PT  - JOURNAL ARTICLE
AU  - Toni Zhong
AU  - Anisha Mahajan
AU  - Katherine Cowan
AU  - Claire Temple-Oberle
AU  - Geoff Porter
AU  - Martin LeBlanc
AU  - Kelly Metcalfe
TI  - Identifying the top research priorities in postmastectomy breast cancer reconstruction: a James Lind Alliance priority setting partnership
AID  - 10.1136/bmjopen-2020-047589
DP  - 2021 Aug 01
TA  - BMJ Open
PG  - e047589
VI  - 11
IP  - 8
4099  - http://bmjopen.bmj.com/content/11/8/e047589.short
4100  - http://bmjopen.bmj.com/content/11/8/e047589.full
SO  - BMJ Open2021 Aug 01; 11
AB  - Background Major improvements in breast cancer treatment in the last decade include advancements in postmastectomy breast reconstruction (PMBR). Unfortunately, the studies in PMBR are primarily researcher or industry led with minimal input from patients and caregivers. The aim of this study is to use the James Lind Alliance (JLA) approach to bring together the patients, caregivers and clinicians in a priority setting partnership to identify the most important unanswered research questions in PMBR.Methods The JLA priority setting methodology involved four key stages: gathering research questions on PMBR from patients, caregivers and clinicians; checking these research questions against existing evidence; interim prioritisation and a final consensus meeting to determine the top 10 unanswered research questions using the modified nominal group methodology.Results In stage 1, 3168 research questions were submitted from 713 respondents across Canada, of which 73% of the participants were patients or caregivers. Stage 2 confirmed that there were a total of 48 unique unanswered questions. In stage three, 488 individuals completed the interim prioritisation survey and the top 25 questions were taken to a final consensus meeting. In the final stage, the top 10 unanswered research questions were determined. They cover a breadth of topics including personalised surgical treatment, safety of implants and newer techniques, access to PMBR, breast cancer recurrence and rehabilitation.Interpretation Identification of the top 10 unanswered research questions is an important first step to generating relevant and impactful research that will ultimately improve the PMBR experience for patients with breast cancer.Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as online supplemental information. Additional data are available upon request.