Research priorities for lower limb amputation in patients with vascular disease

Abstract

Introduction: Major lower limb amputation (MLLA) is a life-changing event often associated with high mortality and morbidity rates. Research into MLLA surgery is limited. The Vascular Society of Great Britain and Ireland (VSGBI) in partnership with the James Lind Alliance (JLA) aimed to identify and develop key research priorities for MLLA. Methods: A modified JLA Priority Setting Partnership was undertaken, encompassing all vascular practice. Two separate Delphi processes to identify research priorities were undertaken with healthcare professionals, patients and carers, led by the VSGBI. The priorities were then scored by the same participants and amalgamated to produce a list for final ranking. The final consensus meeting was attended by patients, carers and healthcare professionals from a variety of backgrounds involved in the care of people with MLLA. Using a nominal group technique, a ranked list of the top ten research priorities were identified. Results: A total of 481 clinicians submitted 1,231 research priorities relating to vascular surgery in general. Sixty-three MLLA-specific research priorities were combined into five final priorities. Three hundred and seventy-three patients or carers submitted 582 research priorities related to vascular surgery in general. Nine MLLA-specific research priorities were identified after combining similar priorities. The final consensus meeting produced a ranked top 10 list of research priorities relating to: MLLA prevention, supporting rehabilitation, improving clinical outcomes following MLLA (preventing/treating pain including phantom limb pain and improving wound healing) and research into information provision for patients undergoing MLLA. Conclusions: The top 10 MLLA research priorities provide guidance for researchers, clinicians and funders on the direction of future research questions that are important to both healthcare professionals and patients.