NIHR Innovation Observatory, Newcastle University, Newcastle upon Tyne, UK
Evidence Synthesis Group, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
BMJ Open Gastroenterol. 2022 May;9(1). doi: 10.1136/bmjgast-2021-000847.
This rapid priority setting exercise aimed to identify, expand, prioritise and explore stakeholder (patients, carers and healthcare practitioners) topic uncertainties on faecal incontinence (FI).
An evidence gap map (EGM) was produced to give a visual overview of emerging trial evidence; existing systematic review-level evidence and FI stakeholder topic uncertainties derived from a survey. This EGM was used in a knowledge exchange workshop that promoted group discussions leading to the prioritisation and exploration of FI stakeholder identified topic uncertainties.
Overall, a mismatch between the existing and emerging evidence and key FI stakeholder topic uncertainties was found. The prioritised topic uncertainties identified in the workshop were as follows: psychological support; lifestyle interventions; long-term effects of living with FI; education; constipation and the cultural impact of FI. When these six prioritised topic uncertainties were explored in more depth, the following themes were identified: education; impact and burden of living with FI; psychological support; healthcare service improvements and inconsistencies; the stigma of FI; treatments and management; culturally appropriate management and technology and its accessibility.
Topic uncertainties identified were broad and wide ranging even after prioritisation. More research is required to unpick the themes emerging from the in-depth discussion and explore these further to achieve a consensus on deliverable research questions.
本快速优先排序研究旨在识别、扩展、优先排序并探讨粪便失禁(FI)患者、照护者和医疗保健从业者的利益相关者主题不确定性。
制作证据差距图(EGM)以直观呈现新兴试验证据、现有系统评价级别的证据和 FI 利益相关者主题不确定性,这些不确定性来自调查。该 EGM 用于知识交流研讨会,促进小组讨论,从而对 FI 利益相关者确定的主题不确定性进行优先排序和探索。
总体而言,发现现有证据与新兴证据以及 FI 主要利益相关者主题不确定性之间存在不匹配。研讨会上确定的优先排序主题不确定性如下:心理支持、生活方式干预、FI 的长期影响、教育、便秘和 FI 的文化影响。当更深入地探讨这六个优先排序的主题不确定性时,确定了以下主题:教育、FI 的影响和负担、心理支持、医疗保健服务改进和不一致、FI 的耻辱感、治疗和管理、文化适宜的管理以及技术及其可及性。
即使经过优先排序,确定的主题不确定性仍然广泛且广泛。需要进一步开展研究以剖析深入讨论中出现的主题,并进一步探讨这些主题,以就可交付的研究问题达成共识。