Research priorities for patients with peripheral arterial disease: a James Lind Alliance Priority Setting Partnership

Abstract

Introduction: Peripheral arterial disease (PAD) is a common health problem associated with reduced mobility, functional capacity and quality of life. Significant research exists in the field of vascular surgery, but its relevance to the research priorities of patients/carers and clinicians/healthcare professionals is unknown. The aim of this process, conducted by the Vascular Society of Great Britain and Ireland with the James Lind Alliance (JLA), was to identify the key research priorities for PAD, from the perspective of patients/carers and clinicians/healthcare professionals. Methods: A modified JLA Priority Setting Partnership was performed in three stages: (1) a clinician/healthcare professional-led Delphi process; (2) a patient/carer-led JLA process; and (3) amalgamation of patient/carer and clinician/healthcare professional-led results for a final round of JLA-led prioritisation. The clinician/healthcare professional Delphi process surveyed vascular clinicians/healthcare professionals, inviting them to submit important research priorities for vascular surgery. This generated a list of priorities which were redistributed for interim scoring. The priorities fitted into nine specific Special Interest Groups (SIGs), one being PAD. This was followed by a patient/carer Delphi process (in association with the JLA) using a similar two-stage process. Finally, research priorities formed by these two processes were amalgamated to produce a refined list relevant to PAD. The PAD SIG then held a final JLA consensus workshop which was attended by patients/carers and clinicians/healthcare professionals, where a nominal group technique was used to produce a ranked top 10 list of research priorities specific to PAD. Results: In the clinician/healthcare professional Delphi process, 481 clinicians/healthcare professionals submitted 1,231 research priorities related to vascular conditions. Two hundred and six PAD-specific priorities were amalgamated into 17 priorities which were recirculated for scoring according to perceived importance. For patients/carers, 582 research priorities were submitted by 373 individuals, and 114 PAD specific priorities were amalgamated into 9. These were recirculated for scoring according to perceived importance. After amalgamation of both sets of priorities, 12 remained, which were discussed at the final consensus meeting, resulting in a final ranked list of 10 PAD-specific research priorities. Research priority themes included improving outcomes, maximising non-invasive therapy, education and diagnosis, and stopping/slowing down PAD and cardiovascular disease progression. Conclusions: We have identified the top 10 PAD-related research priorities from the perspective of patients/carers and clinicians/healthcare professionals. This should provide guidance for researchers, clinicians, healthcare professionals and funders to ensure that proposed PAD research is addressing priorities that are considered important to all parties.