Group Concept Mapping Research Articles

Conceptualizing the key components of rehabilitation following major musculoskeletal trauma: A mixed methods service evaluation.

The reorganization of acute major trauma pathways in England has increased survival following traumatic injury, resulting in an increased patient population with diverse and complex needs requiring specialist rehabilitation. However, national audit data indicate that only 5% of patients with traumatic injuries have access to specialist rehabilitation, and there are limited guidelines or standards to inform the delivery of rehabilitation interventions for individuals following major trauma. This group concept mapping project aimed to identify the clinical service needs of individuals accessing our major trauma rehabilitation service, prioritize these needs, determine whether each of these needs is currently being met, and plan targeted service enhancements. Participants contributed towards a statement generation exercise to identify the key components of rehabilitation following major trauma, and individually sorted these statements into themes. Each statement was rated based on importance and current success. Multi-dimensional scaling and hierarchical cluster analysis were applied to the sorted data to produce themed clusters of ideas within concept maps. Priority values were applied to these maps to identify key areas for targeted service enhancement. Fifty-eight patients and health care professionals participated in the ideas generation activity, 34 in the sorting, and 49 in the rating activity. A 7-item cluster map was agreed upon, containing the following named clusters: Communication and Coordination; Emotional and psychological wellbeing; Rehabilitation environment; Early rehabilitation; Structured therapy input; Planning for home; and Long-term support. Areas for targeted service enhancement included access to timely and adequate information provision, collaborative goal setting, and specialist pain management across the rehabilitation pathway. The conceptual framework presented in this article illustrates the importance of a continuum of rehabilitation provision across the injury trajectory, and provides a platform to track future service changes and facilitate the codesign of new rehabilitation interventions for individuals following major trauma.

Understanding side effects of therapy for myasthenia gravis and their impact on daily life

BackgroundMyasthenia gravis is a chronic, autoimmune, neuromuscular junction disorder characterized by skeletal muscle weakness. Current therapies for myasthenia gravis are associated with significant side effects. The objective of this study was to characterize the side effects, and associated health-related quality of life and treatment impacts, of traditional myasthenia gravis treatments.MethodsThis study had two phases; a Phase 1 interview and a 2-part web-based survey in Phase 2 that included brainstorming (Step 1) and rating (Step 2) exercises using group concept mapping. In Phase 1, all 14 participants reported experiencing side effects from myasthenia gravis treatments which had significant impacts on daily life. In Phase 2, 246 participants contributed to Step 1; 158 returned for Step 2.ResultsThe brainstorming exercise produced 874 statements about side effects and their impact, which were reduced to 35 side effects and 23 impact-on-daily life statements. When rating these statements on severity, frequency, and tolerability, blood clots, infections/decreased immunity, weight gain, and diarrhea were the least tolerable and most severely rated. The most frequent and severe impacts were sleep interference and reduced physical and social activities.ConclusionsBased on these findings, there appears to be a need for better and more tolerable treatments for myasthenia gravis patients.

A HEALTHY LIFE FOR AFRICAN AMERICAN WOMEN CARING FOR OLDER ADULTS: A CONCEPT MAPPING STUDY

Achieving optimal health and well-being among African American older adults with chronic conditions requires addressing the needs of their caregivers. This study aimed to elucidate how African American females caring for older adults view health and the factors that influence health. We identified African American women ages 24 to 64 caring for an adult 60 years or older for group concept mapping (GCM), a mixed-methods approach. Participants (N=25) first completed idea generation by providing unlimited short, free-text responses to the focus prompt, “A healthy life for a caregiver includes: ___.” The 512 identified factors were reduced to 99 unique ideas. Participants then sorted the 99 ideas into clusters based on conceptual similarity and rated each idea on desirability and familiarity. Ratings were recorded on a 5-point Likert scale, ranging from very undesirable to extremely desirable and not at all familiar to extremely familiar. Data were analyzed and mapped via CS Global Max software. A cluster map with 12 outcome domains best fits the data. Identified clusters included: (1) Spirituality, (2) Maintaining relationships, (3) Good character, (4) Action to cope, (5) Preserving self, (6) Support, (7) Personal empowerment, (8) Resources, (9) Release (10) Striving for peace, (11) Wellness, (12) Self-care. Seven of the 99 ideas (representing 5 of 12 domains) were rated as desirable but unfamiliar (“go zone”). We identified elements necessary for health and wellbeing from the perspective of African American caregivers. Go-zone items represent opportunities to intervene to promote the health of African American women caring for older adults.

