Research priorities for vascular services: results of the UK Vascular James Lind Alliance Priority Setting Process

Abstract

Introduction: The configuration of vascular services is a challenging process where treatment options, access and delivery of services is variable. There is a significant financial burden to the NHS due to rising demand for vascular services; however, guidelines for treatment options and delivery are frequently based on low levels of clinical and cost effectiveness evidence. Therefore, further research is required but capacity is limited and funding is highly competitive. To address this issue, the Vascular Society of Great Britain and Ireland (VSGBI) in association with the James Lind Alliance (JLA) undertook a national Priority Setting Process (PSP) for vascular conditions. This paper presents the results of this process, with a focus on the topic of ‘vascular services’. Methods: A modified JLA Priority Setting Partnership was implemented in three overarching phases: (1) a clinician-led survey to gather clinician research priorities; (2) a patient and carer-led survey to gather patient and carer research priorities; (3) a consensus workshop to discuss clinician and patient priorities and agree a list of joint research priorities. Consensus was achieved using the nominal group technique and a ranked ‘top 10’ list of research priorities for vascular services was established. Results: In the first phase (clinician-led survey), 481 clinicians submitted 1,231 research priorities related to vascular conditions in general. Of these, 338 service-related research priorities were reduced to 16 overarching summary priorities recirculated for interim scoring. In the second phase (patient and carer-led survey), 373 patients and carers submitted 582 research priorities. Of these, 25 service-related priorities were developed and recirculated for interim scoring. In the third phase (consensus workshop), clinician and patient priorities were amalgamated into 18 priorities for discussion. The final ‘top 10’ list of vascular service research priorities relate to: service configuration (organisation, access and delivery), patient experience, education and training (staff and patients), lifestyle and prevention, audit and evaluation and outcomes, diagnostics screening and risk assessment and communication. Conclusion: The ‘top 10’ vascular service-related priorities demonstrate the research 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 research in these areas of greatest importance.