Prioritizing research for patients requiring surgery in low- and middle-income countries
Nepogodiev D., Moore R., Biccard B., Rayne S., Costas-Chavarri A., Lapitan MC., Makupe A., Oluseye Adisa A., Uzair Qureshi A., Drake TM., Ademuyiwa A., Alexander P., Allen Ingabire JC., Al-Saqqa SW., Khairy Salem H., Teddy Kojo Anyomih T., Lawani I., Lorena Aguilera M., Ramos-De la Medina A., Spence R., Tabiri S., Yepez R., Smart N., Chu K., Davies J., Fitzgerald JE., Ghosh D., Koto Z., Magill L., Muller E., Ots R., Shaw C., Verjee A., Harrison EM., James Garden O., Sundar S., Glasbey JC., Chakrabortee S., Martin J., Lilford R., Smith M., Brocklehurst P., Morton DG., Bhangu A.
Abstract Background The National Institute for Health Research Global Health Research Unit on Global Surgery is establishing research Hubs in low- and middle-income countries (LMICs). The aim of this study was for the Hubs to prioritize future research into areas of unmet clinical need for patients in LMICs requiring surgery. Methods A modified Delphi process was overseen by the research Hub leads and engaged LMIC clinicians, patients and expert methodologists. A four-stage iterative process was delivered to prioritize research topics. This included anonymous electronic voting, teleconference discussions and a 2-day priority-setting workshop. Results In stage 1, Hub leads proposed 32 topics across six domains: access to surgery, cancer, perioperative care, research methods, acute care surgery and communicable disease. In stages 2 and 3, 40 LMICs and 20 high-income countries participated in online voting, leading to identification of three priority research topics: access to surgery; outcomes of cancer surgery; and perioperative care. During stage 4, specific research plans to address each topic were developed by Hub leads at a priority-setting workshop. Conclusion This process identified three priority areas for future research relevant to surgery in LMICs. It was driven by front-line LMIC clinicians, patients and other stakeholders representing a diverse range of settings. The results of the prioritization exercise provide a future framework for researchers and funders.