A modified Delphi process to establish research priorities in hernia surgery

D S G Scrimgeour,A De Beaux,N J Smart,N Dames,L Laidlaw,L Horgan, ,S R Knight,M Allan,B East,M S J Wilson,S Blackwell,D Light

doi:10.1007/s10029-021-02519-0

Abstract

BackgroundAbdominal wall hernia repair is one of the most commonly performed surgical procedures worldwide, yet despite this, there remains a lack of high-quality evidence to support best management. The aim of the study was to use a modified Delphi process to determine future research priorities in this field.MethodsStakeholders were invited by email, using British Hernia Society membership details or Twitter, to submit individual research questions via an online survey. In addition, questions obtained from a patient focus group (PFG) were collated to form Phase I. Two rounds of prioritization by stakeholders (phases II and III) were then completed to determine a final list of research questions. All questions were analyzed on an anonymized basis.ResultsA total of 266 questions, 19 from the PFG, were submitted by 113 stakeholders in Phase I. Of these, 64 questions were taken forward for prioritization in Phase II, which was completed by 107 stakeholders. Following Phase II analysis, 97 stakeholders prioritized 36 questions in Phase III. This resulted in a final list of 14 research questions, 3 of which were from the PFG. Stakeholders included patients and healthcare professionals (consultant surgeons, trainee surgeons and other multidisciplinary members) from over 27 countries during the 3 phases.ConclusionThe study has identified 14 key research priorities pertaining to abdominal wall hernia surgery. Uniquely, these priorities have been determined from participation by both healthcare professionals and patients. These priorities should now be addressed by well-designed, high-quality international collaborative research.

Highlights

Abdominal wall hernias are common and hernia repair is one of the most commonly performed operations in the world, generating huge health care costs
With the addition of 19 questions proposed by the patient focus group (PFG), the final Phase I cohort totaled 266 research questions from 113 stakeholders (Fig. 2)
Stakeholders were from 19 countries (Fig. 3A) and included patients (n = 19) and healthcare professionals (n = 94); professor or consultant surgeon (71.3%), surgical trainee/fellow/specialty doctor (25.5%), other (3.2%)

Summary

Introduction

Abdominal wall hernias are common and hernia repair is one of the most commonly performed operations in the world, generating huge health care costs. The incidence of inguinal hernias, primary ventral hernias and incisional hernias are rising due to an aging population and the world obesity crisis [1, 2] Despite this phenomenon there is a persistent lack of high-quality evidence regarding the management of abdominal wall hernias. Two rounds of prioritization by stakeholders (phases II and III) were completed to determine a final list of research questions. Following Phase II analysis, 97 stakeholders prioritized 36 questions in Phase III This resulted in a final list of 14 research questions, 3 of which were from the PFG. Conclusion The study has identified 14 key research priorities pertaining to abdominal wall hernia surgery These priorities have been determined from participation by both healthcare professionals and patients. These priorities should be addressed by well-designed, high-quality international collaborative research

Objectives

Methods

Results

Conclusion