research has transformed stroke care,¹ and through research, we can continue to meet contemporary stroke challenges. There is an urgent need to promote and support the global research agenda for stroke, particularly among low- and middle-income countries.² Despite this, stroke remains a relatively underfunded research area, receiving five times less funding than cancer research.³ Thus, stroke researchers, funders, and policymakers face a fundamental problem, and there are many important questions but only limited resource to support the necessary research to answer them.

Priority setting seeks to identify key unanswered research questions by consulting a range of stakeholders with differing professional expertise (e.g. clinicians, researchers), or firsthand experience (e.g. patients and caregivers) of a condition of interest.⁴ Research prioritization provides a means of targeting resources to the areas of greatest perceived need.⁴ Priority setting exercises are impactful and are increasingly used to direct the international research and funding agenda.

A range of methods are available for priority setting, and there is no consensus on the optimal approach. The three most commonly used methods are those described by the Child Health and Nutrition Research Initiative (CHNRI), James Lind Alliance (JLA), or Delphi-based consensus.^4,5 Each of these methods shares common features of collating views across stakeholders and systematically ranking priorities to produce an ordered list⁴ (Table 1).

Table 1. Description of three common prioritization methods.

Table 1. Description of three common prioritization methods.

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Several stroke prioritization exercises have been published over the last decade, including a recent high-profile exercise led by the UK Stroke Association⁸ and JLA. However, priorities are likely to be contextual, and may vary according to the healthcare system, priority setting method employed, and the participants included.⁹ Comparing priority-setting exercises may highlight common themes in research questions and also allows us to explore the reasons for any differences.

The aim of this review was to provide a comprehensive overview of published stroke research priority exercises by collating and comparing published priority-setting exercises across international healthcare systems. As a secondary aim, we described the potential effect of healthcare setting, year of prioritization exercise, prioritization method, and stakeholder involvement on the resulting research priorities identified.