BMJ 2000;320:976-980 ( 8 April )

Papers

Use of consensus development to establish national research priorities in critical care

Keryn Vella, research fellow, ^a Caroline Goldfrad, statistician, ^a Kathy Rowan, scientific director, ^a Julian Bion, reader in intensive care medicine, ^b Nick Black, professor. ^c

^a Intensive Care National Audit and Research Centre, London WC1H 9HR, ^b Department of Anaesthesia and Intensive Care, University of Birmingham, Birmingham B15 2TH, ^c Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London WC1E 7HT

Correspondence to: N Black n.black{at}lshtm.ac.uk

Objectives: To test the feasibility of using a nominal group technique to establish clinical and health services research priorities in critical care and to test the representativeness of the group's views.
Design: Generation of topics by means of a national survey; a nominal group technique to establish the level of consensus; a survey to test the representativeness of the results.
Setting: United Kingdom and Republic of Ireland.
Subjects: Nominal group composed of 10 doctors (8 consultants, 2 trainees) and 2 nurses.
Main outcome measure: Level of support (median) and level of agreement (mean absolute deviation from the median) derived from a 9 point Likert scale.
Results: Of the 325 intensive care units approached, 187 (58%) responded, providing about 1000 suggestions for research. Of the 106 most frequently suggested topics considered by the nominal group, 37 attracted strong support, 48 moderate support and 21 weak support. There was more agreement after the group had metoverall mean of the mean absolute deviations from the median fell from 1.41 to 1.26. The group's views represented the views of the wider community of critical care staff (r=0.73, P<0.01). There was no significant difference in the views of staff from teaching or from non-teaching hospitals. Of the 37 topics that attracted the strongest support, 24 were concerned with organisational aspects of critical care and only 13 with technology assessment or clinical research.
Conclusions: A nominal group technique is feasible and reliable for determining research priorities among clinicians. This approach is more democratic and transparent than the traditional methods used by research funding bodies. The results suggest that clinicians perceive research into the best ways of delivering and organising services as a high priority.

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