The purpose of this Question Verification Form is to enable Priority Setting Partnerships (PSPs) to describe clearly how they checked that their questions were unanswered, before starting the interim prioritisation stage of the process.
The JLA requires PSPs to be transparent and accountable in defining their own scope and evidence checking process. This will enable researchers and other stakeholders to understand how individual PSPs decided that their questions were unanswered, and any limitations of their evidence checking.
Name of the PSP
James Lind Alliance Emergency Medicine Priority Setting Partnership Refresh
Please describe the scope of the PSP
As a refresh PSP, the scope will essentially follow that of the original emergency medicine PSP. The scope is thus defined as:
- Inclusive of whole of UK and Ireland
- Focussed on NHS settings
- Will focus on care and what happens within the walls of the emergency department
- Will include arrival at the emergency department and point of handover.
The PSP will exclude from its scope questions about:
- Paediatric emergency care
- Patients that have arrived at an emergency department, but are not in the care of an emergency department, e.g. patients waiting on an ambulance outside an emergency department.
The Steering Group is responsible for discussing what implications the scope of the PSP will have for the evidence-checking stage of the process. Resources and expertise will be put in place to do this evidence checking.
Please provide a brief overview of your approach to checking whether the questions were unanswered
The methods used in any step were agreed through consultation between the Steering Group members, guided by the PSP’s aims and objectives.
Step 1: Awareness raising
PSPs will need to raise awareness of their proposed activity among their patient, carer and clinician communities, to secure support and participation. Depending on budget, this may be done by a face-to-face meeting, or there may be other ways in which the process can be launched, e.g. via social media. It may be carried out as part of steps 1 and/or 3. The Steering Group should advise on when to do this. Awareness raising has several key objectives:
- to present the proposed plan for the PSP
- to generate support for the process
- to encourage participation in the process
- to initiate discussion, answer questions and address concerns
- to include the original priorities in the refresh exercise.
Step 2: Identifying unanswered questions
The PSP carried out a consultation to gather unanswered questions from patients, carers and clinicians. A period of 12 weeks was given to complete this exercise. As the target audience of the PSP is representative of the general population, no specific groups are to be targeted as part of its dissemination. However, the PSP recognised the need to reach seldom heard or marginalised communities. The steering group therefore liaised with RCEM’s EDI and WEMSIG committees to discern meaningful strategies and networks for dissemination. In addition, the steering group compiled key contacts in a Master Contact Spreadsheet to ensure networks are best utilised.
The Steering Group used the following methods to reach the target groups
- Method 1: utilise an online survey for dissemination
- Method 2: ensure diverse representation in the steering group, for wider and inclusive dissemination
- Method 3: to develop a Comms plan with the RCEM Communications Manager including a comms pack to facilitate wider dissemination
- Method 4: engage existing patient group networks
- Method 5: to reach out to partner organisations, with a view to dissemination
- Method 6: to run or coincide launch with some kind of event (if possible).
Existing sources of unanswered questions were also be searched
Please list the type(s) of evidence you used to verify your questions as unanswered
Each question underwent a mini-systematic review using BestBETs methodology by two reviewers to establish whether evidence already existed. BestBETs methodology consists of a three-part question: (1) patient characteristic; (2) intervention(s) or defining question; and (3) relevant outcome(s), and a structured approach to finding and reviewing the literature. Volunteers from the emergency medicine community (including medical students and emergency medicine registrars) undertook the reviews. The outcomes of the mini-systematic reviews were reviewed by members of the steering committee; if the research question was determined to be answered then the question was not included in the prioritisation survey. A review of the existing top 30 questions was also undertaken by the steering group and the team at the JLA to establish research completed (or underway) that answered the question. Many of the mini-reviews are in the process of being published in peer reviewed journals (as an example)
On confirmation that submitted questions remained unanswered, and removal of duplicates, all unanswered questions, including those from the 2017 JLA PSP, were included in an interim list of questions. The steering group produced lay summaries of each along with a glossary of terms. Any questions identified by committee members as being out of scope were removed.
Please list the sources that you searched in order to identify that evidence
Each individual mini-systematic review had its own search list generated with search terms and a list of sources detailed. As a minimum this should include Medline from 1966 to the present day or NICE health care databases and it was suggested that other databases such as Embase and the Cochrane databases should be used.
What search terms did you use?
Each individual mini-systematic review had its own search list generated with search terms using the following guide for search terms [All terms to do with the patient group] AND [All terms to do with treatment A] AND [All terms to do with treatment B].
Please describe the parameters of the search (eg time limits, excluded sources, country/language) and the rationale for any limitations
The parameters were set by the reviewers but they were advised for it to be from inception until the present day and in English.
Names of individuals who undertook the evidence checking
Ed Carlton
Sam Love
Dora Holden
Louis de Bernard
Jonathon Lowe
Genevieve Lawrence
Pip Wilson
Rhiannon Jones
Ahmad Saqer
Ed Baker
Briony Seden
Ceri Battle
Charlotte Underwood
Laura Cottey
Lan Tran
Dolly McPherson
Sam Scotcher
Thomas S
Melanie Barker
Matt Reed
Virgina Newcombe
Christina Taylor
Owen Williams
Michael Conelly
Dominque Jones
Peter Gimson
James Chu
Thomas Shanahan
Eloise Graham
James Dear
Christina Taylor
Rick Body
Ahmad Saqer
Alisdair Corfield
Sarah Wilson
Charlotte Taylor
Phil Moss
Leo Wood
Graham Johnson
Michelle Angus
Fareeda Sohrabi
Tom Hughes
Samantha Cooper
Adrian Boyle
David Lowe
Alice Byram
Tanya Baron
Felix Wood
On what date was the question verification process completed?
June 2022
Any other relevant information
Please see the full published methodology