Mapping the Perceived Sexuality of Heterosexual Men and Women in Mid- and Later Life: A Mixed-Methods Study.

IntroductionThere is currently limited research that examines the meaning of sexuality at midlife and later life.AimThis study investigates how heterosexual men and women in mid- and later life perceive their sexuality and the factors that influence it.MethodsGroup concept mapping was used to produce a conceptual map of the experience of sexuality for heterosexual adults ages 45 years and above. Group concept mapping data were collected using 6 open-ended survey questions that asked about sexuality, intimacy, and desire. Thematic analysis was used to examine how participants perceived their sexuality to have changed as they aged. Thematic analysis data were collected using a single open-ended survey question.Main Outcome MeasureStatements generated from 6 of the open-ended survey questions were rated by participants using a 5-point Likert scale for how important participants felt that each statement was to themselves personally. Participants responses to the seventh open-ended survey question were examined using thematic analysis to understand whether participants felt that their sexual experiences had changed over time and, if so, how they had changed.ResultsEight themes were identified across the different phases of group concept mapping. These were, in order of importance, partner compatibility, intimacy and pleasure, determinants of sexual desire, sexual expression, determinants of sexual expression, barriers to intimacy, sexual urges, and barriers to sexual expression. Seven areas of change were identified in terms of perceived changes to sexuality with age. These included changes to perspective, relationship dynamics, environment, behavior, body/function, sexual interest/desire, and sexual enjoyment.ConclusionThe results highlight the prioritization of interrelationship dynamics in mid- and later life sexuality over sexual functioning and sexual urges. These findings may facilitate the development of new perspectives on how sexuality is experienced in the later years and provide new avenues for intervention in situations where sexual problems arise.Macleod A, Busija L, McCabe M. Mapping the Perceived Sexuality of Heterosexual Men and Women in Mid- and Later Life: A Mixed-Methods Study. Sex Med 2019; 8:84–99.

Collective Economic Conceptualization of Cider and Wine Routes by Stakeholders

AbstractThe coherence and systemic strength of the collaborative process among thematic route stakeholders are key factors to economic success for individual businesses and regional economic development. The objective of this article is to identify the economic action set to rejuvenate the Cider Route and the Wine Route of the Montérégie region (Quebec, Canada). Group concept mapping is used to estimate the conceptualization and perceptions of stakeholders (cideries, wineries, tourism professionals, visitors) regarding the articulation of the action set. The contribution is threefold. Methodologically, the approach taken supports both the estimation of the concept map and associated perception measures. Empirically, eight action clusters are identified to articulate stakeholders’ “organizational” and “selling” dimensions of the routes. Practically, action priorities identified and feasibility constraints are helpful to target the capability development support needed by route stakeholders to collaborate. (JEL Classifications: D02, L23, L26, L66, Q18)

Teaching them, teaching me: youth conceptualize benefits of being a mentor in an indigenous high school peer mentoring program

ABSTRACTIn this mixed methods case study, we investigated the benefits of being a youth mentor to younger peers as part of the Fourth R: Uniting Our Nations Peer Mentoring Program for Indigenous youth. Data were collected from 11 youth mentors via interviews and returned to them for interpretation and meaning-making through a statement sorting and rating activity as part of a group concept mapping procedure. The group concept mapping revealed three themes: (a) Cultural Connections, (b) Benefits to Self, and (c) Relationships with Family and Friends. Implications for programming are discussed and the benefit of group concept mapping as a culturally appropriate methodology is highlighted.

