You are here

Article Text

Article menu
Surgery
Original research
Research priorities for the management of complex fractures: a UK priority setting partnership with the James Lind Alliance
  1. Christopher Patrick Bretherton1,
  2. Henry A Claireaux1,
  3. Jonathan Gower2,
  4. Shan Martin3,
  5. Angela Thornhill4,
  6. Louise Johnson5,
  7. Lucy Silvester6,
  8. Rebecca Samantha Kearney7,
  9. Mark Baxter8,
  10. Paul Dixon9,
  11. Victoria Giblin10,
  12. Xavier Luke Griffin11,
  13. William Eardley9
  1. 1 Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
  2. 2 James Lind Alliance, Southampton, UK
  3. 3 Patient Representative, Wessex, UK
  4. 4 Patient Representative, East Midlands, UK
  5. 5 Clinical Psychology, Leeds General Infirmary, Leeds, UK
  6. 6 Physiotherapy, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
  7. 7 Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
  8. 8 Orthogeriatrics, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  9. 9 Trauma & Orthopaedic Surgery, James Cook University Hospital, Middlesbrough, UK
  10. 10 Plastic Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  11. 11 Trauma & Orthopaedic Surgery, Queen Mary University of London, London, UK
  1. Correspondence to Christopher Patrick Bretherton; christopher.bretherton{at}ndorms.ox.ac.uk

Abstract

Objective To determine research priorities for the management of complex fractures, which represent the shared priorities of patients, their families, carers and healthcare professionals.

Design/setting A national (UK) research priority setting partnership.

Participants People who have experienced a complex fracture, their carers and relatives, and relevant healthcare professionals and clinical academics involved in treating patients with complex fractures. The scope includes open fractures, fractures to joints broken into multiple pieces, multiple concomitant fractures and fractures involving the pelvis and acetabulum.

Methods A multiphase priority setting exercise was conducted in partnership with the James Lind Alliance over 21 months (October 2019 to June 2021). A national survey asked respondents to submit their research uncertainties which were then combined into several indicative questions. The existing evidence was searched to ensure that the questions had not already been sufficiently answered. A second national survey asked respondents to prioritise the research questions. A final shortlist of 18 questions was taken to a stakeholder workshop, where a consensus was reached on the top 10 priorities.

Results A total of 532 uncertainties, submitted by 158 respondents (including 33 patients/carers) were received during the initial survey. These were refined into 58 unique indicative questions, of which all 58 were judged to be true uncertainties after review of the existing evidence. 136 people (including 56 patients/carers) responded to the interim prioritisation survey and 18 questions were taken to a final consensus workshop between patients, carers and healthcare professionals. At the final workshop, a consensus was reached for the ranking of the top 10 questions.

Conclusions The top 10 research priorities for complex fracture include questions regarding rehabilitation, complications, psychological support and return to life-roles. These shared priorities will now be used to guide funders and teams wishing to research complex fractures over the coming decade.

  • complex fractures
  • trauma
  • priority setting

Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information. Online supplemental data including all indicative questions and out of scope submissions can be found on the JLA website at: https://www.jla.nihr.ac.uk/priority-setting-partnerships/complex-fractures/

Data availability statement

Supplementary data including) all indicative questions and out of scope submissions can be found on the JLA website at: https://www.jla.nihr.ac.uk/priority-setting-partnerships/complex-fractures/ Online supplemental data including all indicative questions and out of scope submissions can be found on the JLA website at: https://www.jla.nihr.ac.uk/priority-setting-partnerships/complex-fractures/

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2021-057198

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Data availability statement

    All data relevant to the study are included in the article or uploaded as online supplemental information. Online supplemental data including all indicative questions and out of scope submissions can be found on the JLA website at: https://www.jla.nihr.ac.uk/priority-setting-partnerships/complex-fractures/

    Data availability statement

    Supplementary data including) all indicative questions and out of scope submissions can be found on the JLA website at: https://www.jla.nihr.ac.uk/priority-setting-partnerships/complex-fractures/ Online supplemental data including all indicative questions and out of scope submissions can be found on the JLA website at: https://www.jla.nihr.ac.uk/priority-setting-partnerships/complex-fractures/

    View Full Text

    Supplementary materials

    • Supplementary Data

      This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

    Footnotes

    • Twitter @BrethertonC, @xlgriffin

    • Contributors All authors (CPB, HAC, JG, SM, AT, LJ, LS, RSK, MB, PD, VG, XLG and WE) made significant contributions to the design, implementation and delivery of this research. HAC conducted the evidence searching. CPB analysed the data and prepared the initial manuscript. All authors have read and approved the final version of this manuscript. CPB is responsible for the overall content as the guarantor.

    • Funding This work was supported by AOUK&I, grant number HFR03160.

    • Competing interests RSK is a member of the UK NIHR HTA CET board, NIHR ICA Doctoral panel, chair of the NIHR RfPB board and holder of a NIHR Senior Fellowship award. RSK has been awarded current and previous NIHR and vs Arthritis research grants. RSK is co-investigator on an NIHR funded study receiving additional support from Stryker Ltd.

      XLG is funded by an NIHR Clinician Scientist Award.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.