Foot and Ankle Surgery PSP Question Verification Form


Published: 01 August 2022

Version: 3

Print this document

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

Foot and Ankle Priority Setting Partnership

Please describe the scope of the PSP

The scope of the foot and ankle PSP is to identify any ongoing uncertainties relating to the adult non-Diabetic population, encompassing both trauma and elective care, specifically operative and non-operative management. The PSP concentrated the scope on post diagnosis care, to prevent too broad a scope, this exclusion also included epidemiological questions, and general health care management within the NHS. As Diabetic foot is a complex conditions encompassing a multitude of different aspects, the PSP took the decision to not include the condition within this uncertainty review.

Please provide a brief overview of your approach to checking whether the questions were unanswered

To review the for the questions having enough evidence to be considered answered, each question block e.g. ankle replacement, rehabilitation etc were split between 5 groups (56 questions). Each group had the merged question available for review, and the original question in case of a query as to the merged question. Each participant selected for literature review and data-analysis so see if the question was considered unanswered, had previous experience in undertaking literature review and data-analysis. Precluding our patient representative from undertaking this process as they did not have the relevant training.

Please list the type(s) of evidence you used to verify your questions as unanswered

Meta-analysis, Systematic review, randomised control trials – double blind.

Please list the sources that you searched in order to identify that evidence

Cochrane, NICE guidance, NICE research recommendations, Medline, OVID, HDAS, PubMed. Each question was then was then graded A-D, as per box below.

A   No systematic review available
B Systematic review available, but authors did not find any RCTs in the literature to include
C Systematic review available, some RCTs found, but no formal meta-analysis performed (This is usually due to poor quality of RCTs or disparities of design/outcome measures)
D Systematic review with meta-analysis available, uncertainty persists

Each reviewer was given a category to review, and then each final question from that category underwent a search to identify for the evidence (as above). Each study was reviewed and allocated a letter according to the grading scheme.

What search terms did you use?

Each search term used were specific to the question (56 questions in total) asked by the PSP. The evidence was split into levels. Using meta-analysis as the primary, then systematic review, finally randomised control trials. English language was the primary limitation, no time scale was applied to each question.

Please describe the parameters of the search (eg time limits, excluded sources, country/language) and the rationale for any limitations

The parameters: Meta-analysis, systematic review, randomised control trial, English language, humans, 18+, peer review journal, from 1946 to current day. We did not limit specifically via country, but this itself was limited by language the study was published in.

Names of individuals who undertook the evidence checking

L Thomson, M Hau, P Allen, M Davies, L Mason, B Scammell, R Kearney, N Davey, J Mangwani, N Gallogly, V, Patel

On what date was the question verification process completed?


Any other relevant information