Research Prioritisation Exercise Research Articles

Arts and humanities research, redefining public benefit, and research prioritization in Ireland

This article looks at the effects of a national policy of research prioritization in the years following Ireland’s economic crisis. A national research prioritization exercise initiated by policymakers redefined the purpose of higher education research, and designed policies in line with this approach. Placing research for enterprise to the fore, it emphasized the economic value that subjects could return on state investments. This article examines the post-crisis policy of prioritization, its relationship with and effects on arts and humanities research, and how the notion of the benefit of research can be broadened while still addressing economic needs. It draws on 22 comprehensive semi-structured interviews with key stakeholders in Ireland’s academic, policy, and civil society communities, and is part of a wider study on the contribution of higher education institution-based arts and humanities research to society and the economy.

Building Health System Capacity Through Implementation Research: Experience of INSPIRE-A Multi-country PMTCT Implementation Research Project.

Background:The INSPIRE—Integrating and Scaling Up PMTCT through Implementation REsearch—initiative was established as a model partnership of national prevention of mother-to-child transmission of HIV (PMTCT) implementation research in 3 high HIV burden countries—Malawi, Nigeria, and Zimbabwe. INSPIRE aimed to link local research groups with Ministries of Health (MOH), build local research capacity, and demonstrate that implementation research may contribute to improving health care delivery and respond to program challenges.Methodology:We used a mixed methods approach to review capacity building activities, as experienced by health care workers, researchers, and trainers conducted in the 6 INSPIRE projects before and during study implementation.Results:Between 2011 and 2016, over 3400 health care workers, research team members, and community members participated in INSPIRE activities. This included research prioritization exercises, proposal development, good clinical practice and research ethics training, data management and analysis workshops, and manuscript development. Health care workers in clinics and district health offices acknowledged the value of hosting implementation research projects and how the quality of services improved. Research teams acknowledged the opportunities that projects provided for personal development and the value of participating in a multicountry research network.Discussion:INSPIRE provided an opportunity for African-led research in which researchers worked closely with national MOH to identify priority research questions and implement studies. Close partnerships between research teams and local implementers facilitated project responsiveness to local program issues. Consequently, processes and training needed for study implementation also improved local program management and service delivery. Additional benefits included improved data management, publications, and career development.

Setting an implementation research agenda for Canadian investments in global maternal, newborn, child and adolescent health: a research prioritization exercise.

Improving global maternal, newborn, child and adolescent health (MNCAH) is a top development priority in Canada, as shown by the $6.35 billion in pledges toward the Muskoka Initiative since 2010. To guide Canadian research investments, we aimed to systematically identify a set of implementation research priorities for MNCAH in low- and middle-income countries. We adapted the Child Health and Nutrition Research Initiative method. We scanned the Child Health and Nutrition Research Initiative literature and extracted research questions pertaining to delivery of interventions, inviting Canadian experts on MNCAH to generate additional questions. The experts scored a combined list of 97 questions against 5 criteria: answerability, feasibility, deliverability, impact and effect on equity. These questions were ranked using a research priority score, and the average expert agreement score was calculated for each question. The overall research priority score ranged from 40.14 to 89.25, with a median of 71.84. The average expert agreement scores ranged from 0.51 to 0.82, with a median of 0.64. Highly-ranked research questions varied across the life course and focused on improving detection and care-seeking for childhood illnesses, overcoming barriers to intervention uptake and delivery, effectively implementing human resources and mobile technology, and increasing coverage among at-risk populations. Children were the most represented target population and most questions pertained to interventions delivered at the household or community level. Investing in implementation research is critical to achieving the Sustainable Development Goal of ensuring health and well-being for all. The proposed research agenda is expected to drive action and Canadian research investments to improve MNCAH.