Patient experience and challenges in group concept mapping for clinical research

Background and objectiveGroup concept mapping (GCM) is a research method that engages stakeholders in generating, structuring and representing ideas around a specific topic or question. GCM has been used with patients to answer questions related to health and disease but little is known about the patient experience as a participant in the process. This paper explores the patient experience participating in GCM as assessed with direct observation and surveys of participants.MethodsThis is a secondary analysis performed within a larger study in which 3 GCM iterations were performed to engage patients in identifying patient-important outcomes for diabetes care. Researchers tracked the frequency and type of assistance required by each participant to complete the sorting and rating steps of GCM. In addition, a 17-question patient experience survey was administered over the telephone to the participants after they had completed the GCM process. Survey questions asked about the personal impact of participating in GCM and the ease of various steps of the GCM process.ResultsResearchers helped patients 92 times during the 3 GCM iterations, most commonly to address software and computer literacy issues, but also with the sorting phase itself. Of the 52 GCM participants, 40 completed the post-GCM survey. Respondents averaged 56 years of age, were 50% female and had an average hemoglobin A1c of 9.1%. Ninety-two percent (n = 37) of respondents felt that they had contributed something important to this research project and 90% (n = 36) agreed or strongly agreed that their efforts would help others with diabetes. Respondents reported that the brainstorming session was less difficult when compared with sorting and rating of statements.DiscussionOur results suggest that patients find value in participating in GCM. Patients reported less comfort with the sorting step of GCM when compared with brainstorming, an observation that correlates with our observations from the GCM sessions. Researchers should consider using paper sorting methods and objective measures of sorting quality when using GCM in patient-engaged research to improve the patient experience and concept map quality.

Bridging Community Mental Health and Primary Care to Improve Medication Monitoring and Outcomes for Patients With Mental Illness Taking Second-Generation Antipsychotics-HDC/DFMC Bridge Project, Phase 1: Group Concept Mapping.

Patients with severe mental illness often lack care coordination between primary care and mental health providers. Siloed patient care across separate health care systems can negatively impact quality and safety of patient care. The purpose of the project discussed in this article is to effectively engage stakeholders from separate primary care and mental health organizations to develop an ideal cross-organization communication system to improve metabolic monitoring for their comanaged patients prescribed second-generation antipsychotics (SGAs). The mixed method approach of group concept mapping was used to engage stakeholders across a nonaffiliated primary care clinic and a community mental health organization over the time period of March 2018 through May 2018. Three important domains in communication were identified: (1) process/workflow, (2) advocacy, and (3) a patient-centered focus. Seven high priority/easier to implement brainstormed items were identified and resulted in practice changes across both organizations, including developing a standard release of information, identifying a point person from each clinic focused on cross-organization care coordination, endorsing an SGA monitoring protocol across organizations, agreeing that metabolic monitoring of SGAs will be the responsibility of the primary care clinicians, beginning monthly medication reconciliation and cross-organization care conferences, developing standard electronic health record documentation, and providing education. Care coordination across all health systems is critical to optimize patient care for chronic medical and psychiatric conditions. Group concept mapping provides a strategic process to allow shared decision-making among stakeholders to take steps toward solving more complex systematic problems such as poor electronic health record interoperability across health systems.

Needs of Foster Care Peer Support Volunteers

Demands associated with foster parenting are substantial and support is crucial. Peer support is a form of support where foster parents connect formally with other foster parents with experience who can provide knowledge, emotional and practical help. The purpose of the present study was to identify what the needs are of foster parents in that peer support role from the views of peer support volunteers themselves. Interviews were conducted with 14 foster parent peer mentors staffing a telephone consultation service for foster parents across a large geographic area. Each was asked: what do you need to be a good peer support volunteer? Results were analyzed using group concept mapping and five concepts emerged, including: Kindness, Self-care, Good People Skills, Fostering Experience, and Informed and Knowledgeable. Results are compared and contrasted with peer support literature.

Using Concept Mapping Activities to Enhance Students’ Critical Thinking Skills at a High School in Taiwan

Concept mapping activities have been used to enhance critical thinking skills as an essential competency for 21st century learners. However, little information has been provided about the relationship between different concept mapping activities and critical thinking skills. This study aimed to examine the effects of the fill-in-the-map activity and the construct-the-map activity on critical thinking skill development. 43 participants were recruited from the course, research seminar, in the department of English at a high school in Taiwan. There were two sections of the course in the same semester. Class A was randomly designated as the fill-in-the-map group and Class B as the construct-the-map group. The collected data included critical thinking survey scores, and interviews. The critical thinking survey scores collected from the two groups were analyzed using a multivariate analysis of variance to examine the difference in critical thinking skill development between the two groups. The multivariate results suggested that different concept mapping activities would produce different learning outcomes. The construct-the-map group significantly obtained higher scores than the fill-in-the-map concept mapping group in the critical thinking skills: inference, interpretation, analysis, evaluation, explanation. The interviews were analyzed to account for why the construct-the-map activity was more effective than the fill-in-the-map activity in developing students' inference, interpretation, analysis, evaluation, explanation skills. Suggestions and implications are proposed to develop critical thinking skills through concept mapping activities.

