Establishing the UK clubfoot research priorities : a multiple-stakeholder consensus study

Clubfoot is the most common congenital foot deformity. Although the overall effectiveness of the Ponseti method is well established, it has traditionally been taught as a unified doctrine, and individual components, particularly those related to the maintenance of correction, have not been evaluated with the same level of rigour. Consequently, high-quality evidence to support clinical decision-making remains limited. This study used a consensus-based approach to identify research priorities for clinical trials in clubfoot management.

This study followed a previously published protocol. A modified Delphi technique was used, which involved an initial scoping survey, a two-round modified Delphi consensus survey, and consensus meetings that included the UK Clubfoot Network Research Committee. The survey was distributed among key stakeholders in the management of clubfoot as well as patients and carers in the UK. Reporting followed the ACCORD checklist.

A total of 103 and 93 participants contributed to rounds one and two of the Delphi process, respectively, scoring research priorities from one (low priority) to five (high priority). Stakeholders identified nine priorities in research across four themes of Primary Treatment, Bracing, Relapse, and Physiotherapy. The highest scoring themes were Relapse and Bracing, and the highest scoring priority was regarding the effectiveness of unilateral versus bilateral bracing.

Identification of research priorities in clubfoot through this study will guide multicentre clinical trials to improve evidence-based clubfoot treatment.