The Kraken in the Aquarium: Questions that Urgently Need to be Addressed in Order to Advance Marine Conservation

Despite advances in marine conservation research, policy, and management, human activities continue to negatively affect marine species, habitats, and ecosystems, and the people who rely on them for needed resources. This begs the question: What is preventing us from being more effective in conserving marine species, habitats, and ecosystems? Answering this requires us to identify gaps in marine conservation efforts and develop a consensus on how best to target our efforts. One way to do this is to conduct research prioritization exercises. The questions discussed here were identified during a series of workshops designed to establish a list of important questions that need to be answered to advance marine conservation. We deemed these particular questions to be in a separate class than those considered in the associated paper “Seventy-One Important Questions for the Conservation of Marine Biodiversity” (Parsons et al. 2014). These questions were put into a separate category because they were identified as areas of ecological, social, and economic research that include external drivers or required sizable paradigm shifts to address. Here we describe and discuss these Kraken in the aquarium questions—the marine equivalent of “the elephant in the room” questions—in four sections: human nature, meeting our responsibilities, entrenched interests, and corporate driven policy. Within each section, we address multiple questions by identifying the issues and offering examples of ways forward where possible. This paper is intended to start a dialogue about these difficult questions that loom over marine conservation research and management. It is becoming increasingly important that the conservation practitioner community engages in these discussions and develops solutions in order for our work to be fully effective.

Study protocol: Determining what young people with rheumatic disease consider important to research (the Young People's Opinions Underpinning Rheumatology Research - YOURR project).

Plain English summaryInvolving young people in research about their health is increasingly recognized as being important to make sure that research is focused more on the needs of young people. However, at present, ideas about what should be researched and found out mainly come from researchers and health professionals like doctors and nurses rather than young people. Therefore, in the past, young people’s ideas about what should be researched in terms of rheumatic problems have not been explored. In this study, we will talk with groups of young people with rheumatic problems across the UK to explore what they think research into their health should focus on. We will also discuss with young people, if and how, they would like to be involved in shaping research into rheumatic problems. The findings from this work will help make sure that the views of young people with rheumatic problems influence the work of a group of researchers and health professionals who concentrate on rheumatology research. This group is called the Barbara Ansell National Network for Adolescent Rheumatology (BANNAR). A national young person’s advisory group will be set up to make sure that the beliefs and ideas of young people with rheumatic disease inform the work of the BANNAR. Background The involvement of people of all ages (including young people) in health-related research is now widely advocated but research priorities are still largely driven by professional agendas, with evidence from the adult literature reporting a mismatch between researcher and patient generated lists of research topics. To date, there have been no studies exploring the research priorities of young people with long term conditions including rheumatic disease. In this study, we will explore young people’s beliefs about their research priorities for rheumatic conditions and whether and how young people would like to become involved in the research process. Methods/Design We will hold up to 16 focus group discussions with young people (11–24 years) across England, Northern Ireland, Scotland and Wales. Two age groups will be recruited to the study, 11–15 year olds to represent early and mid-adolescence and 16–24 year olds to reflect late adolescence and emerging adulthood. Focus groups will be as interactive and engaging as possible, using a mixture of statement sorting and a research prioritization exercise to stimulate the discussion. Young people will be recruited via members of the Barbara Ansell National Network for Adolescent Rheumatology (BANNAR) and relevant national charities. Focus groups will be audiotaped and transcribed for analysis. Discussion This project will help ensure full representation from young people with rheumatic diseases in the development of a research strategy for BANNAR and will ultimately inform a young person’s led involvement strategy to facilitate the future ethical and meaningful involvement of young people in BANNAR members’ future research programmes. In addition, a national young persons’ advisory group will be established, the constitution and format of which will be determined by the young people themselves.