Engaging children and youth in research and evaluation using group concept mapping

Group concept mapping is a systematic methodology that recognizes participants’ expertise in their own experiences. In this approach, participants share their diverse knowledge and interpret the data generated by all group members. This approach uniquely blends quantitative and qualitative techniques to create illustrative, structured conceptualizations. In this article, we describe the steps in group concept mapping and report feedback on this method from 37 children and youth who participated in group concept mapping studies. We recommend group concept mapping as an engaging way to involve children and youth in research and evaluation activities.

Conceptualizing the benefits of a group exercise program developed for those with chronic fatigue: a mixed methods clinical evaluation

Purpose Fatigue is a disabling and prevalent feature of many long-term conditions. Orthostatic dizziness is a commonly experienced by those with fatigue. The purpose was; to evaluate factors contributing to successful delivery of a novel group exercise program designed for people with chronic fatigue and orthostatic symptoms and identify targets to improve future program content and delivery. Research methods We used group concept mapping methodology. Participants of the exercise program with a long-term physical health condition and chronic fatigue- contributed ideas in response to a focus question. They sorted these ideas into themed piles and rated them for importance and success of the program delivery. Multidimensional scaling and cluster analysis were applied to the sort data to produce ideas clusters within a concept map. Value ratings were compared to evaluate the success of the program. Results The resulting concept map depicted seven key themed clusters of ideas: Exercises, Group atmosphere, Physical benefits, Self-management of symptoms, Acceptance and Education. Value plots of the rating data identified important and successful conceptual ideas. Conclusions The concept maps have depicted key concepts relating to the successful delivery of a novel exercise program for people with fatigue and identified specific targets for future program enhancements. Implications for rehabilitation Orthostatic symptoms are common in those with fatigue and might be a target for group-based exercise programs. People with fatigue value a group-based exercise program that targets orthostatic symptoms. The key concepts of a group-based exercise program valued by those with fatigue are the exercises, group atmosphere, physical benefits, self-management support, acceptance, education and support with looking forwards following the program.

How do Hearing Aid Owners Acquire Hearing Aid Management Skills?

Clinical studies have found up to 90% of hearing aid owners demonstrate difficulty with basic hearing aid management tasks and almost 50% of hearing aid owners self-report not receiving enough practical help from their clinician regarding how to use their hearing aid. Although studies have highlighted the overwhelming amount of information and training required to learn how to use a hearing aid appropriately, a gap remains in the literature regarding the range of methods by which hearing aid owners acquire the knowledge and skills for hearing aid use, and whether these approaches are considered beneficial. To gain insight into how both hearing aid owners and hearing health clinicians view the acquisition of hearing aid management skills and the efficacy of currently used methods of hearing aid training. Concept mapping techniques were used to identify key themes, wherein participants generated, sorted, and rated the importance of statements in response to the question "How do hearing aid owners learn the skills required to use, handle, manage, maintain, and care for their hearing aids?" Twenty-four hearing aid owners (aged 56-91 years; 54.2% male) and 22 clinicians (aged 32-69 years; 9.1% male). Participant perspectives were collected via group concept mapping sessions in October 2015. Hierarchical cluster analysis was used to identify themes and develop a framework for understanding how skill acquisition occurs. Participants rated each method of hearing aid skill acquisition as to how beneficial it was and how often it was used. Participants identified 75 unique items describing how hearing aid management skills are acquired within six concepts: (1) Relationship with the clinician, (2) clinician as a source of knowledge and support, (3) hands-on experience, (4) seeking additional information, (5) asking support people for help, and (6) external resources. The results of this study highlight the diverse methods and sources by which hearing aid owners learn the skills necessary to use, manage, and maintain their hearing aids. Significant emphasis was placed on the role of the hearing health clinician to provide training, support, and an ongoing professional relationship, with lesser roles played by family, friends, and other health professionals.

Comparing two teaching methods based on concept map and lecture on the level of learning in basic life support

Education and training about Basic Life Support is necessary for different medical groups such as nurses. Different teaching methods have been developed to preserve essential medical information, knowledge and skills. The purpose of the study was to determine the effect of concept map-based and lecture-based teaching methods on the level of nursing students’ learning in Basic Life Support.This quasi-experimental study was conducted in 2015 on 57 nursing students from a nursing school in Tehran. Students were selected by census and then divided into lecture (n = 29) and concept map groups (n = 28) by random allocation. The effect of education on knowledge (before, immediately after, one week after and one month after session) and practice (before and immediately after session) was studied.No significant differences were found between the mean scores of knowledge and practice before intervention (P > 0.05). After intervention the mean scores of knowledge were not statistically significant between the two groups (P > 0.05) but mean scores of practice were significantly higher in the concept map group (P = 0.03).In achieving skill and practice goals, it seems that the concept map-based teaching method was more effective than the lecture method.

