Vascular disease is the collective term for diseases of the veins and arteries. Every part of the body to which blood flows can be affected by it. It’s as common as cancer and heart disease and accounts for 40% of deaths in the UK and estimated health and care costs of £9 billion.
Why set Priorities for Vascular Research?
Despite ongoing research activity in the UK and other countries, there are still many questions about the prevention, diagnosis and treatment of vascular disease that remain unanswered. However, funding is highly competitive and resources are increasingly limited, which means that researchers and policy makers need to know where best to focus their efforts in order to maximise impact on health outcomes.
85% of research investment is wasted when the needs of users of research are ignored
Chalmers I, Glasziou P. Avoidable waste in the production and reporting of research evidence. Lancet. 2009;374(9683):86-9.
What are the Benefits of a Priority Setting Process?
Priority setting processes (PSPs) can help to address this issue by systematically identifying gaps in evidence and establishing recommendations for research priorities. The James Lind Alliance is internationally recognised as an authoritative and independent organisation to guide this work and produce an unbiased result. They specialise in bringing together patient and clinician voices and give equal weighting to the views of the different groups.
Patients and carers across the UK are closest to the conditions and living with the effects every day. They have valuable insight to share.
Here at Hull York Medical School, our Vascular Research Group manage the work of the Vascular PSP and specifically lead the following national sub-specialty interest groups: Vascular Access (Mr George Smith), Venous (Mr Dan Carradice), Wounds (Professor Ian Chetter).
How did the Vascular Priority Setting Partnership agree the priorities?
The Vascular Priority Setting Partnership publication has been published and details the background, methodology and results of the Vascular PSP in full. A summary of the process is provided here and outlined below.
The Vascular PSP was undertaken in three main phases;
- Delphi Survey: an initial Delphi survey to gather the opinions of vascular health care professionals about their research priorities.
- A James Lind Alliance (JLA) survey to gather the opinions of vascular patients and carers about their research priorities.
- Final workshops to bring together patient and healthcare professional priorities to jointly agree research priorities.
Phase One; Clinician Delphi Survey Summary.
The aim was to survey the opinions of vascular health care professionals, to identify and rankresearch priorities using a modified Delphi methodology. A full description of this phase of the project has been published:
Identifying the research priorities of healthcare professionals in UK vascular surgery: modified Delphi approach.
Phase Two; Patient and Carer Survey with the James Lind Alliance (JLA).
Following the success of the vascular health care professional Delphi survey, the Vascular PSP worked in collaboration with the James Lind Alliance to identify and score patients and carers research priorities.
The Steering Group
is made up of representatives from vascular health care professions, service users and carers. This group agrees the plan of action, scope and takes responsibility for the PSP.
We ran a survey inviting anyone with a vascular condition, their carers or family to submit research priorities.
The term vascular covers such a broad range of conditions, we established Special Interest Groups (SIGs) to help support and promote the project in these areas, ensuring different types of vascular condition were fairly represented throughout this process.
- Diabetic Foot
- Peripheral Arterial Disease
- Service Organisation
Each SIG has its own membership comprising allied health professionals (surgeons, nurses, radiologists, technologists, trainees, physiotherapists) and patients.
With oversight from the steering group, a team from the Vascular Research Group sorted all the priorities and worked with the SIGs to group the responses into vascular condition areas (SIGs).
The long list of summary questions were checked against existing research evidence to ensure they were true uncertainties. Any priorities that were already answered by research were removed.
Overarching summary priorities were agreed and put forward to the next round of survey for scoring.
We ran a second survey and invited patients and carers to select their vascular area/s of interest and to score the priorities within this area using a Likert scale (Extremely Important to Not at all Important or Don’t know).
Phase Three; Final SIG Workshops: A combined approach.
Final prioritisation workshops took place between January and September 2021. The nine special interest groups (SIGs) held individual workshops to agree on their 'top ten' list of research priorities.
Following JLA recommendations, work was undertaken by each SIG in advance to agree on a final combined shortlist of clinician and patient priorities to be discussed at the workshops.Where clinician priorities and patient priorities overlapped, the patient priority was put forward.
Due to the ongoing risk of COVID-19, face to face workshops were not possible, however the JLA adapted their process to deliver the workshops online via zoom. Each workshop was facilitated by the Vascular PSP lead JLA advisor and followed the JLA methodology, using a Nominal Group Technique to generate discussion, ranking, consensus and agreement.
A ranked list of the top 10 most important research priorities for each Special Interest Group.
Vascular patients and healthcare professionals should now advocate these research priorities, helping to direct funding into areas of upmost need and greatest impact.
NIHR James Lind Alliance Priority Setting Partnerships rolling call
Each SIG is in the process of publishing the outcomes of the workshop:
D. Bosanquet, S. Nandhra, K. Wong, J. Long, I. Chetter and R. Hinchliffe. Research priorities for lower limb amputation in patients with vascular disease. Journal of Vascular Societies Great Britain and Ireland 2021 Vol. 1 Issue 1 Pages 11-16. DOI: http://doi.org/10.54522/jvsgbi.2021.001
De Siqueira JR, Fielding CA, Pettigrew GJ, Robson MG, Rogers SK, Steiner K, Withers W, Long J, Gronlund T, Chetter I, Smith GE. Defining priorities in vascular access research..J.Vasc.Soc.G.B.Irel. 2022;1(2):30-33. http://doi.org/10.54522/jvsgbi.2022.013
Lawson JA,1 Bown MJ,2 Bicknell CD,3 Long J,4 Gronlund TA,5 on behalf of the VSGBI Aortic Special Interest Group/ James Lind Alliance Priority Setting Partnership. Research priorities for aortic diseases: results of the James Lind Alliance/Vascular Society GBI priority setting exercise. J.Vasc.Soc.G.B.Irel. 2022;1(2):34-41. http://doi.org/10.54522/jvsgbi.2022.009
Pymer S, Harwood AE, Long J, Chetter IC, Saratzis A, Coughlin P, on behalf of the Vascular Society of Great Britain and Ireland Peripheral Arterial Disease Special Interest Group James Lind Alliance Priority Setting Partnership. Research priorities for patients with peripheral arterial disease: a James Lind Alliance Priority Setting Partnership J.Vasc.Soc.G.B.Irel. 2022;1(2):23-29. https://doi.org/10.54522/jvsgbi.2022.011