Scientists’ framing of the ocean science–policy interface

Scientists’ ideas, beliefs, and discourses form the frames that shape their choices about which research to pursue, their approaches to collaboration and communicating results, and how they evaluate research outputs and outcomes. To achieve ocean sustainability, there are increasing calls for new levels of engagement and collaboration between scientists and policy-makers; scientists’ willingness to engage depends on their current and evolving frames. Here, I present results about how scientists involved in diverse fields of ocean research perceived their role as scientists working at or near the ocean science–policy interface and how this related to their perceptions regarding ocean research priorities. The survey of 2187 physical, ecological and social scientists from 94 countries showed that scientists held different perspectives about their appropriate level of engagement at the ocean science–policy interface and the relative primacy of science versus politics in formulating ocean policy. Six clusters of scientists varied in their frames; three clusters accounted for 94% of the sample. Of 67 research questions identified from 22 research prioritization and horizon scanning exercises, the top eight were shared among all three clusters, showing consistency in research priorities across scientists with different framings of their role at the science–policy interface. Five focused on the mechanisms and effects of global change on oceans, two focused on data collection and management for long-term ocean monitoring, and one focused on the links between biodiversity and ecological function at different scales. The results from this survey demonstrated that scientists’ framings of the role of ocean science at the science–policy interface can be quantified in surveys, that framing varies among scientists, and that research priorities vary according to the framings.

Introducing INSPIRE: an implementation research collaboration between the Department of Foreign Affairs, Trade and Development Canada and the World Health Organization.

The government of Canada, through the Department of Foreign Affairs, Trade and Development (DFATD) has supported global efforts to reduce the impact of the HIV pandemic. In 2012, WHO and DFATD launched an implementation research initiative to increase access to interventions that were known to be effective in the prevention of mother-to-child transmission of HIV and to learn how these could be successfully integrated with other essential services for mothers and children. In addition to facilitating the implementation research projects, DFATD and WHO promoted four approaches: (1) Country-specific implementation research prioritization exercises, (2) Ministry of Health involvement, (3) Country-led, innovative, high-quality research, and (4) Leveraging regional networks and learning opportunities. While no single aspect of INSPIRE is unique, the process endeavors to promote and support high-quality, rigorous, locally-led implementation research that will have a substantial impact on the health and survival of HIV-infected women and their children.

International scientists' priorities for research on pharmaceutical and personal care products in the environment

Pharmaceuticals and personal care products (PPCPs) are widely discharged into the environment via diverse pathways. The effects of PPCPs in the environment have potentially important human and ecosystem health implications, so credible, salient, and legitimate scientific evidence is needed to inform regulatory and policy responses that address potential risks. A recent "big questions" exercise with participants largely from North America identified 22 important research questions around the risks of PPCP in the environment that would help address the most pressing knowledge gaps over the next decade. To expand that analysis, we developed a survey that was completed by 535 environmental scientists from 57 countries, of whom 49% identified environmental or analytical chemistry as their primary disciplinary background. They ranked the 22 original research questions and submitted 171 additional candidate research questions they felt were also of high priority. Of the original questions, the 3 perceived to be of highest importance related to: 1) the effects of long-term exposure to low concentrations of PPCP mixtures on nontarget organisms, 2) effluent treatment methods that can reduce the effects of PPCPs in the environment while not increasing the toxicity of whole effluents, and 3) the assessment of the environmental risks of metabolites and environmental transformation products of PPCPs. A question regarding the role of cultural perspectives in PPCP risk assessment was ranked as the lowest priority. There were significant differences in research orientation between scientists who completed English and Chinese language versions of the survey. We found that the Chinese respondents were strongly orientated to issues of managing risk profiles, effluent treatment, residue bioavailability, and regional assessment. Among English language respondents, further differences in research orientation were associated with respondents' level of consistency when ranking the survey's 15 comparisons. There was increasing emphasis on the role of various other stressors relative to PPCPs and on risk prioritization as internal decision making consistency increased. Respondents' consistency in their ranking choices was significantly and positively correlated with SETAC membership, authors' number of publications, and longer survey completion times. Our research highlighted international scientists' research priorities and should help inform decisions about the type of hazard and risk-based research needed to best inform decisions regarding PPCPs in the environment. Disciplinary training of a scientist or engineer appears to strongly influence preferences for research priorities to understand PPCPs in the environment. Selection of participants and the depth and breadth of research prioritization efforts thus have potential effects on the outcomes of research prioritization exercises. Further elucidation of how patterns of research priority vary between academic and government scientists and between scientists and other government and stakeholders would be useful in the future and provide information that helps focus scientific effort on socially relevant challenges relating to PPCPs in the environment. It also suggests the potential for future collaborative research between industry, government, and academia on environmental contaminants beyond PPCPs.

