690 A national priority setting partnership to develop neonatal research questions suitable for practice-changing randomised trials in the United Kingdom

Abstract

<h3>Aims</h3> More than 1 in 10 babies in many high-income settings will receive neonatal care. Neonatal conditions contribute to almost half of all child deaths in the UK and to many long-term health conditions. Despite this importance, much neonatal care is not based upon high-quality research evidence. There is an increased focus on prioritisation projects within healthcare using initiatives such as the James Lind Alliance to support unified decision making across specific specialities. Methodologically robust clinical trials are required to improve neonatal care and reduce unwanted variations in practice. Previous neonatal research prioritisation processes have identified important themes rather than specific questions amenable to clinical trials. Practice-changing trials require well defined research questions, commonly organised using the Population, Intervention, Comparison, Outcome (PICO) structure. By narrowing the scope of research priorities to those which can be answered in clinical trials and by involving a wide variety of different stakeholders, the ‘Neonatal Research Priority Setting Partnership’ (figure 1) provides a robust and transparent process to identify and prioritise research questions important to families and answerable within the NHS to inform future practice-changing clinical trials. <h3>Methods</h3> A steering group comprised of parents, doctors, nurses, allied health professionals, researchers and representatives from key organisations (Neonatal Society, British Association of Perinatal Medicine, Neonatal Nurses Association, Royal College of Paediatrics and Child Health and the National Institute of Health Research Clinical Research Network) was identified to oversee this project. We invited submissions of research questions formatted using the PICO structure from the following stakeholder groups using an online questionnaire: parents, patients, healthcare professionals and academic researchers. Previously unanswered, non-duplicate research questions will be entered into a two round eDelphi prioritisation survey of all stakeholder groups. Research questions will be ranked by second round, mean aggregate scores. <h3>Results</h3> Engagement has been excellent across different stakeholder groups, with the project webpage being viewed over 800 times. The introductory webinar was attended by 74 delegates with a further 22 delegates subsequently viewing it online. To date, over 100 research questions have been submitted through the bespoke online questionnaire covering a wide breadth of neonatal topics from therapeutic hypothermia to family centred care. After completion of the two round eDelphi survey, the final list of prioritised research questions will be disseminated through traditional academic channels, directly to key stakeholder groups through representative organisations and on social media. The outcome of the project will be shared with key research organisations such as the National Institute for Health Research (NIHR), academic institutions and researchers looking to improve neonatal care through practice changing clinical trials. <h3>Conclusion</h3> Neonatology within the UK is ideally placed for collaborative research due to centrally funded healthcare, the neonatal network structure facilitating close relationships between units and the accessibility of large national databases. The ‘Neonatal Research Priority Setting Partnership’ demonstrates the feasibility of including a wide range of key neonatal stakeholders to identify and prioritise research questions suitable for evaluating in well-structured clinical trials, addressing the many clinical uncertainties.