Community food assistance, informal social networks, and the labor of care

In 2016, the Atlanta Community Food Bank (ACFB) launched the Stabilizing Lives project to develop programs and policies that could better address clients’ needs as well as including clientele as part of the planning process. The ACFB partnered with a research team at the University of Georgia to conduct a participatory research project aimed at developing deeper insights into the factors contributing to both instability and stability in the lives of pantry clientele. This article describes the outcomes this research, offering both a substantive contribution to scholarship on food insecurity and emergency food systems and a methodological innovation through a staged mixed-method participatory research project. Through use of a culture-centered approach, this project created discursive spaces within which to outline emergency food models that support informal networks of care. We used a range of methods, including photo elicitation, concept mapping, individual interviews, and focus groups, to facilitate conversation among agency staff, volunteers, and clientele about the effectiveness of current program models and potential new ideas. Specifically, we suggest that through such practices, food pantries and local agencies may help inform new program models that contribute to household stability, and push back against the sometimes alienating and atomizing paradigm found in current emergency food programs.

047 Modelling logical intervention pathways through a stakeholder authored concept map to design complex interventions aimed at improving participation for people with Sjögren’s syndrome

Background: Participation in daily activities is problematic for many people with primary Sjogren’s syndrome (pSS). A group concept map, co-developed with 232 patients, family and healthcare staff stakeholders (patients with pSS, family members and health professionals) contained 7 themed clusters of prioritized ideas. To utilize the map to develop future interventions, our aims were: 1) model logical clear pathways through the map; 2) identify specific facilitators and outcomes from the ideas within the map which relate to agreed intervention targets within the priority logical pathway. Methods: To utilize these maps to develop future interventions, we explored their content further during three steering group interpretation sessions and through a validation process with clinicians. Steering group members (n = 6) individually considered the map and agreement was reached on the logical pathways following three interpretation meetings. Specific priority intervention targets within one pathway were selected from within the concept map through discussion and reaching consensus. The priority intervention targets and all individual highly rated ideas from within the concept map which explicitly related to these targets were presented to experienced psychologists, physiotherapists and occupational therapists (n = 10) for validation. The clinicians were asked to provide specific examples of how these related ideas could be applied and evaluated within a clinical setting. Results: The themed clusters in order of priority included; patient empowerment, symptoms, wellbeing, access & coordination of healthcare, knowledge & support, friends/family and public awareness. Four logical pathways were drawn through the themed clusters within map and are listed in order of priority: 1) To improve patient empowerment the priority symptoms of fatigue, dryness, pain and sleep need to be addressed in order to improve wellbeing. 2) Priority symptoms can be addressed through appropriate access & coordination of healthcare which could positively impact on patient empowerment. 3) Knowledge and support could be delivered through an appropriate healthcare system and may impact on public awareness and support. 4) Friends and family are more likely to be supportive if there was better public awareness of pSS. Their support could facilitate patient empowerment. Pathway 1 included the highest rated themed clusters. The steering group agreed to focus on the intervention targets of fatigue, pain and sleep as these were often not being adequately addressed in current clinics. The clinician validation process provided specific intervention examples for each priority idea relating to the targets of fatigue, pain and sleep and suggested outcome measure tools. Conclusion: A priority logical intervention pathway to improve participation in Sjogren’s syndrome has been developed through a rigorous process of stakeholder engagement and a consensus activity. A clinician validation process has produced specific ingredients and outcomes to form components of a future complex intervention to improve participation in pSS patients.