Foresight and “grand challenges” within research and innovation policies

PurposeThe paper seeks to discuss how foresight is used to understand the implications of global changes for research and innovation policies. It aims to present a recent Irish case study that identified grand challenges in the national context, with their implications for research and innovation.Design/methodology/approachThe foresight project is described and provides knowledge and analysis for a broader, national research prioritisation exercise. The paper analyses the implementation of the Irish foresight exercise and the main outputs generated. It connects the results of the project with the literature on foresight, innovation and grand challenges.FindingsThe emergence of grand challenges within research and innovation policy discourse in Europe has refreshed key questions for foresight theory and practice. Although many grand challenges have relatively clear implications for research and innovation (investment), others do not. A bottom‐up, participatory process produced a broader set of grand challenges.Research limitations/implicationsThe concept of grand challenges is still relatively new.Practical implicationsNot all research and innovation priorities are linked to grand challenges. National policies need to take account of grand challenges whilst continuing to support other research and innovation needs.Originality/valueThe paper introduces a novel approach for identifying grand challenges and responses within the research and innovation system through a bottom‐up process.

Developing a Culture to Facilitate Research Capacity Building for Clinical Nurse Consultants in Generalist Paediatric Practice

This paper reports a research capacity building exercise with a group of CNCs practicing in the speciality of paediatrics in New South Wales (NSW), Australia. It explores the first step in building a research culture, through identifying the research priorities of members of the NSW Child Health Networks Paediatric Clinical Nurse Consultant group, and this forms the major focus of this paper. A nominal group technique (NGT) was utilised with sixteen members to identify research topics for investigation which were considered a priority for improving children's health care. The group reviewed and prioritised 43 research topics in children's health which were identified in the literature. As a result of conducting this research prioritisation exercise, the group chose two research topics to investigate: reasons for children representing to the Emergency Department and a comparison of the use of high-flow and low-flow nasal prongs in children with bronchiolitis. The research team will continue to mentor the nurses throughout their research projects which resulted from the NGT. One bridge to leadership development in enhancing patient care is translating knowledge to practice and policy development. This study leads the way for a group of CNCs in paediatric nursing to combine their research capacity and influence clinical knowledge.

The Evidence Base for Occupational Therapy in Mental Health: More Systematic Reviews Are Needed

To shape its work, the Research Centre for Occupation & Mental Health is interested in research priorities. Systematic reviews develop an overview of the research available about an intervention, which can provide evidence to underpin practice. They also however, identify gaps in the knowledge base and so are useful for research-prioritization exercises. A rigorous literature search identified only four systematic reviews about occupational therapy in mental health, which suggests that more are needed to underpin practice. This article also explains a six-stage process for conducting a systematic review that can be used by occupational therapists in mental health.

Moving from Rabies Research to Rabies Control: Lessons from India

BackgroundDespite the availability of effective interventions and public recognition of the severity of the problem, rabies continues to suffer neglect by programme planners in India and other low and middle income countries. We investigate whether this state of ‘policy impasse’ is due to, at least in part, the research community not catering to the information needs of the policy makers.Methods & FindingsOur objective was to review the research output on rabies from India and examine its alignment with national policy priorities. A systematic literature review of all rabies research articles published from India between 2001 and 2011 was conducted. The distribution of conducted research was compared to the findings of an earlier research prioritization exercise. It was found that a total of 93 research articles were published from India since 2001, out of which 61% consisted of laboratory based studies focussing on rabies virus. Animals were the least studied group, comprising only 8% of the research output. One third of the articles were published in three journals focussing on vaccines and infectious disease epidemiology and the top 4 institutions (2 each from the animal and human health sectors) collectively produced 49% of the national research output. Biomedical research related to development of new interventions dominated the total output as opposed to the identified priority domains of socio-politic-economic research, basic epidemiological research and research to improve existing interventions.ConclusionThe paper highlights the gaps between rabies research and policy needs, and makes the case for developing a strategic research agenda that focusses on rabies control as an expected outcome.

