Research Priorities for Carotid Conditions: results of the UK Vascular James Lind Alliance Priority Setting Process

Abstract

Introduction: Recent estimates of the prevalence of carotid plaque disease and carotid stenosis in people aged 39–79 years are 21.2% and 1.5% of the global population, respectively. Carotid artery disease and its management has one of the largest evidence-based areas of surgical practice, but several important questions remain unanswered. The Vascular Society of Great Britain and Ireland (VSGBI) in association with the James Lind Alliance (JLA) undertook a national Priority Setting Process (PSP) to identify carotid disease research priorities. This paper presents the results of this process. Methods: A modified JLA Priority Setting Partnership was developed to gather clinician, patient and carer research priorities for vascular conditions. Consensus workshops were held to discuss clinician and patient priorities and agree a list of joint research priorities. Consensus was achieved using a nominal group technique and a ranked ‘top 10’ list of research priorities for carotid conditions was established. Results: In the first phase (survey), 481 clinicians submitted 1,231 research priorities related to general vascular conditions. There were overlapping themes within the 1,231 priorities and, of these, 68 were carotid-specific research priorities which were reduced to six main priorities recirculated for interim scoring. In the second phase (patient and carer-led survey), 373 patients and carers submitted 582 vascular research priorities. Of these, 18 carotid priorities were reduced to 10 and recirculated for interim scoring. In the third phase (consensus workshop), clinician and patient priorities were amalgamated into 14 priorities for discussion. Finally, a ranked final ‘top 10’ list of carotid research priorities was established addressing themes including risk predication, personalised treatment, prevention, screening and surveillance. Conclusion: The ‘top 10’ carotid-related research priorities identify areas considered to be most important from the perspective of patients, carers and healthcare professionals. Researchers can now focus their efforts on addressing these important questions and funders should increase their investment to support new studies in these areas of greatest importance.