PSP FAQs

The James Lind Alliance - a non-profit organisation which in 2013 became part of the National Institute of Health Research (NIHR) - has overseen over 30 PSP's to date in a wide range of health areas, from asthma to stillbirth. Its guidebook sets out clear processes for identifying research questions, checking whether they have been answered by existing research, and then prioritising them to derive a Top Ten list of priorities for future research. The essential elements of the process are a) bringing together patients, carers and clinicians to have an equal say in determining the research agenda; b) decisions at each stage being made by group consensus (usually by a steering group comprising a diverse range of stakeholders); c) transparency and openness.

The ideas-gathering survey was open for 2 months from June - July 2014 and is now closed; those ideas formed the basis of a second survey (in early 2015) to choose the most important questions for future research. The PSP has now published its final results (which you can see here), which means we can't add further suggestions at this point.

We sought input from as wide a range of stakeholders as possible. 'Stakeholders' were divided into healthcare 'providers' - i.e. 'anyone involved in delivering anaesthesia or perioperative care' - and 'service users', or 'lay' stakeholders, i.e. 'anyone who has had, or who may have in the future, anaesthesia or perioperative care', plus their carers and relatives.

Contributions were received from individuals (who responded to both surveys) and from stakeholder organisations, who contributed research suggestions in the first survey. The 45 stakeholder organisations involved can be viewed here [. We estimate that the professional bodies represent around 40,000 perioperative professionals (including all anaesthetists), and the patient / carer organisations at least 50,000 'lay' stakeholders.

All the 1,476 research suggestions submitted via the first survey were classified by theme into groups of similar questions. This allowed us to see the most common (or popular) themes and to combine duplicate questions (i.e. where respondents have proposed essentially the same research question using different wording). From this, we compiled a shortlist of 92 'summary' research questions for the second (interim prioritisation) survey.

The second 'prioritisation' survey (which was open during February - March 2015) asked respondents to choose their personal 'top ten' questions from the shortlist of 92 summary questions. The highest-ranked 25 questions were taken forward to a face-to-face 'final prioritisation' workshop in May.

Both the original survey and the interim prioritisation survey were open to anyone with an interest in future Anaesthesia and Perioperative research. The prioritisation survey received 1,718 responses in total - from over 1,300 clinicians, and more than 600 patients and carers. (Some people are both, of course - which is why 1,300 plus 600 adds up to more than 1,718!).

The 25 most popular questions (by number of votes received) were taken forward to the final workshop in May 2015 as candidate questions for the final Top Ten research priorities.

All the partner organisations were invited to send a representative to the final prioritisation meeting. 23 stakeholder representatives attended the workshop (ten patients or carers, and thirteen clinicians) which involved face-to-face discussion in small groups (and then in one big group) of the 25 most popular questions from the interim prioritisation survey. The aim was to ensure representation of a diverse range of stakeholder interests in selecting the final Top Ten.

The final report of the PSP was published in BMJ Open in December 2015. Further academic publications exploring specific aspects of the PSP are planned.

A full list of publications to date can be found on the news page [. The results have also been communicated to each of the PSP's partner organisations, and discussed and promoted within the NIAA research council and other anaesthetic research funding bodies. Various presentations have also been given at national and international anaesthetic and perioperative conferences (e.g. Dingle conference 2015, EBPOM 2015.) Other efforts to publicise and disseminate the PSP's results among its relevant target audiences are ongoing.

The NIAA is working with the National Institute of Health Research (NIHR) to explore the possibility of commissioned funding calls, and other ways of incorporating the PSP's results into the NIHR's research agenda. The NIAA Funders' Forum and NIAA Research Council have both approved the results of the PSP. The top ten priorities will likely play a significant role in funding bodies' decisions when allocating research funds.

Quantifying the influence of the PSP results on the overall research agenda is likely to be challenging. Even if the PSP were able to keep tabs on all anaesthetic research being conducted across the world, it would be difficult to assess the effect of the PSP results in bringing a specific research project to fruition. However, the NIAA has a broad overview of most UK-based anaesthetic research activity, and we will encourage anecdotal reporting of instances where the PSP results influenced funding decisions.

We deliberately avoided setting an arbitrary time limit on how long the PSP's results could be considered 'valid', since no one can sensibly predict either the findings or the implications of future research (and thus how quickly any of the top ten priorities is likely to become obsolete). However, the NIAA's expectation is that another research priority exercise will be needed in 5-10 years' time; meanwhile the top ten will be informally reviewed every 1-2 years to assess what progress has been made towards answering them.