Creating Barriers to Mental Health Care in the Netherlands: Reply

Back to table of contents Previous article Next article LettersFull AccessCreating Barriers to Mental Health Care in the Netherlands: ReplyBelinda R. Bruwer, M.B.ChB., M.Med. (Psych.), and Soraya Seedat, M.Med. (Psych.), Ph.D.Belinda R. BruwerSearch for more papers by this author, M.B.ChB., M.Med. (Psych.), and Soraya SeedatSearch for more papers by this author, M.Med. (Psych.), Ph.D.Published Online:14 Jan 2015https://doi.org/10.1176/ps.62.9.pss6209_1106aAboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail In Reply: We thank Dr. Hovens and Dr. van der Ploeg for their interesting and valuable remarks regarding barriers to mental health care in the Netherlands. The points that they highlight are extremely valid; structural barriers will likely increase significantly if access to mental health treatment becomes even more difficult for financial reasons. Even though attitudinal barriers emerged in our study as the more prevalent barrier, we would like to emphasize again that structural barriers may further impede mental health treatment once attitudinal barriers are overcome. It is of great concern that people seeking treatment for mental illness in the Netherlands are being discriminated against and further marginalized.Fiscal austerity measures across Europe, and more globally, only serve to widen the treatment gap, which in low- and middle-income countries is now 70% for people with schizophrenia (that is, only 30% of those with schizophrenia receive treatment) and 98% for mood disorders (1). The World Health Organization's analysis of mental health services found a distinct positive relationship between treated prevalence rates for mental disorders and country-level income—a pattern evident across low-, middle-, and high-income countries (1). Another finding was the striking disparity in spending on mental health services in low- and middle-income countries—only 3 cents per capita in low- and middle-income settings and 70 times higher in high-income countries. Furthermore, the vast majority of spending on mental health services was found to occur in psychiatric hospitals, leaving community mental health services seriously underresourced.Consistent with the concerns that Dr. Hovens and Dr. van der Ploeg raise about the negative impact of affordability on accessibility of mental health care is the paradoxical finding that emerges from these cross-national analyses: where there is more poverty, people are more likely to pay for mental health care out of their own pockets. On the African continent more than 50% of countries do not have social insurance schemes. To illustrate this more concretely: both antipsychotic and antidepressant medications are more expensive in lower- and middle-income countries than in upper-middle-income countries.Very recently, a consortium of clinicians, researchers, and advocates embarked on a research prioritization exercise to identify global grand challenges in addressing the scourge of mental disorders in order to improve the lives of people with mental illness (2). One of the top 25 challenges they identified is the need to “create parity between mental and physical illness by investing in treatment, prevention, research and training.” Realizing this goal will require a substantial shift in thinking and commitment to equitable funding for mental health services by health ministries around the world.References1 Saxena S , Lora A , Morris J , et al.: Mental health services in 42 low- and middle-income countries: a WHO-AIMS cross-national analysis. Psychiatric Services 62:123–125, 2011 Link, Google Scholar2 Collins PY , Patel V , Joestl SS , et al.: Grand challenges in global mental health. Nature 475:27–30, 2011 Crossref, Medline, Google Scholar FiguresReferencesCited byDetailsCited byNone Volume 62Issue 9 September 2011Pages 1106-1107 Metrics PDF download History Published online 14 January 2015 Published in print 1 September 2011

