Guidance for Researchers and Research Funders

Background

The principal aim of medical research is to improve patient care. The benefits of involving patients and carers in all stages of research design and implementation are therefore being increasingly recognised. To that end, research funding bodies often look for evidence of patient involvement in the design of a research proposal; similarly, researchers applying for grants or other funding sources are more likely to succeed if they have involved patients in the design of their research and can demonstrate how patient involvement has ensured the relevance and acceptability of the proposed research to patients.

A fundamental part of making research patient-relevant is ensuring we're asking questions that matter to patients at the outset. Priority Setting Partnerships (PSPs) explicitly aim to identify and prioritise unanswered questions that patients, carers and clinicians all want answered. By showing that your research proposal aligns with research priorities identified in a PSP, you can thus demonstrate that the subject under investigation is one that patients care about.

How to use the Top Ten

For researchers

The Top Ten research priorities identified from the Anaesthesia and Perioperative Care PSP are all fairly general in scope: none could reasonably be considered a 'ready-to-go' research hypothesis. However, researchers often have a specific research question when applying for research funding. The key, therefore, is to demonstrate how the specific question that forms the basis of the research proposal relates to the PSP's identified research priorities. You can do this in various ways, but we suggest the following approach:

1) Look through the PSP's 'Top ten research priorities' and mark any that you think your research aligns with.

2) Find additional questions from the 25 highest ranked questions from the prioritisation survey (see list here) that didn't feature in the final top ten, but which are nevertheless relevant to your research hypothesis. This list shows you the 'overall rank' from the prioritisation survey, and the respective rank among clinicians and patients / carers. If it's highly ranked (especially by patients / carers), you should emphasise that in your research proposal as evidence of its importance.

3) Visit UK DUETs to explore in more depth the original ideas and suggestions that contributed to the research questions in the prioritisation survey. (Here you will also find a brief review of the existing research evidence relating to each question.)

Example

You wish to apply for funding for a research project to investigate the hypothesis:

'Goal-directed intraoperative fluid therapy improves post-operative outcomes in high risk patients undergoing major colorectal surgery.'

1) The following research questions from the PSP's top ten are relevant to your research hypothesis:
• How can we improve recovery from surgery for elderly patients? (Relevant because elderly patients are generally high risk, and form a large proportion of the major colorectal surgery patient population)
• Do enhanced recovery programmes improve short and long-term outcomes? (Relevant because intraoperative gold-directed fluid therapy is an important component of most ERPs)

2) A look through the 25 questions from which the top ten were chosen reveals these additional questions that could be considered relevant to your research hypothesis:
• How can we reduce the effects of anaesthesia on brain function, particularly in the elderly? (ranked 1st overall, and 1st by patients & carers)
• What are the consequences of low blood pressure around the time of surgery, particularly in the elderly? (ranked 8th overall, 11th by patients / carers)
• Does cardiac output monitoring improve outcomes after surgery? How can we improve cardiac output monitoring? (10th overall, 33rd by patients / carers)
• How can we reduce complications (adverse events) after surgery? (13th overall, 13th by patients / carers)
• What is the best choice of intravenous fluids to improve outcomes after surgery? (20th overall, 32nd by patients / carers)
• How can we reduce the risks of anaesthesia in elderly patients? (22nd overall, 23rd by patients / carers)

3) You can look at the relevant pages on UK DUETs to explore individual research suggestions that were incorporated into each of the questions from steps 1 and 2 - you may find that your research hypothesis (or something very close to it) was proposed as a research idea by respondents in the original survey.

For research funding bodies

Your organisation will probably already have specific areas or 'high priority' topics for future funding. However, any alignment between those areas and the research priorities identified in the PSP will bolster the patient-relevance credentials of your organisation's research goals. The same steps outlined above can be used to find areas of overlap between your organisation's (pre-existing) research focus and the research priorities from the PSP.

Alternatively, your organisation may simply decide to give preference to research proposals that relate to the PSP's top ten research priorities. If so, comparing an applicant's research proposal against the priorities identified in the PSP will allow your organisation to judge whether it is likely to provide evidence that might help answer any of the PSP's research questions.

Final Word

The PSP's aim was to inform the research agenda by identifying important research topics. However, it is no substitute for the peer review process in allocating research funds, and there is no expectation that either researchers or research funding bodies should realign their research priorities merely to address the topics deemed most important by the PSP.

Nonetheless, close alignment with research priorities from the PSP can clearly provide useful support to both researchers and research funding bodies wishing to demonstrate that their research will help answer genuinely 'important' questions. We suggest that the PSP results should be therefore be used as supporting evidence of the overall importance and patient-relevance of specific research projects.

Further guidance on making use of PSP results can be found on the JLA website. We would also remind researchers and research funding bodies that other PSPs - for example the Intensive Care PSP - may have identified research priorities relevant to areas of anaesthesia and perioperative care. Reviewing the priorities identified in those PSPs may thus reveal additional alignment that may be used to support the proposed research.