3345 Group Concept Mapping of Stakeholder’s Ideas to Increase the Quantity and Quality of Clinical and Translational Research in Rhode Island

OBJECTIVES/SPECIFIC AIMS: We sought to solicit and synthesize stakeholders’ ideas for how the Advance-CTR program can best increase the quality and quality of clinical and translational research in Rhode Island, and to apply these findings to address barriers and strengthen research capabilities across our partner institutions. METHODS/STUDY POPULATION: We utilized a Group Concept Mapping approach, involving university and Institution-based researchers and administrators. The process was conducted using the web-based concept mapping application CS Global Max (Concept Systems, Inc). Respondents were asked to provide their best ideas for promoting clinical and translational research in RI. These ideas were then organized by our project team into a set of unique items for consideration by attendees of an Advance-CTR retreat. Participants were tasked with sorting these ideas by theme (cluster), and were also asked to rate each idea according its importance and feasibility. Using the online software, these clusters and ratings were analyzed to identify key themes and to explore differences among sub-groups. RESULTS/ANTICIPATED RESULTS: The Group Concept Mapping exercise yielded 150 statements that were edited down to 78 unique ideas, and clustered into nine themes (e.g., institutional collaboration, training). Fifty-seven retreat participants completed the sorting and rating tasks of the concept mapping exercise. Overall, ideas rated as highly important and highly feasible included “providing seed grants to encourage new collaborations across basic science,” and “connecting researchers with common interests.” Top rated items varied across institutions and according to respondent demographics, allowing us to consider the unique issues relevant to particular groups. Relative rankings of clusters across groups revealed notable differences, such as higher importance placed on community engagement among administrators as compared with researchers, and differences in needs for internal support for research between universities. DISCUSSION/SIGNIFICANCE OF IMPACT: Group Concept Mapping was an effective and insightful participatory approach to engage our program’s stakeholders in developing ideas and identifying challenges to enhancing clinical and translational research in Rhode Island. Our results have implications for project decision-making and initiatives to facilitate translational research in RI. Thus, results have been presented to the Advance-CTR community via webinar, as well as Advance-CTR project leadership and advisory committees.

Conversations about group concept mapping: Applications, examples, and enhancements Kane M and Rosas S

Conversations about group concept mapping: Applications, examples, and enhancements <i>Kane M and Rosas S</i>

What motivates university students to like or dislike an educational online video? A sentimental framework

Viewers' rating of educational online videos provides a clue about content quality and is frequently used as filter in video search and recommendation systems. However, it is unclear what motivates students to give a positive or negative rate to an educational video. In the presented study we tried to find out the reasons behind students' ratings. A total of 51 students were asked to rate a total of 54 YouTube's videos and to write using their own words the reasons for each rating. After cleaning the responses, 1602 and 732 reasoning statements for Like or Dislike ratings were analyzed using group concept mapping, respectively. A sentimental framework could be established consisting of six clusters in this order of significance: explanation, technical presentation, content, voice and language, efficiency, and interestingness. Toward generalizing this framework, we investigated the relationship between the online ratings of the selected videos and the active ratings by our students. We found out that the online liking ratio strongly relates to the liking ratio by our students (R2=91.3%). Furthermore, we investigated students' rating tendencies as function of their performance and gender. We found out that higher-performance students are more likely to like or dislike a video, whereas lower-performance students are less determined. The gender only affected the disliking tendency with female students making more use of the corresponding rate. The findings of the study can help students searching for educational videos as well as producers of such videos towards improved content quality and learning outcomes.

Eliciting patient-important outcomes through group brainstorming: when is saturation reached?

PurposeGroup brainstorming is a technique for the elicitation of patient input that has many potential uses, however no data demonstrate concept saturation. In this study we explore concept saturation in group brainstorming performed in a single session as compared to two or three sessions.MethodsFifty-two predominately African American adults patients with moderately to poorly controlled Diabetes Mellitus participated in three separate group brainstorming sessions as part of a PCORI-funded group concept mapping study examining comparing methods for the elicitation of patient important outcomes (PIOs). Brainstorming was unstructured, in response to a prompt designed to elicit PIOs in diabetes care. We combined similar brainstormed responses from all three sessions into a ‘master list’ of unique PIOs, and then compared the proportion obtained at each individual session, as well as those obtained in combinations of 2 sessions, to the master list.ResultsTwenty-four participants generated 85 responses in session A, 14 participants generated 63 in session B, and 14 participants generated 47 in session C. Compared to the master list, the individual sessions contributed 87%, 76%, and 63% of PIOs. Session B added 3 unique PIOs not present in session A, and session C added 2 PIOs not present in either A or B. No single session achieved >90% saturation of the master list, but all 3 combinations of 2 sessions achieved > 90%.ConclusionsSingle sessions elicited only 63-87% of the patient-important outcomes obtained across all three sessions, however all combinations of two sessions elicited over 90% of the master list, suggesting that 2 sessions are sufficient for concept saturation.Trial registrationNCT02792777. Registered 2 June 2016.