Creating Barriers to Mental Health Care in the Netherlands: Reply

Back to table of contents Previous article Next article LettersFull AccessCreating Barriers to Mental Health Care in the Netherlands: ReplyBelinda R. Bruwer, M.B.ChB., M.Med. (Psych.), and Soraya Seedat, M.Med. (Psych.), Ph.D.Belinda R. BruwerSearch for more papers by this author, M.B.ChB., M.Med. (Psych.), and Soraya SeedatSearch for more papers by this author, M.Med. (Psych.), Ph.D.Published Online:14 Jan 2015https://doi.org/10.1176/ps.62.9.pss6209_1106aAboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail In Reply: We thank Dr. Hovens and Dr. van der Ploeg for their interesting and valuable remarks regarding barriers to mental health care in the Netherlands. The points that they highlight are extremely valid; structural barriers will likely increase significantly if access to mental health treatment becomes even more difficult for financial reasons. Even though attitudinal barriers emerged in our study as the more prevalent barrier, we would like to emphasize again that structural barriers may further impede mental health treatment once attitudinal barriers are overcome. It is of great concern that people seeking treatment for mental illness in the Netherlands are being discriminated against and further marginalized.Fiscal austerity measures across Europe, and more globally, only serve to widen the treatment gap, which in low- and middle-income countries is now 70% for people with schizophrenia (that is, only 30% of those with schizophrenia receive treatment) and 98% for mood disorders (1). The World Health Organization's analysis of mental health services found a distinct positive relationship between treated prevalence rates for mental disorders and country-level income—a pattern evident across low-, middle-, and high-income countries (1). Another finding was the striking disparity in spending on mental health services in low- and middle-income countries—only 3 cents per capita in low- and middle-income settings and 70 times higher in high-income countries. Furthermore, the vast majority of spending on mental health services was found to occur in psychiatric hospitals, leaving community mental health services seriously underresourced.Consistent with the concerns that Dr. Hovens and Dr. van der Ploeg raise about the negative impact of affordability on accessibility of mental health care is the paradoxical finding that emerges from these cross-national analyses: where there is more poverty, people are more likely to pay for mental health care out of their own pockets. On the African continent more than 50% of countries do not have social insurance schemes. To illustrate this more concretely: both antipsychotic and antidepressant medications are more expensive in lower- and middle-income countries than in upper-middle-income countries.Very recently, a consortium of clinicians, researchers, and advocates embarked on a research prioritization exercise to identify global grand challenges in addressing the scourge of mental disorders in order to improve the lives of people with mental illness (2). One of the top 25 challenges they identified is the need to “create parity between mental and physical illness by investing in treatment, prevention, research and training.” Realizing this goal will require a substantial shift in thinking and commitment to equitable funding for mental health services by health ministries around the world.References1 Saxena S , Lora A , Morris J , et al.: Mental health services in 42 low- and middle-income countries: a WHO-AIMS cross-national analysis. Psychiatric Services 62:123–125, 2011 Link, Google Scholar2 Collins PY , Patel V , Joestl SS , et al.: Grand challenges in global mental health. Nature 475:27–30, 2011 Crossref, Medline, Google Scholar FiguresReferencesCited byDetailsCited ByNone Volume 62Issue 9 September 2011Pages 1106-1107 Metrics PDF download History Published online 14 January 2015 Published in print 1 September 2011

