Boney, Ritchie Oliver Caleb;
(2025)
Improving the quality and patient relevance of perioperative research.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
Background: Health research has recently evolved from being exclusively expert-led towards an inclusive collaboration between patients and healthcare professionals (HCPs). However, Anaesthesia and Perioperative Medicine (APOM) have lagged other disciplines in embracing this collaborative approach. We conducted two research initiatives to demonstrate the feasibility and benefits of stakeholder participation. The first – the Anaesthesia and Perioperative Care Priority Setting Partnership (APoC-PSP) – brought stakeholders together to agree priorities for future research. The second – the Core Outcome Measures for Perioperative and Anaesthetic Care (COMPAC) initiative – employed stakeholder collaboration to develop a Core Outcome Set (COS) for future trials. Methods: APoC-PSP: Stakeholders volunteered research ideas and suggestions via an online survey. Those suggestions were condensed into a shortlist and prioritised through a second online survey. Finally, the highest priority topics were discussed at a stakeholder workshop, where the ‘Top Ten’ research priorities were agreed. COMPAC: A systematic review was conducted to understand recent trends in APOM trial outcome reporting. We then undertook a survey seeking stakeholder views regarding important outcomes after major surgery. Stakeholder representatives then participated in a modified Delphi process to agree a perioperative Core Outcome Set. Results: APoC-PSP: 1,476 research ideas and suggestions were received from 623 contributors. These were refined into 92 ‘summary’ research questions and ranked by 1,718 second survey respondents. At the final workshop, 23 stakeholder representatives discussed the 25 highest-ranked questions and agreed the ‘Top Ten’ research priorities. 4 COMPAC: The systematic review found widespread variation in outcome reporting. In the stakeholder survey, over 90% of ~4,000 respondents rated clinical outcome measures critically important, but patient-centred outcomes were rated lower, particularly among HCPs. Sixty-seven stakeholders contributed to the Delphi process, which yielded eight core outcomes and four ‘additional important patient-centred’ outcomes from a 64- outcome longlist. Conclusions: Collaborative consensus methodology was used to agree future priorities and outcome measures for APOM research. Both initiatives found areas of close agreement between different stakeholders, while also uncovering some significant differences between HCPs’ and service users’ perspectives. These results highlighted the importance of comprehensive stakeholder participation to avoid missing certain stakeholder viewpoints and maximise relevance of APOM research to all users.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Improving the quality and patient relevance of perioperative research |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2025. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10203603 |
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