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Identifying Research Priorities in Canadian Adult and Pediatric Critical Care: Results From a James Lind Alliance
Kirsten M Fiest1,2,3, Karla D Krewulak1, Tamara Rader4
1Department of Critical Care Medicine, Alberta Health Services & University of Calgary, Calgary, AB, Canada.
Objectives:
Despite advances in critical care medicine, many questions remain unanswered, and existing guidelines are often based on low-quality evidence. This priority setting partnership (PSP), following the James Lind Alliance (JLA) methodology, aimed to identify the top ten research priorities for critical care medicine in Canada based on input from patients, families, and healthcare providers.
Design:
Three-phase, national, JLA PSP.
Setting:
Canada-wide, involving adult and PICUs.
Subjects:
Patients with lived experience of critical illness, family members of ICU patients, and healthcare providers (physicians, nurses, and allied health professionals).
Interventions:
None.
Measurements And Main Results:
Participants contributed uncertainties through open surveys (phase 1), ranked questions through a national survey (phase 2), and achieved consensus on the final priorities during a virtual workshop (phase 3). Phase 1 included 154 respondents (44 patients/family members, 110 healthcare providers) submitting 509 in scope questions, resulting in 64 unique indicative questions. Phase 2 included 244 participants (63 patients/families, 191 healthcare providers), prioritizing 20 questions to advance to the final workshop. Phase 3 involved 24 individuals (12 with lived experience, 12 healthcare providers) from six provinces, who reached consensus on the top ten research priorities. Briefly, the top three priorities were: 1) improving physical, cognitive, and mental health outcomes post-ICU/PICU; 2) supporting goals-of-care conversations with families; and 3) characterizing short- and long-term post-ICU outcomes and predictors. The full top ten priorities are presented in the article.
Conclusions:
This national JLA PSP identified the top ten patient, family, and healthcare provider-driven research priorities for critical care medicine in Canada. These priorities aim to guide future research that is meaningful, inclusive, and evidence-informed.
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