How Research-Prioritization Exercises Affect Conservation Policy

Conservation scientists are concerned about the apparent lack of impact their research is having on policy. By better aligning research with policy needs, conservation science might become more relevant to policy and increase its real-world salience in the conservation of biological diversity. Consequently, some conservation scientists have embarked on a variety of exercises to identify research questions that, if answered, would provide the evidence base with which to develop and implement effective conservation policies. I synthesized two existing approaches to conceptualizing research impacts. One widely used approach classifies the impacts of research as conceptual, instrumental, and symbolic. Conceptual impacts occur when policy makers are sensitized to new issues and change their beliefs or thinking. Instrumental impacts arise when scientific research has a direct effect on policy decisions. The use of scientific research results to support established policy positions are symbolic impacts. The second approach classifies research issues according to whether scientific knowledge is developed fully and whether the policy issue has been articulated clearly. I believe exercises to identify important research questions have objectives of increasing the clarity of policy issues while strengthening science-policy interactions. This may facilitate the transmission of scientific knowledge to policy makers and, potentially, accelerate the development and implementation of effective conservation policy. Other, similar types of exercises might also be useful. For example, identification of visionary science questions independent of current policy needs, prioritization of best practices for transferring scientific knowledge to policy makers, and identification of questions about human values and their role in political processes could all help advance real-world conservation science. It is crucial for conservation scientists to understand the wide variety of ways in which their research can affect policy and be improved systematically.

What are the highest priorities for research in emergency prehospital care?

The recent UK Department of Health publication “ Taking Healthcare to the Patient: Transforming NHS Ambulance Services ”1 recommended that the Department of Health should commission a programme of work...

The case for user involvement in research: the research priorities of cancer patients

User involvement in health research has increased in influence in recent years. (The definition of 'user' is contentious. The term does not solely include patients and their carers, but may also include members of the general public, potential patients and public, community and voluntary organizations and health professionals. This paper uses this broader definition of the term.) Involving users in research activity inevitably challenges the traditional autonomy of expert clinicians or academics in the research process. Consequently, attitudes to user involvement are typically polarized, either perceiving such involvement as a universal panacea or as a malevolent force that jeopardizes research practice. This paper moves beyond simplistic characterizations of user involvement to consider the benefits of engaging users in research and reflects on commonly asserted criticisms of such activity. Findings from a recently completed research prioritization exercise, the Macmillan Listening Study, will be cited to justify the need to involve users in research [1].

Health risk assessment for nanoparticles: A case for using expert judgment

Uncertainties in conventional quantitative risk assessment typically relate to values of parameters in risk models. For many environmental contaminants, there is a lack of sufficient information about multiple components of the risk assessment framework. In such cases, the use of default assumptions and extrapolations to fill in the data gaps is a common practice. Nanoparticle risks, however, pose a new form of risk assessment challenge. Besides a lack of data, there is deep scientific uncertainty regarding every aspect of the risk assessment framework: (a) particle characteristics that may affect toxicity; (b) their fate and transport through the environment; (c) the routes of exposure and the metrics by which exposure ought to be measured; (d) the mechanisms of translocation to different parts of the body; and (e) the mechanisms of toxicity and disease. In each of these areas, there are multiple and competing models and hypotheses. These are not merely parametric uncertainties but uncertainties about the choice of the causal mechanisms themselves and the proper model variables to be used, i.e., structural uncertainties. While these uncertainties exist for PM2.5 as well, risk assessment for PM2.5 has avoided dealing with these issues because of a plethora of epidemiological studies. However, such studies don’t exist for the case of nanoparticles. Even if such studies are done in the future, they will be very specific to a particular type of engineered nanoparticle and not generalizable to other nanoparticles. Therefore, risk assessment for nanoparticles will have to deal with the various uncertainties that were avoided in the case of PM2.5. Consequently, uncertainties in estimating risks due to nanoparticle exposures may be characterized as ‘extreme’. This paper proposes a methodology by which risk analysts can cope with such extreme uncertainty. One way to make these problems analytically tractable is to use expert judgment approaches to study the degree of consensus and/or disagreement between experts on different parts of the exposure-response paradigm. This can be done by eliciting judgments from a wide range of experts on different parts of the risk causal chain. We also use examples to illustrate how studying expert consensus/disagreement helps in research prioritization and budget allocation exercises. The expert elicitation can be repeated over the course of several years, over which time, the state of scientific knowledge will also improve and uncertainties may possibly reduce. Results from expert the elicitation exercise can be used by risk managers or managers of funding agencies as a tool for research prioritization.